Antimicrobial Resistance Pattern and Spectrum of Multiple-drug-resistant Enterobacteriaceae in Iranian Hospitalized Patients with Cancer

Abstract

Background:Nosocomial infections are one of the most leading causes of morbidity and mortality in patients with cancer. The emergence of multiple-drug-resistant (MDR) strains of Gram-negative bacteria causing nosocomial infection has become a serious concern in cancer patients. Therefore, the present study aimed to determine the spectrum and antibiotic resistance pattern of Gram-negative bacteria related nosocomial infections among Iranian cancer patients.Materials and Methods:This descriptive cross-sectional study was conducted during the 6 months from December 2015 to May 2016 in two tertiary care centers located in Isfahan and Arak Province. Gram-negative bacteria obtained from different clinical specimens from hospitalized patients with cancer and were identified using standard microbiological methods. Antibiotic susceptibility pattern was determined by the disk diffusion method according to the Clinical and Laboratory Standards Institute (CLSI) recommendation.Results:Of totally 259 culture positive cases, Escherichia coli showed the highest isolation rate (60.6%) followed by Klebsiella pneumoniae (26.6%) and Proteus spp (11.2%). The rate of MDR isolates were 91.5% (237/259). Overall, the most frequent source of bacterial isolation was urinary tract infection (65.6%) followed by skin and soft-tissue infection (23.6%). The antibiotic susceptibility results showed meropenem (MEN) and ceftazidime as the most effective antibiotics for E. coli, K. pneumoniae, and Proteus spp. isolates. Moreover, MEN was the most effective antibiotic against MDR isolates.Conclusion:The study findings showed a significant distribution of MDR Gram-negative bacteria which may increase the burden of healthcare-associated infections in cancer patients. Although, carbapenem can be considered as effective agents toward MDR strains for empirical antibiotic therapy in our region.

Urinary tract infection in cancer patients and antimicrobial susceptibility of isolates in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

“…This finding was in agreement with the study conducted in Egypt (30%) and India (40%) [ 19 , 20 ]. However, this finding was lower (60.6%) than the study documented in Iranian cancer patients [ 21 ] and higher than (21.2%) the study recorded in Gondar [ 14 ]. The second frequently isolated gram-negative bacteria were Klebsiella pneumonia (22.2%) which is in lined with the study documented by Ashour and El-Sharif [ 19 ].…”

“…Intriguingly, we did not identify any gram positive bacteria and Pseudomonas aeruginosa from gram negative bacteria in our study participants even if these uropathogen were a commonly isolated as etiologic agent of UTI [ 21 – 23 ].…”

Antimicrobial Resistance Profiles for Different Isolates in Aden, Yemen: A Cross-Sectional Study in a Resource-Poor Setting

“…It is an expected outcome due to the worldwide existence and prevalence of multidrug-resistant clones [48][49][50]. Similarly, a study in Iranian hospitalized patients with cancer showed significant spreading of MDR gram-negative bacteria, which may raise the problem of healthcare-associated infections in cancer patients [51,52].…”

Bacterial Profile and Antibiotic Resistance among Cancer Patients with Urinary Tract Infection in a National Tertiary Cancer Hospital of Nepal

“…There is increasing evidence from different parts of the world of the high prevalence of antimicrobial resistance (AMR) in cancer patients [ 1 , 2 , 3 , 4 , 5 ]. Patients with cancers are immunosuppressed and therefore at a high risk of serious opportunistic infections [ 6 ].…”