Tgp chi YDuvc hgc - Tru&ng Bgi hgc Y Duvc Hue- Tqp 6. so 4 - thang 8/2016
DjNH DANH LOAI M O T SO CHUNG N A M MEN PHAN LAP T& BENH NHAN BANG KY THUAl KHOI PHO MALDI - TOF (MALDI TOF MASS SPECTROMETRY)
VA GIAI T R I N H T U G E N
Ngo Thi Minh Chdu', Ton Nit Phuang Anh', Bo Thj Bich Thdo' Silvana Sana', Antonella Santona^, Piero Cappucinnelli'
(1) Trudng Dgi hgc Y Dugrc Hue (2) Bgi hgc Sassari, Cgng hoa Y T d m tat
Oat van d e : N a m m e n i i t i c nhan gay b g n h q u a n t r g n g d n g u d i , d i e b i e t b e n h d o Candida spp. la bgnh p h d b l l n . Nghien e&u eiia c h i i n g t d i d u p e t i e n hanh t r i n 1 2 1 c h u n g n a m m e n p h i n l | p d u p e t y 103 bgnh nhan t h u d c Bgnh vign T r u d n g Ogi hpc Y D u p c Hue va B e n h v i g n Trung u a n g H u i t & 1/2013 - 6 / 2 0 1 4 . Muc tieu: Ojnh danh loai m p t s d ehiing n a m m e n phan l i p d u a c t & cac b g n h n h a n d u p e ehan d o a n nhiem nam ndng hoge n a m s i u . Phu'ang phap n g h i i n cii'u: C h u n g t o i a p d y n g ky t h u g t k h d i p h d MALDI - TOF (Maidi Tof Mass: Matrix-assisted laser d e s o r p t i o n / i o n i z a t i o n Mass S p e c t r o m e t r y ) , ket h p p v d i ky t h u i t PCR va giai trinh t y gen d e d i n h danh l o i i vi n a m . Ket qua: Cd 1 2 1 c h u n g n a m phan lap d u p c , t r o n g d d Catbicans 43,80%, Ctropicalis 17,36%, C.parapsilosis 11,75%, Cglabrata 7,44%, C.orthopsilosis 4,96%, C.metapsHosis 0,83%, Ckrusei 3 , 3 1 % , C.norvegensis 0,83%, Cguilliermondii 0,83%, Cdigboiensis 2,48%, C.famata 1,65%, C.blankii 0,83%, Cmesorugosa 0,83%, Geotrichum capitatum 1,65%, Trichosporon asahii 1,65%. K i t l u i n Trong nghien c y u ciia chOng t o i t y le Colbicans, Cnon albicans va cae n a m m e n khae lan iu-pt l i 43,80%, 47,9% va 3,3% (gom Geotrichum capitatum va Trichosporon asahii]. Trong d o m d t s d loai Candida non albicans hiem gap n h u : C. orthopsilosis, C.metopsHosis, C.norvegensis, Cdigboiensis, Cblankii, Cmesorugosa.
Tir khda: Ndm men, Candida sp, ky thugt khoi pho MALDI - TOF.
