Intestinal Candida Overgrowth and Candida Infection in Patients with Leukemia: Effect of Bifidobacterium Administration

Probiotics have preventive as well as curative effects on several types of diarrhea of different etiologies. Prevention and therapy (or alleviation) of diarrhea have been successfully investigated for numerous dietary probiotics to establish probiotic properties and to justify health claims (the medicinal use of probiotic food and the therapy of gastrointestinal diseases itself may not be advertised under current food laws). Other probiotic microorganisms (e.g., Lactobacillus rhamnosus GG,

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“…Side effects were ameliorated by the administration of probiotic bacteria before and during chemo- (80) or radiotherapy (81,82).…”

Section: Diarrhea In Immunocompromised Subjectsmentioning

confidence: 99%

Probiotics and Prebiotics: Effects on Diarrhea1

Vrese¹,

Marteau

2007

The Journal of Nutrition

241

135

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“…Antibiotic-associated overgrowth of Candida species in the gastrointestinal tract may have important clinical implications. Tomoda et al (14) found that leukemia patients with Ն10…”

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confidence: 99%

Effect of Parenteral Antibiotic Administration on Establishment of Intestinal Colonization by Candida glabrata in Adult Mice

Pultz¹,

Stiefel

Ghannoum

et al. 2005

Antimicrob Agents Chemother

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We examined the effect of antibiotic treatment on establishment of intestinal colonization by Candida glabrata in adult mice. Subcutaneous ceftriaxone, piperacillin-tazobactam, clindamycin, and metronidazole promoted increased density of stool colonization, whereas cefepime, levofloxacin, and aztreonam did not. These findings suggest that antibiotics that inhibit intestinal anaerobes promote C. glabrata colonization.The gastrointestinal tract is a primary site of colonization by Candida species and is frequently a source for hematogenous dissemination in cancer patients (1). Antibiotics play a crucial role in the pathogenesis of Candida infections by inhibiting competing indigenous microflora, thereby facilitating acquisition and overgrowth of Candida species in the gastrointestinal tract and at other sites (1). Several studies suggest that antibiotics that inhibit obligate anaerobes in the intestinal tract may be more likely to promote overgrowth of C. albicans than those that do not (1,4,5,7,(8)(9)(10)(11), but little data regarding the effect of antibiotics on colonization with other Candida species are available. We used a mouse model to test the hypothesis that antibiotics with potent activity against intestinal anaerobes (piperacillin-tazobactam, metronidazole, ceftriaxone, and clindamycin) promote overgrowth of Candida glabrata, whereas agents with minimal activity against anaerobes (cefepime, levofloxacin, and aztreonam) do not.Four C. glabrata strains were used: ATCC 90030, MRL 191, A129, and A239. The fluconazole MICs for the strains were 32, 16, 0.5, and 4 g/ml, respectively. The experimental protocol was approved by the Cleveland Veterans Affairs Medical Center's Animal Care Committee. Female CF1 mice (Harlan Sprague-Dawley, Indianapolis, Ind.) weighing 25 to 30 g were used. To prevent cross-contamination, mice were housed in individual cages with filter tops. An initial experiment (four mice per group) was performed to examine the ability of the four C. glabrata strains to colonize the intestinal tract. Mice were treated daily with subcutaneous normal saline (0.2 ml) or piperacillin-tazobactam (8 mg in 0.2 ml of normal saline) for 2 days before and 6 days after orogastric inoculation of 10 8 CFU of C. glabrata with a stainless steel feeding tube (Popper & Sons, New Hyde Park, N.Y.). Piperacillin-tazobactam was chosen for the initial experiment because we have previously demonstrated that it inhibits anaerobes, facultative gram-negative bacilli, and enterococci in the stool of mice (2). Fresh stool samples were collected at baseline and 1, 3, and 6 days after inoculation of C. glabrata. For quantification of C. glabrata, serially diluted stool samples were plated onto Sabouraud dextrose agar (Becton, Dickinson, and Company, Sparks, Md.) containing piperacillin-tazobactam (16 g/ml) and incubated in room air at 37°C for 48 h. The lower limit of detection was ϳ2 log 10 CFU/g. Strains A239 and ATCC 90030 were chosen to evaluate the effect of different antibiotics on establishment of colonization because ...

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“…Like the EB virus and Aspergillus infection through respiratory tract (13,14), urinary tract infection caused by Escherichia coli (15) and derma infection is caused by Herpes Zoster (16). However, infection caused by intestinal microbiology is rare, just a report of intestinal dysbacteriosis (17). As Chun-Ru Hsu et al (18) reported K. pneumoniae can translocate across the intestinal epithelium; the gut is always the epicentre of antibiotics resistance (19).…”

Section: Discussionmentioning

confidence: 99%

Multi-Sites Infection Caused by Klebsiella pneumoniae After Hemopoietic Stem Cell Transplantation

Huang

Zhang

2017

Jundishapur J Microbiol

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Introduction: Leukemia patients can easily become hypoimmunity after hemopoietic stem cell transplantation, endogenous infection often happens in these patients. Meanwhile, Klebsiella pneumoniae is often isolated from various specimens in inpatient. It can lead to infections in the whole body, especially in those immunosuppressed patients. Case Presentation: A 22-year-old girl with complete remission after chemotherapy for her acute lymphoblastic leukemia was presented to the 2nd affiliated hospital of Zhejiang University for hemopoietic stem cell transplantation. She got a good check-up, however, her spirit was a little bad. Her primitive lymphocyte (0.06%) and total lymphocyte (27.05%) in the peripheral blood were in the normal range. She received a 224 mL stem cell transfusion including mononuclear cell (4.87 × 10 8 /kg) CD34+ (0.6%) as well as reached the transplantation threshold of CD34+ cell (3 × 10 6 /kg). Nine days after transplantation, there were no severe side effects except a little bit of vomit. However, the symptom of diarrhea appeared first. K. pneumoniae was isolated from the stool, then invaded into the blood, and caused sepsis. It disseminated and caused multi-sites infection. Conclusions: It should be kept in mind that K. pneumoniae can translocate across the intestinal epithelium. It is important to pay attention to the bacterium isolated from the intestine in immunosuppressed patients.

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Intestinal Candida Overgrowth and Candida Infection in Patients with Leukemia: Effect of Bifidobacterium Administration

Cited by 22 publications

References 12 publications

Probiotics and Prebiotics: Effects on Diarrhea1

Probiotics and Prebiotics: Effects on Diarrhea1

Effect of Parenteral Antibiotic Administration on Establishment of Intestinal Colonization by Candida glabrata in Adult Mice

Multi-Sites Infection Caused by Klebsiella pneumoniae After Hemopoietic Stem Cell Transplantation

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