I am one of the person who deeply believed this syndrome is mainly caused by alteration of the intestinal bacterial flora. Later, step by step, I was reading materials, books, speaking with Drs, etc and understood the immune system is more responsible than anything. I understand the antagonistic flora has a role in keeping the yeast under control,but no the main role. I have a lot of evidence not only from medical papers but from candida sufferers too. The flora plays a role but you can recover it and still have a fungal overgrowth if your immune system doesn’t reactivate. There are many people who have never taken anything to disrupt the flora who develop a fungal overgrowth. Then, there are people who have taken broad spectrum antibiotics for 6 months and don’t get an intestinal fungal overgrowth. Moreover, there are at least 3 main gut different dominant bacterial enterotypes in human suggesting different interaction yeast/bacterias. As I said, I thought the flora was the most important but forum discussions, people stories, and medical evidence made me change this idea toward to the immune system. In fact, all candida books I have read and own from Dr.Truss, Dr.Crook, Dr.Trowbridge, Dr.Cranton, Dr.Crandall, etc point to an immune tolerance to the fungus and a loaded immune system, even when some of them mention the flora as antagonistic.
One of the biggest evidence is the amount of success stories found from those who have detoxed heavy metals in order to overcome this syndrome.Another evidence showed after successful recover of the gut microbiota with Fecal Transplants and HPI. There are many people who have done these procedures to overcome CRC that still have the infection, but their CDSA have shown total flora recover. (what they look for)
I am not resting importance to the gut microbiota, and there is too much to be learned about it yet to be really aware of its role in health, but the actual evidence indicates candida is more associated to an immune dysfunction than a dysbiosis.