TÌNH HÌNH KHÁNG THUỐC CỦA MỘT SỐ CHỦNG NẤM CANDIDA PHÂN LẬP TẠI BỆNH VIỆN BỆNH NHIỆT ĐỚI TRUNG ƯƠNG (1/2017-12/2018)

Abstract

The immediate objective of this study is to describe the distribution of Candida species among Candidiasis patients admitted to the National Hospital of Tropical Diseases (NHTD) between January 2017 and December 2018. We then calculated the proportion of antifungal resistance of Candida isolates. Results: During the study period, from 811 fungi positive specimens we detected 423 Candida isolates, of which 45 isolates were from Candidaemia patients. Among those Candida isolates causing Candidaemia, the most predominant was C. albicans (48,9%, 22/45) followed by C. parapsilosis (22,2%, 10/45), and C. tropicalis (11,1%, 5/45). We identified a Cadidaemia patient who was co-infected by C. metapsilosis and C. parapsilosis group III. Meanwhile, C. tropicalis (53,6%, 104/194) and C. albicans (33,5%, 65/194) were the main cause of urinary tract infection. In particular, we found Candida in sterile body fluids (peritoneal fluid/abdominal fluid, liver abscess) of six patients, C. albicans (83,3%, 5/6). All Candida isolates were tested for antifungal susceptibility using Vitek sytem. Overall, 86,3% (296/343) of Candida isolates were phenotypically susceptible to fluconazole which is a first-line drug to treat Candidiasis, while 94,8% (331/349) of total tested isolates were susceptible to amphotericin B. Antifungal susceptibility testing reveled significant proportions of C. tropicalis (27,3% and 18,2%, respectively) resistant (or at intermediate level) to fluconazole and voriconazole. In conclusion, C. albicans, C. tropicalis were the most common species of invasive fungal infections in hospitalized patients in NHTD. Most of Candida isolates were still susceptible to amphotericin B, echinocadins and flucytosine, but they were less susceptible to voriconazole and fluconazole.