The Serodiagnosis of Moniliasis

Soon after broad spectrum antibiotic drugs became available for therapy, reports appeared in the literature describing moniial infections of the anogenital area and oral mucosa. Cannon (1) reported on the considerable amount of attention being centered upon the problem of the rising frequency of monilial infections in relation to antibiotic therapy. Loh and Baker (2) studied the fecal flora of 19 normal subjects following the administration of broad spectrum antibiotic therapy and found that in most instances there was rapid 100-fold to 1000-fold increase of Candida albicans. In four patients who had previously shown no yeasts, the presence and proliferation of yeasts was observed during and following medication. They concluded that the growth of yeasts seemed to be stimulated by the antibiotics either directly or indirectly through suppression of other organisms. Valentine (3) also reported on superinfection with Candida albicans when high concentrations of broad spectrum drugs reach the intestinal tract. He believed that with the destruction of the sensitive organisms, the resistant yeasts, normally inhibited, can multiply and give rise to infection. Carpenter (4) summarized the data from his hospital and concluded that antibiotic therapy rendered conditions favorable for the growth of certain fungi by suppression or alteration of the bacteria in common hosts. Norris and Armstrong (5) in their publication stated that there has been an in crease in the incidence of patients suffering from Candida albicans infections and that this was caused, in part, by the prolonged use of antibiotics. Seletz (6) reported on his observations during the past 12 years and concluded that the incidence of fungi in the so-called intractable anogenital pruritus cases ranged above 90 per cent, whether as primary or secondary invaders. Bratlund and Holten (7) in reviewing the literature stated that the increasing use of antibiotics is the main cause of the increasing incidence of moniiasis and that adults are affected quite frequently. Manheim and Alexander (8) reported on 300 cases of monilial anorectal complications following oral ingestion of broad spectrum antibiotics. Kligman (9) observed that Candida albicans regularly emerges in abundance in the mouths and gastrointestinal tracts of those receiving wide spectrum antibiotics. Keefer (10) as well as Woods, Manning and Patterson (11) also reported on oral, intestinal, bronchopulmonary, genital, dermal and generalized moniial infections following the use of antibiotic therapy.