Yeast infection in immunocompetent patients: fomenting ferment to foil the fermenter.

Interest in Candida species as a cause of hospital-associated infection is currently outstripped only by the recent focus on coagulase-negative staphylococci as significant nosocomial pathogens. Once considered little more than saprophytic nuisances, Candida sp. have assumed a progressively important role as hospital-associated pathogens. Coincident with the advent of effective, broad-spectrum antibacterial therapy, Candida sp. have become more commonly isolated from clinical specimens, not only in tertiary referral centers where severely immunocompromised patients are often treated, but also in acute care and community hospitals. In one major municipal hospital Candida sp. are the fifth most common blood culture isolate. In 1984, Candida was the fourth most common blood culture isolate at The Clinical Center of the National Institutes of Health, trailing only S. epidermidis, S. aureus, and E. coli (VJ Gill, personal communication). Clinically significant candidal syndromes such as Candida endophthalmitis, Candida osteomyelitis, Candida meningi t i s , 4 Candida per i ton i t i s , 5 and , most recently, Candida hepatitis have become relatively com-