CLINICAL AND EXPERIMENTAL STUDIES ON CANDIDA ALBICANS

Abstract

It is a well-known fact that during the antibiotic treatment serious complications such as bronchopulmonary and systemic Candidiasis are not infrequently encountered.
To get some informations about the mechanism of the onset of Candidiasis, the locationof Candida albicans in human bodies and the influences of the oral administration of the broad-spectrum antibioties on its appearance are studied.
As no studies have been attempted as to the metabolism of C. alb. and the mode of action of fungicidal agents on it, the terminal respiratory pattern of C. alb. and the mechanism of the inhibitory action of the several fungicidal agents are investigated.
Clinical Studies.
(1) The fecal fungal flora (especially C. alb.) was studies in 16 healthy adults and 28 patients without severe gastrointestinal disturbances. After oral administration of several antibiotics such as TM., AM., CM., and SM., a marked increase in the frequency of appearance and in number of not only Candida group but also of Cryptococcus and Saccharomyces was obtained.
(2) To clarify the location of C. alb. in the digestive tracts, Miller-Abbott intubation was performed in 10 patients in order to obtain the intestinal juice which was put into the Littman's isolating media. In one of 5 cases with normoacidity of gastric juice, C. alb. was discovered in only one portion, colon, ascendens, which in two of 5 with anacidity C. alb. was found in duodenum and jejunum accompanied with the ordinary intestinal bacterial flora.
(3) Bronchial secretion, sputum and throat secretion of 82 pulmonary tuberculous patients were tested by culture media for C. alb.. The bronchoscopic technique was used to obtaine the bronchial secretion. The results showed that C. alb. was recovered in sputum of II of 82 caces, in throat secretion of 9, and in the bronchial secretion of only one case, who had no sign of the bronchopulmonary candidiasis.
(4) For the first time in the literature, terminal chlamydospores of C. alb. were found in the freshly expectorated sputum from a patient who was suspected of the bronchopulmonary candidiasis.
Experimental Studies.
(1) The (intact) C. alb. was able to oxidize acetate, and glucose, but not citrate, α-ketoglutarate, succinate, fumarate and malate. The inhibitory effect of malonate on the oxygen-uptake was not demonstrated.
(2) The C. alb. dried at 37°C for 16 hours, demonstrate the additional ability of oxidizing succinate and fumarate. The inhibitory effect of malonate was also observed. However it lost the ability to oxidize glucose.
(3) The C. alb. ground at low temperature oxidized such substrate as pyruvate, acetate, , citrate, α-ketoglutarate, succinate, fumarate, and malate, and the inhibition of oxidation of succinate by malonate was clearly demonstrated.
From the date described above, it was considered that the membrane of C. alb. had specific permeability to several substrates and this permeability could be altered partially by drying. The so-called TCA cycle, not demonstrated in the intact cells on account of its specific permeability, could be demonstrated in the ground cells where the cell-membrane was destroyed.
(4) The minimal concentrations of Vitamin K₃, Aureothricin and Trichomycin to inhibit the growth of C. alb. were 78γ/cc, 25γ/cc and 1.4u/cc respectively. As to Paraben derivatives, Butylparaben was most effective than any other derivatives (methyl, ethyl, propyl paraben) and 78γ/cc was minimal necessary concentration.
(5) Butylparaben and Vitamin K₃ showed the unspecific inhibitory effect on TCA cycle of C. alb..
(6) It seemed that Aureothricin affected some enzymatic activity of the cell-membrane but not TCA cycle..
(7) Trichomycin affected the oxidation of amino-acid but not TCA cycle. Of those four agents Trichomycin caused the most remarkable morphological changes of C. alb..