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Candida albicans can be spread from one person to the next by direct contact or in fluids like saliva. It is so common that many people carry the fungus without any symptoms and it is usually some change in the person's health that triggers the infection to become a problem.
Candida grows where the skin is moist and warm. It is often found in the mouth, vagina, penis and between the buttocks. For most of the time any infection is prevented from taking hold by the skin's tough outer layer, the body's immune system and friendly commensal bacteria. Any reduction in these defences can result in candidiasis.
Patients with a weakened immune system are vulnerable and candidiasis can develop in AIDS sufferers who often get serious infections of the lungs. Patients on cancer therapy or drugs to suppress their immune system following an organ transplant are also susceptible to opportunistic infections like candida.
Antibiotics reduce the numbers of commensal bacteria in the mouth and vagina which allows the fungus to become established. Oral candida is common in new-born babies because they do not have commensal bacteria in their mouths and can be infected during birth. Nappy rash sometimes provides enough damage to the surface of the skin between the buttocks to provide the opportunity for candida to infect.
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