Microbial and Antibiotic Susceptibility Profile among Isolates of Clinical Samples of Cancer Patients admitted in the Intensive-care Unit at Regional Tertiary Care Cancer Center: A Retrospective Observational Study

Abstract

Cancer patients in intensive care unit (ICU) are vulnerable for developing multidrug resistant nosocomial infections. The antimicrobial resistance due to inappropriate use of antibiotics results in significant morbidity and mortality in these cancer patients. The present retrospective study was done to describe the antimicrobial sensitivity pattern of common organisms in isolates of clinical samples of patients admitted in ICU at our tertiary care cancer center. Materials and methods The study was carried out at ICU of a regional tertiary care cancer center for a period of 1 year from October 2016 to September 2017. All clinical samples were collected and processed for culture and antibiotic susceptibility testing were carried out on isolates as per Clinical Laboratory Standard Institute guidelines. Results A total of 644 specimens were collected. Escherichia coli, Acinetobacter spp., Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus and Enterococcus spp. were most commonly encountered. In positive bacterial cultures, majority were Gram-negative isolates (84.14 %). Klebsiella was the most common gram-negative isolate (34.78%) and Enterococcus spp. were the most common Gram-positive isolates (61.53%). A high level of resistance to various antibiotics was noted among Gram-negative bacteria compared to Gram-positive isolates. Majority of the Gram-negative isolates were sensitive to Imipenem, Meropenem, and Colistin sensitivity among Gram-negative isolates was 100%. Linezolid, Teicoplanin and Vancomycin were most sensitive antimicrobials against the Gram-positive bacteria. Conclusion Regular monitoring of the pattern of resistance of bacteriological isolates in cancer patients is critical to develop antibiotic policy to combat these infections and reduce morbidity and mortality. How to cite this article Garg VK, Seema M et al . Microbial and Antibiotic Susceptibility Profile among Isolates of Clinical Samples of Cancer Patients admitted in the Intensive-care Unit at Regional Tertiary Care Cancer Center: A Retrospective Observational Study. Indian J of Crit Care Med 2019;23(2):67-72.

Bacterial profiling and antibiotic-resistant pattern among cancer patients

“…This finding is slightly higher than the study conducted by Naznzeen et al; where S.aureus was reported at 65.38% among gram-positive isolates. (7) This finding was rather different from the prevalence rate in a study done by Kumar et al [25] In this study, E.coli 34.0% reported the highest growth in the pus sample which is in contrast to many studies where E.coli was reported low 13%, [26] 8.3%, [27] 16.5% [28] and 14.0%. [29] Similarly, in the urine sample, the predominant isolate observed was E.coli 55.8 % in this study which is similar to a study done by Shrestha et al where E.coli was reported at 58.0% in urine samples.…”

Bacterial Infection among Cancer Patients: Analysis of Isolates and Antibiotic Sensitivity Pattern

“…They noted that 50% of Enterococcus were vancomycin resistant, whereas, in our study, only 8.3% of Enterococcus were vancomycin-resistant enterococci (VRE). This may be attributed to the fact that vancomycin is not used for empirical prophylactic therapy in our hospital settings [ 16 ].…”

Epidemiology and Microbiological Profile of Common Healthcare Associated Infections among Patients in the Intensive Care Unit of a General Hospital in Kuwait: A Retrospective Observational Study

“…They often undergo invasive procedures such as intra-tracheal intubation for mechanical ventilation, insertion of intravascular and urinary catheters, using monitoring devices as part of a routine or to closely monitor and deliver therapies resulting in Device-associated Hospital-acquired Infections (DA-HAIs) in some of the patients, especially if proper care-bundle is not observed [1,2]. Furthermore, there are usually several other risk factors in these patients making them vulnerable to develop nosocomial infections leading to high morbidity and mortality [3,4]. The rate of occurrence of infection among patients in the ICU is five to sevenfold higher as compared to general inpatient admissions contributing to 20-25% of all nosocomial infections in a hospital [5][6][7].…”

“…The type of infection, the profile of pathogens causing these infections, their antimicrobial susceptibility patterns also vary according to the location. It is, therefore, imperative for the treating clinician to have adequate information of the spectrum of microorganisms and the AMR patterns prevalent in that particular setting for initiating empirical therapy with appropriate antimicrobial agents [ 3 ].…”