Danna P L, Urban C, Bellin E, Rahal J J
Infectious Disease Section, Booth Memorial Medical Centre, Flushing, New York 11355.
Lancet. 1991 Mar 2;337(8740):511-4. doi: 10.1016/0140-6736(91)91296-7.
The part that candida plays in antibiotic-associated diarrhoea was investigated in 24 elderly inpatients (mean age 74 years) who tested negative for Clostridium difficile toxin and other intestinal pathogens. 7 had intestinal overgrowth of Candida species (greater than or equal to 10(5) cfu/ml). None of the 24 matched, antibiotic-treated controls without diarrhoea had candida overgrowth. All 5 patients with diarrhoea and candida overgrowth treated with oral nystatin responded with resolution of diarrhoea and lowering of faecal counts to less than 10(4) cfu/ml within 7 days of start of antifungal therapy despite continuation of antibacterial therapy. In the other 2 patients with candida overgrowth, the diarrhoea subsided spontaneously and faecal candida counts returned to normal (less than 10(4) cfu/ml) after antibacterial agents were withdrawn. In patients without candida overgrowth, diarrhoea persisted until antibiotics were withdrawn, at a mean of 16 days after study entry.
对24名艰难梭菌毒素及其他肠道病原体检测呈阴性的老年住院患者（平均年龄74岁），研究了念珠菌在抗生素相关性腹泻中所起的作用。7名患者念珠菌属肠道过度生长（大于或等于10⁵cfu/ml）。24名匹配的、接受抗生素治疗但未腹泻的对照者均无念珠菌过度生长。所有5名腹泻且念珠菌过度生长的患者口服制霉菌素治疗后，尽管继续使用抗菌治疗，但在抗真菌治疗开始后7天内腹泻缓解，粪便计数降至10⁴cfu/ml以下。另外2名念珠菌过度生长的患者，停用抗菌药物后腹泻自行缓解，粪便念珠菌计数恢复正常（小于10⁴cfu/ml）。在无念珠菌过度生长的患者中，腹泻持续存在，直至停用抗生素，平均在研究入组后16天。