Abstract
IDENTIFICATION OF YEASTS SPECIES COLLECTED FROM PATIENTS USING MALDI -TOF MASS SPECTROMETRY
TECHNIQUE AND SEQUENCING
Ngo Thi Minh Chau', Ton Nu Phuong Anh', Do Thi Bich Thao' Silvana Sana', Antonella Santona^, Piero Cappucinnelli^
(1) Hue University of tVledicine and Pharmacy (2) University of Sassari, Italia
Background: Yeasts are i m p o r t a n t o p p o r t u n i s t i c p a t h o g e n in h u m a n , in w h i c h Candida spp. are t h e most c o m m o n causative agents. This s t u d y was carried o u t o n 1 2 1 yeast strains c o l l e c t e d f r o m 103 patients in Hue University Hospital a n d Hue Central Hospital f r o m January 2013 t o June 2 0 1 4 . Objective: To identify yeasts species f r o m systemic mycoses and superficial mycoses. M e t h o d s : W e applied MALDI - TOF Mass S p e c t r o m e t r y t e c h n i q u e s , PCR and DNA s e q u e n c i n g t o d e t e c t yeasts species. Results: There w e r e 121 yeast strains c o l l e c t e d , in w h i c h Colbicans 4 3 . 8 0 % , Ctropicalis 17.36%, Cparapsilosis 11.75%, Cglabrata 7.44%, Corthopsilosis 4 . 9 6 % , Cmetapsilosis 0.83%, Ckrusei 3 , 3 1 % , C norvegensis 0.83%, Cguilliermondii 0.83%, Cdigboiensis 2.48%, C.famata 1.65%, Cblankii 0.83%, Cmesorugosa 0.83%, Geotrichum capitatum 1.65%, Trichosporon asahii 1.65%. C o n c l u s i o n s : In o u r study, t h e prevalences o f C.abicans, Cnon albicans and o t h e r yeasts species w e r e 43.80%, 4 7 . 9 0 % and 3 . 3 0 % respectively. W e r e p o r t e d some rare species of Candida non albicans, i n c l u d i n g C orthopsilosis, Cmetapsilosis, C.norvegensis, Cdigboiensis, Cblankii, and Cmesorugosa.
Keywords: Yeast, Candida spp., MALDI - TOF Moss Spectrometry.
I 28
Tgp chl YDuvc hgc - Tru&ng Bgi hgc Y Dugc Hue- Tap 6, sS4 • thdng 8/2016
1. DATVANDE
Nam men giy bgnh phd biln eho ngudi gdm cae gidng Candida, Cryptococcus. Ngoai ra mdt sd giong nam men khac cung ed the ed vai trd gay bgnh d ngudi bao gom Rhodotorula, Malassezia, Trichosporon... [15]. Trong cic gidng nam men niy thi gidng Candida l i gidng giy bgnh phd biln nhat [4,8,15]. V l mgt bgnh smh, d ngu'di khde mgnh mpt so loai Candida spp. cd t h i sdng hoai sinh b mpt sd vi tri cua eathe va trd thanh t i c nhan gay bgnh trong mpt sd dilu kign thugn lpi nhat d|nh [15]. Bgnh ly d ngirdi do nam Candia spp. rat da dang, bgnh cd the la cac t h i bgnh nam ndng nhir viim am dao-am hd, vigm da, viem quanh mdng - vigm mdng, viem giic mae, viem dng tai... cho din eic the bgnh nam sau xam lan nhir viem phoi, viem npi mac ea tim, nhilm triing huyet...[15]. Candida spp. la tac nhan gay nhilm triing huyet pho biln, xip th& 4 trong 10 tic nhan vi sinh vgt gay nhilm triing huyet phd biln nhit b benh nhan dieu tri tai cae dan vj cham sdc tich cyc [4,8,12], va nhiim Candida spp. xam lan b cac bgnh nhan vdi cic bgnh ly nang da lam tang ty Ig t& vong cung nhu'tang ehi phi dilu tri [4,9]. Sy da dgng trong bgnh nguyen ciia bgnh thudc gidng nlm Candida va sy khac nhau trong dap &ng dieu tri vdi thuoc khang nam da lim cho viec dieu tri bgnh, dgc bigt l i trong nh&ng tru'dng hyp benh nam lan tda, nam siu trd thanh khd dieu tn thanh cdng va khd tien lypng, ty Ig t& vong cao [7,9,10,12]. Vi viy nghign e&u ve bgnh nguygn thudc gidng Candida va m&e dp nhgy vdi thuoc khing nam cua cac loai vi nam thupc gidng niy dang la van de du'pc sy quan tam eua nhilu nha nghiin c&u b nhieu quoc gia khac nhau.
