In Reply.—We agree with Dr Kohr that broad-spectrum antibiotics play a significant role in C albicans sepsis by promoting the colonization of the GI tract. The GI tract then acts as a reservoir with subsequent resorption and bloodstream invasion occurring in some cases.1-3 Krause et al4 have demonstrated that a threshold dose of C albicans to produce invasion of the bloodstream in healthy adults was 1012 colonies of C albicans given orally. Since similar data are not available in children, we have studied colonization of the GI tract by C albicans in 38 premature infants. We determined colony count per gram of stool in specimens obtained once a week. We found that 69% had counts of over 8 million colonies per gram of stool, and two infants in this group developed C albicans sepsis. In the remaining 31%, the colony count was less than 8 million
PAPPU LD, PUROHIT DM. Primary Renal Candidiasis-Reply. Am J Dis Child. 1985;139(5):444. doi:10.1001/archpedi.1985.02140070017016
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