MYCOLOGICAL ASPECTS OF GASTROINTESTINAL MICROFLORA

There are two aspects about the presence of Candida in the human oroin testinal tract: (i) it is a part of normal human flora and (ii) it is a risk factor for immunocompromised patients. The orointestinal tract can be considered a reservoir for Candida species, several of which ar e from the oral cavity, stomach, duodenal juice and faeces. Their germ counts in normal small and large bowel do not exceed 10(4) cfu/ml res p. g. The input of Candida to a well-developed faecal flora system und er continuous flow culture conditions did not lead to a multiplication of the yeast. The take in of faecal flora into a Candida continuous f low culture diminish Candida germ counts. If, however, the faecal flor a was destroyed, e.g. by antibiotics, we found the yeasts multiplying, with the formation of germ tubes and mycelial structures. Colonizatio n by Candida has to be seen as a starting-point of the development of subsequent candidosis in immunosuppressed or intensive care patients. The best protection against Candida colonization in the gut is the exi stence of a normal bacterial flora. Lactulose, which promotes the Gram -positive potential of faecal flora, may protect indirectly by support ing the indigenous flora.