Cumulative antimicrobial susceptibility data for a tertiary-level paediatric oncology unit in Johannesburg, South Africa

Knorring, Nina von; Nana, Trusha

doi:10.4102/sajo.v3i0.65

Cited by 7 publications

(8 citation statements)

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“…Multidrug-resistant was detected in more than 80% of all the A. baumannii isolates. The high MDR rates are in accordance with other South African studies (Lowings et al, 2015;Lowe et al, 2018;Law et al, 2019;Von Knorring et al, 2019; 10.3389/fmicb.2022.863129 Anane et al, 2020;Nogbou et al, 2022). The detection of nine colistin resistance isolates (9.4%) is worrisome as this is one of the last-resort antibiotics.…”

Section: Resistancenodulation-division Adeabc and Adefghsupporting

confidence: 91%

Molecular characterisation of Acinetobacter baumannii isolates from bloodstream infections in a tertiary-level hospital in South Africa

et al. 2022

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Acinetobacter baumannii is an opportunistic pathogen and causes various infections in patients. This study aimed to describe the clinical, epidemiological and molecular characteristics of A. baumannii isolated from BCs in patients at a tertiary-level hospital in South Africa. Ninety-six isolates from bloodstream infections were collected. Clinical characteristics of patients were recorded from patient files. Organism identification and AST was performed using automated systems. PCR screening for the mcr-1 to mcr-5 genes was done. To infer genetic relatedness, a dendrogram was constructed using MALDI-TOF MS. All colistin-resistant isolates (n = 9) were selected for WGS. The patients were divided into three groups, infants (<1 year; n = 54), paediatrics (1–18 years; n = 6) and adults (≥19 years; n = 36) with a median age of 13 days, 1 and 41 years respectively. Of the 96 A. baumannii bacteraemia cases, 96.9% (93/96) were healthcare-associated. The crude mortality rate at 30 days was 52.2% (48/92). The majority of the isolates were multidrug-resistant (MDR). All isolates were PCR-negative for the mcr-1 to mcr-5 genes. The majority of the isolates belonged to cluster 1 (62/96) according to the MALDI-TOF MS dendrogram. Colistin resistance was confirmed in nine A. baumannii isolates (9.4%). The colistin-resistant isolates belonged to sequence type (ST) 1 (5/6) and ST2 (1/6). The majority of ST1 isolates showed low SNP diversity (≤4 SNPs). All the colistin-resistant isolates were resistant to carbapenems, exhibited an XDR phenotype and harboured the blaOXA–23 gene. The blaNDM gene was only detected in ST1 colistin-resistant isolates (n = 5). The lpsB gene was detected in all colistin-resistant isolates as well as various efflux pump genes belonging to the RND, the MFS and the SMR families. The lipooligosaccharide OCL1 was detected in all colistin-resistant ST1 and ST2 isolates and the capsular polysaccharide KL3 and KL17 were detected in ST2 and ST1 respectively. This study demonstrated a 9.4% prevalence of colistin-resistant ST1 and ST2 A. baumannii in BC isolates. The detection of the lpsB gene indicates a potential threat and requires close prospective monitoring.

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Section: Resistancenodulation-division Adeabc and Adefghsupporting

confidence: 91%

Molecular characterisation of Acinetobacter baumannii isolates from bloodstream infections in a tertiary-level hospital in South Africa

et al. 2022

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“…Oncology patients on chemotherapy are at particular risk for bacterial, and fungal infections and bloodstream infection remains the leading cause of morbidity and mortality in patients undergoing treatment for cancer which causes life-threatening complications and a significantly elevated risk of infection-related death [1][2][3]. More than half of all cancer cases and about 60% of deaths occur in developing countries [4,5].…”

Section: Introductionmentioning

confidence: 99%

“…Bacterial BSIs and antimicrobial resistance frequently result in treatment failure and prolonged infections in cancer patients [16][17][18]. The most common bacterial isolates from patients with cancer were S. aureus, A. baumannii, K. pneumoniae, P. aeruginosa, and E. coli [1][2][3]. S. aureus is one of the major pathogens of humans causes various suppurative diseases, food poisoning, pneumonia, sepsis, and toxic shock syndrome by producing many virulence factors, including toxins (αtoxin, β-toxin, δ-toxin, P-V Leukocidin, enterotoxin, exfoliative toxin, and toxic shock syndrome toxin), enzymes (coagulase, proteases, lipase, hyaluronidase, staphylokinase, and nuclease), antigens (capsule, protein A, fibrin binding protein, and adhesins), immune-modulatory factors, and iron acquisition factors [19][20][21].…”

