Bacterial Infection among Cancer Patients: Analysis of Isolates and Antibiotic Sensitivity Pattern

Abstract

Introduction. Cancer patients being immunosuppressed are vulnerable to develop infections. Knowledge of the changing epidemiology of infections has a pivotal role in its management. Aims and Objectives. The study is undertaken to assess the types of bacterial infections in cancer patients undergoing anticancer treatment, the associated bacterial pathogens, and their antibiotic sensitivity patterns. Materials and Methods. A retrospective surveillance study was undertaken in our center. Positive culture reports and other clinical details of cancer patients diagnosed with infection during a stay in the tertiary care center from 1st January 2015 to 31st December 2016 were analysed by descriptive statistical methods chi-square test and odds ratio to study the association. Results. Out of 638 cancer patients diagnosed with infections in the 2-year period, 140 patients had positive cultures, representing 272 specimens and 306 isolates. Common specimens sent for culture were blood sputum, urine, and pus. 214 isolates (69.9%) were gram-negative bacilli, and 92 (30.1%) were gram-positive cocci. The most common isolates were Klebsiella spp. (18.30%), Pseudomonas spp. (17.65%), and Escherichia coli (14.71%) followed by Staphylococcus aureus (13.72%). Among the gram-negative organisms, the antibiotic resistance rates reported to fluoroquinolones, aminoglycosides, and third-generation cephalosporins were 45.13%, 39.20%, and 48.58%, respectively. 26.92% of the organisms are resistant to all three antibiotics. 50.4% of Klebsiella spp. and Escherichia coli were ESBL producers. Gram-negative organisms showed 11.63% resistance to β-lactam/β-lactamase inhibitor combination, and 22.22% of gram-negative organisms are resistant to carbapenems. 50% of the Staphylococcus spp. were methicillin resistant, but all were sensitive to vancomycin. Conclusion. The surge in the number of gram-negative infections emphasizes the need for broad-spectrum empirical therapy targeting the same. Rate of resistance of the isolated gram-negative organisms to the routinely used empirical therapy is alarming. Prudent use of antibiotics, based on culture reports wherever possible, is of utmost importance to save the lives of infected patients and prevent further development of antibiotic resistance.

Epidemiological Profile and Detection of Resistance Genes in Bloodstream Infection in Cancer Patients: High Occurrence of Metallo-β-lactamases in Enterobacteriales

“…BGNs showed greater resistance to aminopenicillins, fourth generation cephalosporins, uoroquinolones, second and rst generation cephalosporins and aminoglycosides, in agreement with the results of a study in India carried out with 66 cases of bloodstream infection 40 . Increased resistance to carbapenems, combinations of beta-lactamase inhibitors, beta-lactamase, aminoglycosides, uoroquinolones and cephalosporins (including high resistance to cefepime) has been observed 41 .…”

“…And the occurrence of vancomycin-resistant Enterococcus was 7,7%, similar to that found by Bhat et al, (2021) 40 . The prevalence of vancomycin-resistant enterococci (VRE) has become stable or decreasing after 2012 42 .…”

“…The epidemiology of the occurrence of bacteremia in cancer patients has changed over time and has been characterized by a change in the pro le from gramnegative bacteria (1960s to 1970s) to gram-positive bacteria (1980s). Gram-negative bacteria have been predominant as the main agents of bloodstream infections in cancer patients in the last two decades on the global stage 40,41 .…”

Synthesis and Evaluation of Some New 4H-Pyran Derivatives as Antioxidant, Antibacterial and Anti-HCT-116 Cells of CRC, with Molecular Docking, Antiproliferative, Apoptotic and ADME Investigations

“…Cancer patients who are undergoing anticancer treatment have severely weakened immune systems; thus, they are more vulnerable to bacterial infections and their life-threatening complications. A previous retrospective surveillance study revealed that the most common associated bacterial pathogens were Klebsiella pneumonia and Enterococcus faecium (bloodstream), Pseudomonas aeruginosa (respiratory tract), Escherichia coli (in urinary tract), Staphylococcus aureus and S. epidermidis (skin and soft tissues) [ 18 ]. It is worth noting that some of these microbes are rather difficult to treat, as they are considered to be drug-resistant isolates [ 19 ].…”

Antioxidant Activities of Artemisia Absinthium and Citrus Paradisi Extracts Repress Viability of Aggressive Liver Cancer Cell Line

“…Oxidative stress promotes genomic instability, tumorigenesis, metastasis, and cancerous cell proliferation [3,4]. The cancer patients being immunosuppressed are more vulnerable to get bacterial infection [5]. Therefore, consideration of both anticancer and antibacterial aspects of treatment is mandatory.…”