Bacteremia in febrile cancer patients in Uganda

Abstract

Objective The aim of this study was to determine the predominant bacterial species causing bacteremia among febrile cancer patients, and their antibacterial resistance profiles at the Uganda Cancer Institute. Results We enrolled in-patients with a documented fever (≥ 37.5 °C). Bacteria from positive blood cultures were identified using standard methods biochemically. Antibacterial susceptibility testing was performed with the Kirby–Bauer disc diffusion method. From a total of 170 febrile episodes, positive blood cultures were obtained from 24 (14.1%). A positive culture was more likely to be obtained from a patient with neutropenia (P = 0.017). Of 22 (66.7%) Gram-negative bacteria isolated, half were E. coli (n = 11). Gram-negative compared to Gram-positive bacteria were most likely to be isolated from patients with a hematologic malignancy (P = 0.02) or patients with neutropenia (P = 0.006). Of the isolated Enterobacteriaceae 85% (n = 20) were resistant to three or more classes of antibiotic and 41% (n = 7) had extended spectrum beta-lactamases. Of the 11 Gram-positive bacteria isolated, the S. aureus isolate was methicillin resistant but susceptible to vancomycin. Multidrug resistant Gram-negative bacteria are the main cause of bacteremia in febrile cancer patients at the Uganda Cancer Institute. There is need for ongoing microbial surveillance, infection prevention and control, and antibiotic stewardship programs.

<p>Prevalence of Extended-Spectrum Beta-Lactamase-Producing <em>Enterobacteriaceae</em> Causing Bloodstream Infections in Cancer Patients from Southwest of Iran</p>

“…In this study, 16.4% of patients suffering from hematological and solid organ malignancies had BSI which was lower than the previous study by Obeng-Nkrumah et al 3 from Ghana who reported the BSI in 22% of cancer patients and higher than the report by Lubwama et al 15 from Uganda who showed the BSI in 14.1% of cancer patients.…”

Microbiological Profile of Blood Stream Infections in Febrile Neutropenic Patients at a Tertiary Care Teaching Hospital in Rishikesh, Uttarakhand

“…Similar findings have been reported by various authors from different parts of the world. 3,[20][21][22][23][24][25][26][27][28] However, there is no specific explanation for this finding. The most common age group of patients in this study was 0 to 10 years which is in agreement with the study conducted by Kamonrattana et al 28 More number of FN patients in our study, had underlying hematological as compared with nonhematological malignancies (solid tumors).…”

“…Similar trend has also been reported by several other studies. [23][24][25]27,32 Varying resistance to different antibiotics was observed among gram-negative and positive bacteria, respectively. Among gram-negative bacilli, percentage resistance to aminoglycosides, β-lactam/β-lactamase inhibitor combinations, fluoroquinolones, cephalosporins, carbapenems, chloramphenicol, ampicillin, co-trimoxazole, and doxycycline was 26.6 to 91.7%, 8.3 to 86.6%, 10 to 66.7%,13.3 to 73.3%, 8.3 to 73.3%, 80 to 93.3%, 13.3 to 20%, 16.7 to 66.6%, and 13.3 to 16.7%, respectively.…”

Prevalence, predictors, and mortality of bloodstream infections due to methicillin-resistant Staphylococcus aureus in patients with malignancy: systemic review and meta-analysis

“…Among a subset of 23 studies that contained data on 3690 Gram-positive BSI cases, the MRSA isolation rate in Gram-positive bacteria was 10% (95% CI 6-14%) (5,13,(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(48)(49)(50). In 15 studies whose number of S. aureus was more than 10, the pooled prevalence of MRSA among S. aureus was 44% (95% CI 32-57%) (5,13,29,33,35,37,39,(42)(43)(44)(45)(46)(47)(48)(49).…”