Khảo sát tính nhạy cảm của một số chủng Candida spp. phân lập từ miệng bệnh nhân ung thư với một số thuốc kháng nấm

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Thông tin xuất bản: Tạp chí Khoa học và Công nghệ - Đại học Nguyễn Tất Thành, 2020

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Candida miệng là một bệnh phổ biến thường gặp ở những đối tượng bị suy giảm miễn dịch và đặc biệt nghiêm trọng với những bệnh nhân ung thư đang trải qua liệu pháp hóa, xạ trị. Để điều trị, rất cần sơ bộ định danh và khảo sát mức độ nhạy cảm của các chủng Candida spp. với các thuốc kháng nấm, nhằm hạn chế tình trạng kháng thuốc. Với 60 chủng Candida spp. phân lập được, bằng các thử nghiệm khảo sát hình thái khuẩn lạc trên môi trường CHROMagar Candida, khả năng sinh bào tử bao dày trên môi trường thạch bột ngô và thử nghiệm sinh ống mầm trong môi trường huyết thanh người, đã sơ bộ định danh đến mức loài được 51 chủng: 34 chủng C. albicans, 14 chủng C. tropicalis, 3 chủng C. krusei. Sử dụng phương pháp khuếch tán đĩa theo hướng dẫn của CLSI M44 – A để đánh giá mức độ nhạy cảm của 60 chủng Candida spp. với các thuốc kháng nấm clotrimazole, nystatin, amphotericin B, fluconazole và miconazol. Kết quả cho thấy, tất cả các chủng đều nhạy cảm với nystatin, không có chủng nào đề kháng với với amphoterin B, các thuốc nhóm azole bị đề kháng nhiều với với fluconazole (11,67%), miconazole (10%) và clotrimazole (5%). Trong các loài Candida spp. phân lập được, C. tropicalis có tỉ lệ đề kháng cao nhất.Oral candidiasis is a common disease in immunocompromised individuals and especially serious to cancer patients that are undergoing chemotherapy and radiation therapy. Therefore it is necessary to identify and evaluate their susceptibility to antifungal agents in vitro. Via conventional techniques such as CHROMagar Candida, chlamydospore formation test on Corn Meal Agar, and germ tube test on human serum, we identified 51/60 strains included: 34 strains of C. albicans, 14 strains of C. tropicalis and 3 strains of C. krusei. Antifungal susceptibility of 60 isolated strains was evaluated by CLSI M44-A disk diffusion method for clotrimazole, nystatin, amphotericin B, fluconazole and miconazole. All isolated strains were sensitive to nystatin and none were resistant to amphotericin B. All C.albicans isolates were susceptible to clotrimazole, nystatin, amphotericin B, fluconazole, and miconazole. The resistance rate for fluconazole, miconazole, and clotrimazole in this study were 11.67%, 10% and 5% respectively. In isolated Candida spp., the resistance rate for antifungal agents of C. tropicalis was the highest.

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