TÌNH HÌNH NHIỄM NẤM XÂM LẤN CỦA MỘT SỐ CHỦNG VI NẤM GÂY BỆNH PHÂN LẬP TRÊN BỆNH NHÂN ĐIỀU TRỊ TẠI BỆNH VIỆN BỆNH NHIỆT ĐỚI TRUNG ƯƠNG (1/2017-12/2018)

Abstract

Objectives: To evaluate invasive fungal infections of some pathogenic fungal strains isolated in patients treated at the National Hospital for Tropical Diseases. Subjects and method: A cross-sectional descriptive study was conducted from January 2017 to December 2018 on 621 pathogenic fungal strains isolated from clinical samples: blood, cerebrospinal fluid, sterile fluid, urine, respiratory secretions of inpatient fungal infections at the National Hospital for Tropical Diseases.

Results: The rate of invasive fungal infections isolated from sterile specimens accounted for 40.7% of the total fungal cultures (+) (the highest in blood was 31.4%; CSF ranked second at 4.2%). T. marneffei, Candida and C. neoformans are common causes of fungal infections, accounting for 74.7%; 16.7% and 7.0%; C. neoformans is the main pathogen in CSF, accounting for 100%. The rate of pathogenic fungi isolated in semi-quantitative invasive specimens accounted for 35.2% of the total fungal cultures (+): urine accounted for the highest proportion of 24.1%, of which Candida was the amain cause 93.9%; catheter/bronchial fluid/endotracheal swabs accounted for 7.4%, Candida 44/65 isolates accounting for 67.7%; T. marneffei 13/65 isolates accounted for 20.0%, A. fumigatus 2/65 isolates accounted for 3.1%. Sputum specimens, A. fumigatus 19/26 isolates accounted for 73.1%; T. marneffei 5/26 isolates accounted for 19.2%. The common invasive fungal spectrum in HIV/AIDS patients is T. marneffei in blood cultures, respiratory fluids (including sputum, endotracheal/catheter/bronchial fluid), sterile fluid (except cerebrospinal fluid). There was no difference in the rate of C. neoformans fungal infection in HIV-infected and non-HIV infected patients with the ratio 1:1, p>0.05. In cerebrospinal fluid specimens, the ratio of HIV infection: no HIV infection in patients infected with C. neoformans fungus was 1:2, the difference was statistically significant p<0.05. Invasive candidiasis was higher in HIV (-) group than HIV (+), p<0.05.