Effect of various nutritional formulations on candidiasis in a hyperalimented rat

The influence of the composition of solutions infused on the outcome of catheter-related sepsis in total parenteral nutrition (TPN) has not been previously studied. This influence is of particular interest in infections caused by Candida because disseminated disease often results despite removal of the infected catheter. The relationship between the persistence of Candida in the tissues and the composition of the TPN solution infused was therefore studied in a hyperalimented rat model of disseminated candidiasis. Doses of 1.2 to 2.0 × 10 5 viable Candida albicans CR 1473 cells were injected into the right internal jugular vein of each of 50 rats, followed in 3 min by the placement of a Silastic catheter into the same vein. Fifteen noncatheterized rats undergoing an identical surgical procedure and challenge with Candida served as a control group. After 7 days, 35 of the 50 rats infused with standard TPN solutions and 5 of 15 control rats showed persistent tissue invasion, as indicated by kidney cultures positive for Candida. A significant correlation was observed between the mean change in body weight during the period of study and the percentage of positive kidney cultures in the rats receiving the TPN solutions. Analysis of organ counts showed that infusion of lipid or solutions containing a high concentration of glucose augmented Candida proliferation in the kidneys to a significant degree. It was concluded that the central catheter and malnutrition may contribute to the persistence of Candida in the tissues. In addition, infusion of lipid or high concentrations of glucose may enhance Candida proliferation.