Ky thugt phin lap d|nh danh nam men cd the l i nh&ng ky thugt don gian nhu' nudi cay tren mdi tru'dng Sabouraud v i cay chuyen tren cic mdi tru'dng thich hpp nhu' mdi trydng thgch bpt ngd CO Tween 80, mdi tru'dng Chromogenic agar, hoge lam cic th& nghigm khic nhau nhu- lgn men du'dng, dong hda dPPng [15]. Tuy nhiin, han che ciia cic ky thuit truyen thong la mat nhieu thPi gian, va trong mpt sd trydng hpp rat khd d l phan bigt mpt sd loai [13,16]. Sy chgm t r i trong chan doin cae tac nhin vi sinh vgt cd the gay can trd trong cdng tic dieu tri v i lam tang ehi phi dieu tri [8]. Vi vgy hien nay k? thuat mdi dypc nhieu nghien c&u tren t h i gidi de egp din la ky thugt khdi pho MALDI - TOF, u'u dilm ciia ky thugt niy l i dp phan giai, dp nhgy, dp ehinh xac v i t y ddng ngay cang cao lam cho ky thugt khdi phd cd tinh &ng dyng cao trong nghiin c&u cac tac nhin vi sinh vgt gay bgnh d ngu'di trong dd cd nam men. Ky thugt khll pho MALDI - TOF cd the giiip djnh danh benh nguygn t& khuan lac trong vai phiit [13]. Vi vgy
ehung tdi thye hign nghien c&u nay vdi vigc ap dyng ky thugt khdi phd MALDI -TOF, phdi hpp vdi ky thugt PCR va giai trinh t y gen nham myc tieu: dinh danh lodi ndm men phan Iqp duac tix bfnh nhdn bj benh ndm nong vd ndm sdu.
2. D6\ TirgfNG VA PHl/aiSIG PHAP NGHIEN CLTU 2.1. Ddi tu'png nghien c&u: 121 chung nam men dupc phan lap t& 103 bgnh nhan t& Bgnh vign Trung u'Ong Hui v i Benh vign Trydng Dai hpc Y Dupc Hue trong thdi giai t& 1/2013 - 6/2014.
2.2. Phu'ang phap nghign ciru: Qui trinh phan lgp dirpc tien hanh nhir sau: bgnh pham dirpc nudi cay tren mdi trirdng Sabouraud dextrose agar chloramphenicol (Biorad, France), 72 gid sau dupe cay chuyen sang mdi tru'dng Chromogennie agar (Biorad, France). Cae thiy nghigm lan lupt dupc lam de dinh danh ban dau bao gom th& nghiem sinh dng mam va thif nghigm sinh bao t& bao day trgn mdi tru'dng Corn Meal Agar Cac ioai vi nam phan lgp du'pc sau dd dupc cat gi& b "20°C trong dung djch glycerol 15%.
Ky thugt khdi phd MALDI - TOF dUpc thyc hien tgi Khoa Smh hpc phan t&, dgi hpc Sassan, Cdng hoa f vdi hg thdng may khdi phd Bruker-Daitonics, Bremen, Germany. Cic budc tien hanh nhy sau:
- Bgnh pham du'pc nudi eay trgn mdi tru'dng Sabouraud dextrose agar chloramphenicol (SC) v i dupc phan tich bang khdi pho trong vdng 48-72g sau khi nudi cay.
- Lly que cay de mpt luang nhd khiim nam lgn dTa dpc khdi phd (MALDI AnehorChip slide).
- Vi nam du'pc x& ly bing cic hda chat sau: Co djnh vdi con Ethanol nguyen chat rSi dpi khd, cd djnh tiep bang acid Formicco 70%, dpi khd, phu bang a-cyano-4-hydroxy cinnamic acid (CHCA) matrix.
- OTa khdi phd dypc du'a vao may dpc khdi phd va phan tich ddi ehieu ket qua vdi ngan hang d& ligu de cho ra ehan doin gidng va loai vi nam phii hpp vdi hg so phii hpp eao: cic kit qua du'pc lya chpn cd hg sd phii hpp d m&c A va B t&c la cd tri sd gia tri la £ 1,8.
