TÌNH HÌNH ĐỀ KHÁNG THUỐC KHÁNG NẤM CỦA CÁC LOÀI CANDIDA SPP. GÂY NHIỄM KHUẨN HUYẾT VÀ NHIỄM KHUẨN TIẾT NIỆU

Abstract

Objective: To investigate the distribution of fungal species causing blood stream infection, urinary tract infection and their antifungal resistance at Cho Ray hospital in 2018.

Methods: Retrospective method. All samples of blood and urine specimens that had positive cultures in 2018 at Microbiology Department of Cho Ray Hospital. Blood samples were added to BD BactecTM Myco / Lytic bottle and monitored in Bactec 9120. If positive, they were isolated on Sabouraud medium. Urine samples were cultured directly on Sabouraud medium. Identication and drug susceptibility testing were performed by YST card and AST YS07 card on Vitek 2 Compact system according to CLSI standard.

Results: There were 89 patients who showed positive blood culture results. Three leading agents caused blood stream infection were C. tropicalis (31; 34.8%), C. albicans (20; 22.5%), C. glabrata (18; 20.2%). In blood stream infection, resistance of Candida spp. to Fluconazone is highest (8; 9.9%), followed by Amphotericin B (7; 8.6%), Voriconazole (7; 8.6%), Flucy- tocine (1; 1.2%). There were not resistant to Caspofungin and Micafungin. There were 116 patients who showed positive urine culture results. Three leading agents caused urinary tract infection were C. tropicalis (43; 37.1%), C. albicans (41; 35.3%), C. glabrata (20; 17.2%). In urinary tract infection, resistance of Candida spp. for Amphotericin B is highest (8; 7.3%), followed by Fluconazole (5; 4.6%), Voriconazole (5; 4.6%), Caspofungin (3; 2.7%). There were not resistant to Flucytosine and Micafungin. Conclusion: The most common fungi in blood stream infection and urinary tract infection were C. tropicalis, C. albicans and C. glabrata, respectively. The resistance to antifungals of Candida spp. strains was less than 10%. In this study, the resistance of Candida spp. With antifungal drugs is relatively low, however, it is necessary to continuously monitor the trend of drug resistance of fungal strains in order to detect changes in resistant rates in order to handle appropriately