Effects of carbapenems and their combination with amikacin on murine gut colonisation by Candida albicans

Abstract

Carbapenems are broad-spectrum antibiotics increasingly used for the treatment of severe infections. We evaluated the effects of four carbapenems given as monotherapies or in combination with amikacin on the level of gastrointestinal colonisation by Candida albicans in a previously established mouse model. Adult male Crl : CD1 (ICR) BR mice were fed chow containing C. albicans or regular chow. The mice fed with Candida chow had their gut colonised by the yeast. Both groups were subsequently given imipenem, meropenem, ertapenem, doripenem or their combination with amikacin or normal saline subcutaneously for 10 days. Stool cultures were performed immediately before, at the end and 1 week after discontinuation of treatment. Candida-colonised mice treated with the antibiotics had higher counts of the yeast in their stools than control C. albicans-colonised animals treated with saline. All four carbapenems and their combination with amikacin caused a significant increase in C. albicans concentration. Mice fed regular chow and treated with the study antibiotics or saline did not have any Candida in their stools. Dissemination of Candida was not detected in any animal. These data suggest that carbapenems and carbapenem plus amikacin induce substantial increases in the murine intestinal concentration of C. albicans.

Peripheral and total parenteral nutrition as the strongest risk factors for nosocomial candidemia in elderly patients: a matched case–control study

“…Our data show that, together with antibiotics with activity against anaerobic organisms, the aminoglycoside use was an independent risk factor for candidemia. Although the aminoglycosides have poor anaerobic activity, in a recent mouse model, amikacin plus various carbapenems was found to induce further higher levels of C. albicans murine intestinal colonisation than those treated with carbapenem alone . Ceftriaxone as well as other antibiotics such as quinolones were not found to be a significant risk factor for candidemia in our series despite their activity against anaerobic flora or their high concentrations in the gastrointestinal tract.…”

The effect of antibacterial and non-antibacterial compounds alone or associated with antifugals upon fungi

“…In a study involving a mouse model receiving single carbapenems (meropenem, imipenem, and ertapenem) or a carbapenem in association with amikacin, a substantial increase in the murine intestinal concentration of C. albicans was found ( Samonis et al, 2013 ). Similar findings were found in humans.…”

Observational Cohort Study of Oral Mycobiome and Interkingdom Interactions over the Course of Induction Therapy for Leukemia

“…Also, bacteremia with fluconazole-resistant Candida has been associated with exposure to several different antimicrobials, including carbapenems, clindamycin, and colistin (15). It has long been known that some antibacterial agents promote fungal growth via indirect effects (16), many of which promote Candida colonization (17,18).…”