FIRST REPORT OF CANDIDA AURIS IN VIETNAM.
Abstract
Early diagnosis and treatment of Candida auris (C. auris) infections improves mortality. At Cho Ray hospital, we successfully isolated and identified C. auris in all specimens by the Vitek 2 and Vitek MS systems. However, determining the sensitivity of C. auris is still difficult because currently neither the Clinical and Laboratory Standards Institute (CLSI) have standards for interpretation. At Cho Ray hospital, in order to provide clinical antifungal susceptibility testing for C. auris, the Department of Microbiology is relying on the provisional recommendations of the U.S. Centers for Disease Control and Prevention. In Vietnam, there are currently no reports on the sensitivity of C. auris. In this article, we have the first report on the sensitivity of C. auris in Vietnam (specifically at Cho Ray Hospital). The method used in this study was the broth microdilution method recommended by the Clinical and Laboratory Standards Institute (CLSI), specifically using the Sensititre YeastOne antifungal panel. The Sensititre YeastOne antifungal susceptibility testing system (Thermo Fisher Scientific - USA) is based on the principle of broth microdilution combined with a colorimetric indicator, closely approximating the standard microdilution method. Each well contains a specific concentration of antifungal agent along with a color indicator. The minimum inhibitory concentration (MIC) is determined as the lowest concentration at which fungal growth is inhibited--indicated by the absence of a color change. The Sensititre YeastOne panel offers several advantages: it is easy to perform, produces clear and interpretable results, and includes standardized guidelines for result interpretation, making it a convenient and reliable tool for antifungal susceptibility testing in clinical laboratories. Result of the sensitivity rate (S) of C. auris to caspofungin was 81.6%, to fluconazole was 94.7%, and to amphotericin B was 71.1%. Resistance to all 3 antifungal groups (azole, echinocandins, polyene) was 0%, resistance to 2 antifungal groups accounted for 7.9% (3 out of 38 samples), resistance to 1 of 3 antifungal groups was 36.8%. At the same time, the similarity of 38 C. auris infections was also assessed using two methods: microdilution combined with color (Sensititre YeastOne - YO10) and diffusion according to concentration on agar plate (Etest) according to US CDC standards to help laboratories have more choices of methods suitable to the existing conditions in the laboratories.
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