CĂN NGUYÊN, KẾT QUẢ ĐIỀU TRỊ VÀ MỘT SỐ YẾU TỐ TIÊN LƯỢNG NẶNG Ở BỆNH NHÂN NHIỄM NẤM HUYẾT ĐIỀU TRỊ TẠI BỆNH VIỆN BỆNH NHIỆT ĐỚI TRUNG ƯƠNG

Abstract

Objectives: comment on treatment results and evaluate several predictors of fungemia patients admitted National Hospital for Tropical Disease (NHTD).

 Subjects and method: 112 patients were diagnosed with fungemia by positive blood culture admitted NHTD from January 2019 to June 2020. Descriptive cross-sectional study.

Result: The main fungal etiologies were T. marneffei (74.11%) and Candida spp. (20.54%), in which C. albicans and C. tropicalis were of equal proportions.The rate of male was higher, the median age of the study patients was 40. The rate of patients receiving appropriate treatment was 78.57%.The improvement rate of treatment was 75.89%, of which T. marneffei infection had a higher rate of improvement than other etiology groups. Predictors of outcome of T. marneffei infection werehigh urea(cut-off point 7.53 mmol /L, sensitivity 76.5%, specificity 89.4%), high SOFA score (cut-off point 3.5 score, sensitivity 70.6%, specificity 80.3%); predictors of outcome of candidemia were platelets (cut-off point 76 G/L, sensitivity 93.3%, specificity 62.5%), high SOFA score(cut-off point 5.5, sensitivity 87.5%, specificity 66.7%), and APACHE II score (cut-off point 17.5, sensitivity 75.0%, specificity 80.0%).

 Conclusion: Treatment result of T. marneffei infection was better than candidemia. Predictors of outcome of T. marneffei infection were urea and SOFA score; predictors of outcome of candidemia were platelets, SOFA scores, and APACHE II scores.