Cae ehimg vi nam ed kit qua dp tin cgy thap khi djnh danh bang ky thugt khdi phd se dupe ap dung ky thugt PCR vdi cgp moi ITSl va ITS2 de khuech dai viing ITS (internal transcribed spacer) trong eau true ADN ciia vi nam. San pham ADN da khuech dai eua vi nam sau khi lam h'nh sgch dupe gdi di giii trinh t y gene de xic djnh loai.
3. KETQUA NGHIEN CU'U 3.1. Dac d i l m cua ddi typng nghien c&u Cd 103 bgnh nhin dypc chpn vao trong nghien cdu trong thdi gian t& 1/2013 - 6/2014. Trong dd cd 81 bgnh nhan den t& Bgnh vign TrPPng Ogi hpc Y
JOURNAL OF MEDICINE A( 2 9 |
TQP chi YDuvc hgc - Tru&ng Bgi hqc YDuvc Hue- Tgp 6, so 4 - thdng 8/2016
Duoc Hue gom cac Khoa: Khoa hoi s&c tich eye (ICU Intensive Care LJnit) 16 ngu'di (15,53%), Khoa Mat 2 ngu'dl (1,94%), Khoa Npi 19 ngyPi (18,45%), khoa Ngogi chin thuang 2 ngu^i (1,94%), Khoa Tai Mui Hpng 3 ngydi (2,91%), Khoa Nhi 5 ngu'di (%), Khoa Ung budu 13 ngu'di (12,62%), Phdng Kham Da lilu 11 ngu'di (10,68%) va phdng kham Phy Khoa 10 ngu'di 3.2. Nguon gdc phan lip cCia cac chung vi nam Bing 1. Ngudn goe eua cac
(9,71%), Ngoai ra ed 22 bgnh nhan den t& Bgnh vign Trung uang Hue: Khoa Huyet hpc lam sang 14 ngudi (13,59%), Khoa Nhi thgn - Tiet nigu 8 ngudi (7,77%).
Tudi trung binh ciia ddi tu'png la 45 tudi, tudi nho nhat la 21 ngiy tudi, tudi Idn nhit l i 89 tudi.
Trong kit qua ed 41 benh nhan nam (39,81%) va 62 bgnh nhan n& (60,19%).
chitng vi nam phan lip Nguon g6c phSn lap
Mau Nu'd'c tieu Niem mgc mieng Dicii ciiQC rCra pile quan Dicii da day Dam Phan Ciiat tiet mui To chijc xoang Dich am dao Bot mong Mil v^t thucfng To dnitc loet giac mgc Djch mang bung
Tong cpng
So lu'g'ng 1 16 26 7 1 19 6 1 2 10 9 2 2 1 103
TyleM 0,97 15,53 25,24 6,80 0,97 18,45 5,83 0,97 1,94 9,71 8,74 1,94 1,94 0,97 100 Vjtri phan lap co tylg cao l i nilm mac migng (25,24%), dam (18,45%), nudc tieu (15,53%), tuy vgy chung tdi cung ghi nhan sy da dang trong phan bd v l nguon gdc cCia cic chung vi nam phan lgp dupe.
3.2. S6 fypng chCing vi nam phan lgp
Ty 103 bgnh nhan ndi trgn chimg tdi phan lgp duac 121 ehung nam men, trong dd ed 87 bgnh nhan chi nhilm duy nhat 1 ehiing vi nam t& 1 vj tri phan lip, 14 benh nhin nhilm 2 chung vi nlm khic nhau t& 1 vj tri phan lgp va 2 benh nhin nhiim 3 chimg nam khic nhau tir 1 v| tri phin lip.
