Candida albicans is a yeast fungus from the Candida group and the most common causative agent of candidiasis. It can be detected in 75 percent of all people.
What is Candida albicans?
Candida albicans is probably the best known member of the facultative pathogenic fungi group. Candida is a polymorphic fungus. This means that it can form different growth forms. This characteristic plays an important role in pathology. Due to its adaptability, Candida albicans can prove to be extremely resistant to therapy in some cases. Normally, the individual fungal cells are round and have a diameter between 4 and 10 µm. However, Candida albicans can also form pseudomyceles and hyphae. Hyphae are indicative of invasive colonization. This form of Candida infestation usually affects only immunocompromised individuals, people with lowered immune systems, such as cancer patients or HIV patients.
Occurrence, distribution, and characteristics
Candida albicans is a fungus that is ubiquitous. It enters the human body through daily food. For example, the pathogen is found on vegetables, meat and fruit. In particular, ready-prepared raw vegetable salads are often highly contaminated with Candida albicans. Studies show that the fungus can survive for at least a month on objects outside the human body at a humidity of between 30 and 50 percent. Only after half a year are usually no more reproducible cells detectable. At a humidity of 100 percent, on the other hand, the fungi survive for up to a year. Normally, Candida albicans belongs to the transient intestinal flora. This means that the fungi enter the intestine via food, but do not settle there. The local healthy intestinal flora, which consists of Escherichia coli, Lactobacilli and Bacteroides, among others, prevents the fungus from spreading permanently in the intestine. It becomes problematic if the intestinal flora is impaired, for example, due to previous antibiotic treatment. A disturbed intestinal flora offers Candida albicans the opportunity to settle in the intestine. To do this, the fungi attach themselves to the intestinal mucosa. When threatened by antifungal drugs, for example, they can change their shape and briefly migrate into the intestinal mucosa. This is the reason why some Candida species are already resistant to the antifungal drug nystatin. Researchers have now found that toothbrushes are a significant source of reinfection. People suffering from Candida albicans should therefore urgently change their toothbrush after therapy. Otherwise, they could become directly reinfected when brushing their teeth. Sexual transmission should also not be underestimated. Many women suffer from recurrent vaginal infections. Most often, these infections are caused by taking antibiotics or cortisone. These affect the vaginal flora and allow fungi to spread. However, sexual transmission is also possible. Men can have a genital infection with Candida albicans without experiencing symptoms. During sexual intercourse without a condom, the yeast fungi are then transmitted. Treatment of the woman then remains ineffective, as further fungal colonies enter the vagina during renewed sexual intercourse. This effect must be considered when treating recurrent genital fungi.
Diseases and complaints
Colonization of the intestine by Candida albicans may go completely unnoticed. Some researchers even believe that a low level of Candida albicans colonization is not pathological, but physiological. However, when yeast proliferate in the intestine, diarrhea, constipation, abdominal pain, and other digestive disorders may result. Candida albicans preferentially metabolizes carbohydrates. When the fungus metabolizes the carbohydrates, alcohols are formed. Among them are also fusel alcohols. These enter the bloodstream via the intestinal mucosa and reach the liver via the portal vein. The liver must break down the alcohols. In the case of a strong colonization, this can lead to a significant burden on the liver. However, Candida albicans can not only infect the intestine. The preferred sites of infection of the yeast fungus also include the oral cavity, the oral mucosa under dentures, the mucosa of the genital area, the conjunctiva in the eye and the nail folds. Moist skin folds also provide optimal growth conditions for the fungus.A whitish, wipeable coating becomes visible on the mucous membranes in the case of Candida infestation. On the skin, the infection manifests itself as severe redness with itching. In women, the fungus tends to manifest itself in the vaginal area. A typical symptom of a vaginal fungal infection is white, friable discharge from the vagina. Unlike the discharge from a bacterial infection, the discharge from Candida infestation does not smell. However, it is associated with itching in the vulva area. In severe cases, erosions may develop, spreading over the vulva to the inner thighs. Genital fungal infections in men are also called balanitis. Here, the glans is affected by the fungal infection. It is inflamed, reddened and secretes purulent secretions. If the immune system is severely weakened, the Candida albicans infection can spread to the heart, stomach, liver, lungs, spleen and central nervous system (CNS). Around 14 percent of all patients in intensive care units are affected by a generalized infection with Candida albicans. Elderly people are more frequently affected than young people. Systemic candidiasis, i.e. extremely severe cases, ends fatally in more than 70 percent. Particularly feared is the so-called Candida sepsis. In this case, large quantities of the pathogen are found in the blood. Candida albicans is now the 4th most dangerous pathogen in hospital infections.