Clostridium difficile Infection and Candida Colonization of the Gut: Is There a Correlation?

We read with interest the article of Manian and Bryant about the possible protective role of gut colonization by Candida species against Clostridium difficile infection (CDI). Although Candida has been involved as part of the normal intestinal microbiota, no recent data seem to confirm the authors’ results. Conversely, an opposite role for non-albicans Candida (NAC) colonization was suggested by Nerandzic et al in a trial on 548 patients with CDI. Recent observations conducted in our 1300-bed teaching hospital Policlinico “Umberto I” in Rome showed that patients treated for severe CDI developed at least 1 episode of candidemia, thus hypothesizing a link between CDI and candidemia.