3.3. Ket qua djnh danh bang ky thuat khdi phd MALDI - TOF
Bang 2. Ket qua dinh danh bang ky thugt khdi phd MALDI - TOF Loal vl nam
Colbicans
C.non albicans
ioai ndm men khac
Ctropicalis Cparapsilosis Cglabrata Corthopsilosis Cmetapsilosis Ckrusei C norvegensis Cguilliermondii Geotrichum capitatum Trichosporon asahii Khong dinh danh dircjc
Tong
So lu'png 53 21 11 9 5 1 4 1 1 2 1 12 121
TV I I M 43,80 17,36 9,09 7,44 4,13 0,83 3,31 0,83 0,83 1,65 0,83 9,92 100
I 3 0 lOURNAL OP MEDICINE AND PHARMACY
Tgp chi Y Duvc hgc - Tru&ng Bgi hgc Y DUQC Hue- Tgp 6,sS4- thdng 8/2016
Trong gidng Candida thi loai Colbicans van la loai phd biln (43,80%). Cae loii C non albicans phan lgp dupc trong nghien ciiu la Ctropicalis, Cparapsilosis, Corthopsilosis, Cmetapsilosis, Cglabrata, Ckrusei, Cnorvegensis, Cguilliermondii. Ngoai ra chiing tdi ghi nhan cac loai nam men khac la Geotrichum capitatum (1,65%), Trichosporon asahii (0,83%) va ed 9,92 % khdng djnh danh dmyc vdi ky thugt khdi phd MALDI -TOF.
3.4. Kit qui giai trinh trinh ti^ gen ciia 12 chung vi nlm khdng djnh danh du'pc bing ky thugt khdi phd MALDI - TOF.
- 3 chiing la Candida parasilopsis - 3 chimg la Candida digboiensis
- 2 chiing l i Debaryomyces hansenii (Candida famata)
-lchisng\a C.blankii -1 chiing l i Corthosilopsis -1 chiing la Candida mesorugosa -1 ehimg la Trichosporon asahii
3.5. Ket qua dmh danh loai dya trin ket qua tdng hpp t& k9 thuit khdi phd va glai trinh t y gen.
Bang 3. Ket qua djnh danh loii bang ky thugt khdi phd va giai trinh t y gen Loii vi nam
Catbicans
C.non albicans
Lodi ndm men khde
Ctropicalis Cparapsilosis Cglabrata Corthopsilosis Cmetapsilosis Ckrusei C norvegensis Cguilliermondii C digboiensis C.famata Cblankii Cmesorugosa Geotrichum capitatum Trichosporon asahii Tong
Sd lypng 53 21 14 9 6 1 4 1 1 3 2 1 1 2 2 121
Tvlgl%) 43,80 17,36 11,75 7,44 4,96 0,83 3,31 0,83 0,83 2,48 1,65 0,83 0,83 1,65 1,65 100
4. BAN LUi^N
Sy da dgng eiia vi n l m phan lgp 3u(?c cho thay su- phd bien cua benh ly do n l m men tren nh&ng bgnh nhan cd ylu td nguy ca, binh thudng nam Candida cd the sdng hogi sinh tren mpt sd vj tri ciia ca t h i v i trd thinh tae nhan giy bgnh khi cd yeu td thugn lpi [8,15]. Cic ddi tu'png trong nghiin c&u cLia chOng tdi d i n t& nhieu khoa phdng khac nhau nhyng ehilm ty Ig cao la eae bgnh nhan bgnh nang tai cac dan vj nhu" ICU, Khoa Npi, Khoa Ung budu, Huyit hpe Lim sing, bgnh nhin dieu trj vdi ligu phap corticoides tgi khoa Nhi Tiet nigu. Theo mpt bai bio tdng quan cua Gary VJ. ylu to vat ehu cd vai trd quan trpng trong bgnh do vi nam, eae bgnh nhan bj bgnh ngng dieu tri tgi ICU, bgnh bdng, phlu thugt, chan thuang la cac nhdm nguy ca cita bgnh nlm do giam s&c de khing, ludn diing khang sinh lieu eao phd rpng, rdi logn khuan ehi tgo mdi trudng thugn
lpi cho nlm phit trien [3]. Vi vay bgnh nam sau, dge bigt bgnh do nlm Candida spp. dang du'pc danh gia la nhdm bgnh mdi noi trong cic bgnh nhilm trijng b cac ddi tu'png suy giam mien djch bam sinh hoic mac phai. Nghiin c&u ciia ehung tdi eijng ghi nhgn dupe mpt ty Ig nhit djnh nhilm 2-3 loai vi nam t&
mot vjtri phan lgp.