Section: Introductionmentioning

confidence: 99%

Bacterial profile and antimicrobial susceptibility patterns in cancer patients

2022

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Background Bloodstream infections have been the leading complications in cancer patients because they are at high risk for antibiotic-resistant bacterial infections. There is increasing evidence from different parts of the world of the high prevalence of antimicrobial-resistant bacterial strains in cancer patients. The burden of the infection is high in developing countries, especially in Ethiopia. Data on bacterial profile and antimicrobial susceptibility patterns among cancer patients in Ethiopia is limited. Thus, this study aimed to determine the predominant bacterial species causing bacteremia and their antibiotic resistance pattern among cancer patients at University of Gondar comprehensive specialized hospital. Methods A hospital-based, cross-sectional study was conducted on 200 study participants from March to July 2021. All cancer patients who developed a fever at the time of hospital visit were included in this study, and their socio-demographic and clinical data were collected using a structured questionnaire. Blood samples (10 mL for adults and 4 mL for children) were collected from each patient, and the collected blood samples were transferred into sterile tryptic soy broth, then incubated at 37°C for 7 days. Tryptic soy broth which showed signs of growth were Gram-stained and sub-cultured on blood agar, chocolate agar, MacConkey agar, and mannitol salt agar. The inoculated plates were then aerobically incubated at 37°C for 18–24 hours and the isolates obtained were identified using standard microbiological methods. Antimicrobial susceptibility tests were done using a modified Kirby-Bauer disk diffusion technique following CLSI 2021 guidelines. Data were entered using EPI data version 4.6 and analyzed with SPSS version 20. Results In this study, out of 200 cancer patients included and 67.5% (135/200) of them were males. The majorities of study participants, 56% (113/200) of cancer patients were pediatrics and 26.5% (53/200) of them belong under five years of age. Out of 200 patient samples that had undergone culture, 27% (54/200) samples had bacterial growth. Gram-positive bacterial isolates were predominant, 61.1%, and S. aureus was the predominant Gram-positive isolate, (51.5.6%), followed by coagulase-negative staphylococci (48.5%). Moreover, K. pneumoniae (47%) and P. aeruginosa (29.5%) were the most common Gram-negative bacterial isolates. Among patients who had BSIs, the highest prevalence of BSIs was observed among males (66.7%), and in pediatrics cancer patients (44.2%). Pediatric study participants were more venerable to bloodstream infection (P = 0.000) compared to adult participants. Meropenem (100%), amikacin (100%), piperacillin/tazobactam (72.3%), and ceftazidime (73.5%) were effective against for Gram-negative isolates while cefoxitin (81.2%) and penicillin (70.5%) were effective for Gram-positive isolates. Additionally, most Gram-negative and Gram-positive bacterial isolates were sensitive for gentamycin (75.9%). Multidrug resistance was seen among 17.1% bacterial isolates, and MDR in Gram-negative and Gram-positive bacteria were 83.3% and 16.7%, respectively. Gram-negative bacterial isolates showed a high prevalence of MDR than Gram-positive isolates. Conclusions and recommendation BSI’s remains an important health problem in cancer patients, and Gram-positive bacteria were more common as etiologic agents of BSIs in cancer patients. S. aureus was the dominant bacteria followed by CoNS, K. pneumoniae, and P. aeruginosa. Multidrug-resistant isolates found in cancer patients and routine bacterial surveillance and study of their resistance patterns may guide successful antimicrobial therapy and improve the quality of care. Therefore, strict regulation of antibiotic stewardship and infection control programs should be considered in the study area.

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“… 12 High rates of AMR at our institution have resulted in broad spectrum antimicrobials being used as empiric therapy. 13 , 14 The statistically significant increase in azole resistance over the five-year study period is of concern. We have previously published data from our laboratory demonstrating the variable sensitivity of the BDG assay for detecting different species causing candidemia.…”

Section: Discussionmentioning

confidence: 99%

Incidence of candidemia and prevalence of azole-resistant candidemia at a tertiary South African hospital – A retrospective laboratory analysis 2016–2020

Chibabhai

2022

Southern African Journal of Infectious Diseases

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Coupled with the limited number of antifungal classes for management of fungal infections is the limited access to available antifungal agents in many countries worldwide. 2 This is becoming increasingly important with the changing epidemiology of candidemia, with species distribution Background: Candidemia is associated with high morbidity and mortality. The epidemiology of candidemia has changed globally over the past 20 years. South African surveillance demonstrated a shift in epidemiology from Candida albicans to non-albicans species including Candida parapsilosis and Candida auris. Hospital-level candidemia incidence from South Africa has not been reported previously. Methods:We performed a retrospective laboratory-based analysis of blood cultures with confirmed causative agents of candidemia. Ward type, department, gender and admission to critical care units were captured. Data were analysed in Microsoft Excel, Statistical Package for the Social Sciences (SPSS) and Epitools. Results:The incidence of candidemia during the study period was 2.87 per 1000 admissions. The total proportion of non-albicans species causing candidemia was 425/618 (69.7%). Overall, 65.4% of candidemia cases occurred in non-critical care units. There was a significant increase in the proportion of C. auris isolates between 2016 and 2020 (p < 0.001). Isolation of C. auris was associated with admission to critical care units (p < 0.001, odds ration [OR] 3.856, 95% confidence interval [CI]: 2.360-6.300). The proportion of azole-resistant candidemia cases increased from 21/53 (39.6%) in 2016 to 41/59 (69.5%) in 2020 (p = 0.002). Conclusion:The incidence of candidemia remained stable over the five-year study period. However, the proportion of C. auris isolates increased significantly during the study period as did the overall proportion of azole-resistant candidemia. Antifungal stewardship and continued hospital-level surveillance are imperative.

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Cumulative antimicrobial susceptibility data for a tertiary-level paediatric oncology unit in Johannesburg, South Africa

Cited by 7 publications

References 30 publications

Molecular characterisation of Acinetobacter baumannii isolates from bloodstream infections in a tertiary-level hospital in South Africa

Molecular characterisation of Acinetobacter baumannii isolates from bloodstream infections in a tertiary-level hospital in South Africa

Bacterial profile and antimicrobial susceptibility patterns in cancer patients

Incidence of candidemia and prevalence of azole-resistant candidemia at a tertiary South African hospital – A retrospective laboratory analysis 2016–2020

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