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

Abstract

Cancer patients are at high risk of antibiotic resistant bacterial urinary tract infections (UTIs). In this study, we assessed the bacterial profile and antibiotic resistance among cancer patients suspected of UTI in B.P. Koirala Memorial Cancer Hospital in Nepal through a cross-sectional study with routinely collected data. All cancer patients who had a recorded urine culture between July 2018–June 2019 were included in the study. Out of 308 patients who had undergone culture, 73 (24%) of samples had bacterial growth. The most common organisms isolated were E. coli (58%), Staphylococcus (11%) and Klebsiella (10%). These bacteria had undergone susceptibility testing to 27 different antibiotics in various proportions. Of the limited antibiotic testing levels, nitrofurantoin (54/66, 82%) and amikacin (30/51, 59%) were the most common. Among those tested, there were high levels of resistance to antibiotics in the “Access” and “Watch” groups of antibiotics (2019 WHO classification). In the “Reserve” group, both antibiotics showed resistance (polymyxin 15%, tigecycline 8%). Multidrug resistance was seen among 89% of the positive culture samples. This calls for urgent measures to optimize the use of antibiotics in UTI care at policy and health facility levels through stewardship to prevent further augmentation of antibiotic resistance among cancer patients.

The Causative Organism of Urinary Tract Infections UTI: a Cross-sectional Study from a Tertiary Hospital In Saudi Arabia

“…Indeed, this emerges as the most common cause among patients admitted with UTI, in general and for those with diabetes, CKD/ESRD, and oncology patients on active treatment. These findings are distinct and incongruent with other studies in which E. coli was the most prevalent uropathogen, followed by Klebsiella and Staphylococcus [15][16][17][18].…”

Efficacy of Urine Dipstick Test in Diagnosing Urinary Tract Infection and Detection of the blaCTX-M Gene among ESBL-Producing Escherichia coli

“…It has been estimated that at least 40% to 50% of women will experience a minimum of one symptomatic UTI with roughly 27% to 48% of affected women experiencing recurrent UTIs [ 3 ]. A UTI is a severe public health problem caused by a variety of pathogens, but most frequently by Escherichia coli followed by Klebsiella pneumoniae , Proteus mirabilis , Enterococcus faecalis , Staphylococcus saprophyticus , Staphylococcus aureus , and Pseudomonas aeruginosa [ 4 , 5 , 6 ].…”

Risk Factors for Infections, Antibiotic Therapy, and Its Impact on Cancer Therapy Outcomes for Patients with Solid Tumors

“…UTIs are common in cancer patients due to cancer therapy, immunosuppression, and indwelling urinary catheters [187][188][189]. Importantly, the urinary tract is the source of ~20% of bloodstream infections in cancer patients [152,153].…”

“…(8-11%), Staphylococcus spp. (11%), and P. mirabilis (1-5%) [187,188]. Multidrug resistance is frequent in cancer patients with UTIs (96%) [188].…”

“…(11%), and P. mirabilis (1-5%) [187,188]. Multidrug resistance is frequent in cancer patients with UTIs (96%) [188]. A high proportion of resistance to fluroquinolones (90-96%), cephalosporins (68-80%), and aminoglycosides (46-50%) has been observed [189,190].…”