Etiological Characteristics in Causative Agents of Infectious Complications in Cancer Patients

Abstract

Background. Infectious complications are the most frequent and severe among all complications in cancer patients. The development of fungal-bacterial infections is particularly difficult. The aim was to develop an etiological description for the causative agents of infectious complications in oncological patients. Materials and methods. The study was conducted from January, 2020 to December (inclusive both dates), 2021. 3662 hospitalized patients (men and women) aged from 1 to 85 years with clinical manifestations of an infection were examined. The traditional microbiological method was used to clarify the etiology of the infectious process and to verify the pathogen. Phenotypic and real-time PCR methods were used for detection of carbapenemase and ESBL production. Results. The organs of the respiratory system, skin, soft tissues, and blood are most susceptible to infectious complications. In the etiology of infectious complications, the leading place is occupied by gram-negative bacteria. The conducted microbiological study made it possible to establish that resistance to cephalosporins and carbapenems in enterobacteria is realized through various resistance mechanisms. Extended-spectrum β-lactamases and carbapenemases are particularly relevant and concerning. Monitoring revealed the growth of carbapenemase-producing isolates of Klebsiella pneumoniae (34.9%), the spread of carbapenemase among Escherichia coli strains (5.1%), the increase in the spread of Acinetobacter baumannii strains with the production of NDM groups (32.6%). Conclusion. Prescription of antibacterial drugs should be based only on the results of microbiological diagnostics. The current situation requires modern methods of microbiological diagnostics: the use of only up-to-date (periodically updated) criteria for determining sensitivity to antimicrobial drugs, as well as the introduction of phenotypic tests that provide reliable information without molecular genetic methods.