Theo kit qua nghiin e&u eCia cic t i c gia d nhieu qudc gia khic nhau ve mgt bgnh nguyen thupc gidng Candida, cd 5 loii gay bgnh phd bien la Candida albicans, Candida glabrata, Cparapsllopsis, Ctropicalis vd Ckrusei [4,8,15]. Ket qua nghign c&u cua Nguyin Khae Lyc v i cpng sy b Hpc vign Quin y ghi nhgn eic loal Candida spp. phd bien l i Colbicans 65%, Cglabrata 6,67%, Ctropicalis 6,67%, Cparapsoiosis 5%, Ckrusei 3,33% [2]. Theo tac gia Giri S. ve bgnh nguyen nam Candida gay nhilm triing huyet thi hon 90% thupe cie loii ndi trgn [4]. Nghien
re AND PHARMACY
Tqp chi Y DUVC hgc - Tru&ng Dgi hgcY Dugc Hui -Tgp 6, so 4- thai
c&u ciia Li F. va epng s y t g i T r u n g Qudc t & 2006 - 2 0 1 1 ghi n h g n t r o n g t d n g sd 9 1 c h i i n g vi n a m p h a n lgp t y m a u v i dich t i e t ciia c o t h e t y Ig n h i l m n a m Candida spp. lan l y p t la: C. albicans vbi t y ig 4 1 , 2 9 % d b g n h p h a m m a u va 5 9 , 0 6 % t r o n g cae dieh t i e t ciia ea t h e , t y lg nay l i 1 8 , 0 6 % v i 2 5 , 7 2 % v d i Ctropicalis, C parapsilosis l i 17,42% v i 5,43%, Cglabrata la 1 1 , 6 1 % va 3,99%, m p t sd loai Candida spp. khac ia 1 1 , 6 1 % va 5,80% [ 1 0 ] , Yashavanth R. v i c p n g s y nghien c y u ve n h i l m n a m Candida spp. d u ' d n g t i e t nigu ghi n h g n C albicans 30,3%, Cglabrata 9,09%, Ctropicalis 4 5 , 4 5 % vd Ckrusei 1 5 , 1 5 % [ 9 ] . N g o i i ra m d t sd loai v i n a m t h u p c g i d n g n i y c u n g d u a c ghi n h i n la b g n h nguygn n h u Ckefur, Cguilliermondii, Clustitaniae, Cstellatoidea, Cdubliniensis [ 4 ] . K i t qua d j n h d a n h loai t h u p c g i d n g Candida t r o n g nghien c&u ciia c h u n g t d i c h o t h a y Colbicans c h i e m t y Ig 4 3 , 8 0 % cao b a n so n h & n g loai k h i c , d i e u nay p h u h o p v d i y van la Colbicans la loai ggp p h o b i e n nhat [3,15]. Tuy n h i g n c h u n g t d i c u n g ghi n h g n t y le n h i l m n h d m C.non albicans la 43,82%, t u a n g d u a n g t y Ig Colbicans (43,80%), d i e u nay p h i i h a p v d i ghi nhgn eua n h & n g n g h i e n c&u gan day la cd s u t r p i len ciia n h d m Candida non albicans. Nghien c & u cua Hall G . v a c p n g s y t g i M y 2003 v l n h i l m t r i i n g h u y e t d o Candida spp. ghi n h g n 5 7 % t h u p c n h d m Cnon albicans [ 6 ] . Trong n h d m Cnon albicans, c h u n g t d i ghi n h i n cac loai ed t^ Ig cao la Ctropicalis 17,36%, t i e p d i n la Cparapsilosis 9,09%, Cglabrata 7,44%.
D a n h g i i v e s y p h d bien eua Ctropicalis, n h i e u k h a o sat eho ket qua d i y la loai du'pc ghi n h i n v d i t a n xuat xep t h & 2 - 3 t r o n g n h d m Cnon albicans [ 1 1 ] . C.
gtofarotfl t h u ' d n g d u p e ghi n h g n c d t a n xuat p h d b i e n t h & hai sau Colbicans t r o n g g i d n g Candida sp n d i chung [ 1 4 ] , t u y vgy k i t qua n g h i e n c & u cua c h i i n g t d i ghi n h g n s y t r p i b a n v e t y Ig eiia Ctropicalis v a Cparapsilosis, co t h e d i y la m p t d i e m khae b i g t v e phan b d l o i i cua g i d n g Candida b n g u d i V i g t N a m .
Ngoai C.parapsilosis, d j n h d a n h d y a v i o k? t h u g t k h d i p h d cd t h i p h i n b i g t c i c t h i n h v i e n k h i c cd cau t r i i c g e n o m t u a n g t y l o i i nay l i Corthosilosis va Cmetapsilosis, day c h i n h l i d i e m m g n h ciia ky thugt khdi p h d so v d i eae ky t h u g t d j n h d a n h c d d i l n khac n h u du'a v i o hinh t h a i hpc hogc d y a v i o cac phan
& n g len m e n d u d n g hoge d o n g hda d u d n g [15].
Nghign c & u eiia chOng t d i e u n g g h i n h g n cd cac loai n a m Candida non albicans n h y Cglabrata, Ckrusei, Cnorvegensis day la n h & n g l o i i v l n a m cd xu hu'dng d e k h i n g t h u d e d a du'pc c i c n g h i g n c & u t r o n g nudc va t r i n t h i g i d i d e cgp d e n [ 1 , 5 , 7 ] .
T r o n g ket q u a cua c h i i n g t d i c d 9,92% n a m men k h d n g d j n h d a n h d y p c v d i ky t h u a t k h d i p h d MALDI - TOF. D i e u nay c u n g t i r P n g t y v d i g h i n h i n ciia m g t so t i c gia khac t r e n t h e g i d i , van d l nay d y p c g i i i thieh la d o t h i e u c a s d d & ligu va da d u p e d e egp t d i trong m p t sd n g h i i n c & u cua c i c t i c gia khae n h a u [13,16].
V d i cac c h i m g k h d n g x i c d j n h nay, k i t qua giai trinh t y xac d j n h eae l o i i n l m m e n l i Cparapsilosis, Corthopsilosis, C digboiensis, C.blankii, Cfamota, Cmesorugosa, Trichosporon asahii. Irong d d m o t sd loai n a m rat h i l m ggp d n g u d i va ed t h e la lan dau t i e n du'pc edng b d p h i n l | p t & n g y d i V i g t Nam n h u Cdigboiensis, C.blankii, C. mesorugosa.
5. KET L U A N
D e tai ciia e h u n g t d i i p d y n g ky t h u i t khdi phd MALDI - TOF va giai t r i n h t y g e n d e x i c djnh l o i i eiia 1 2 1 e h i m g n l m m e n p h a n lgp t & 103 b g n h nhan thude Benh vign Tru'dng Ogi hpc Y D u p c Hue va Bgnh vien Trung u a n g Hue, ket qua n h i r sau: C albicans 4,80%, Ctropicalis 17,36%, C.parapsilosis 11,75%, Cglabrata 7,44%, Corthopsilosis 4,96%, Cmetapsilosis 0,83%, Ckrusei 3 , 3 1 % , Cnorvegensis 0,83%, Cguilliermondii 0,83%, Cdigboiensis 2,48%, C.famata 1,65%, Cblankii 0,83%, Cmesorugosa 0,83%, Geotrichum capitatum 1,65%, Trichosporon asahii 1,65%.
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