Rare bacterial isolates causing bloodstream infections in Ethiopian patients with cancer

Abstract

BackgroundIn recent years, saprophytic bacteria have been emerging as potential human pathogens causing life-threatening infections in patients with malignancies. However, evidence is lacking concerning such bacteria, particularly in sub-Saharan countries. This study was designed to determine the spectrum and drug resistance profile of the rare bacterial pathogens causing bloodstream infections (BSIs) in febrile cancer patients at a referral hospital in Ethiopia.MethodsBetween December 2011 and June 2012, blood samples were collected from 107 patients with cancer in Tikur Anbessa hospital. Culturing was performed using the blood culture bottles and solid media and the microorganisms were identified using the gram staining and APINE identification kits (Biomerieux, France). The disk diffusion method was used for the antimicrobial susceptibility testing.ResultsOverall, 13 (12.2%) rare human pathogens were isolated from 107 adult febrile cancer patients investigated. Aeromonas hydrophilia species (a fermentative gram-negative rod) was the predominant isolate, 30.8% (4/13), followed by Chryseomonas luteola 15.4% (2/13), Sphignomonas poucimobilis 15.4% (2/13), and Pseudomonas fluorescens 15.4% (2/13). Of the nine isolates tested for a nine set of antibiotics, 89% were resistant to amoxicillin-clavulanic acid, ampicillin, and trimethoprim-sulphamethoxazole.ConclusionsThis study revealed the emergence of saprophytic bacteria as potential drug-resistant nosocomial pathogens in Ethiopian patients with cancer. As these pathogens are ubiquitous in the environment, infection prevention actions should be strengthened in the hospital and early diagnosis and treatment with appropriate antibiotics are warranted for those already infected.

<p>Distinct Antimicrobial Resistance Profiling Of Clinically Important <em>Aeromonas</em> Spp. In Southwest China: A Seven-Year Surveillance Study</p>

“…To date, data of Aeromonas bacteremia in mainland China are lacking, while this present study illustrated A. hydrophila complex was predominant in Aeromonas bacteremia. This is consistent with the results of studies in Korean peninsula and Ethiopia13,25 but contrasts with a 16-year retrospective study in Japan with the predominance of A. caviae 26. Since most of Aeromonas bacteremia were secondary to hepatobiliary tract infections and peritonitis and our present data showed A. hydrophila complex was predominant in bile and ascites, it is supposed that the heterogeneity of primary infections and immune state of patients should be blamed for this discrepancy in Aeromonas bacteremia.…”

Bacterial Profile among Patients with Suspected Bloodstream Infections in Ethiopia: A Systematic Review and Meta-Analysis

“…The included studies were conducted in four regions (Amhara, Tigray, Oromia, and Southern Nations, Nationalities, and Peoples' Region (SNNPR)) and from the two self-administrative cities (Addis Ababa and Dire Dawa). Of the 26 studies that fulfilled the review inclusion criteria [ 7 , 11 , 14 , 16 , 35 , 36 , 38 – 52 , 55 ], eleven studies were conducted in Amhara region [ 7 , 8 , 11 , 14 , 36 , 40 , 44 , 45 , 52 – 54 ], nine in Addis Ababa [ 16 , 41 , 43 , 46 , 48 – 50 , 55 , 56 ], three in Oromia region [ 35 , 38 , 42 ], and a single study from Tigray [ 39 ], Dire Dawa [ 51 ], and SNNPR [ 47 ]. The sample size of individual studies ranged from 83 [ 53 ] to 856 [ 36 ].…”

Microbial spectrum and drug-resistance profile of isolates causing bloodstream infections in febrile cancer patients at a referral hospital in Addis Ababa, Ethiopia

“…Except for a single report on rare bacterial pathogens by the same authors, 18 to our knowledge, this study is the first comprehensively to address microbial spectrum and drug-susceptibility patterns of pathogens causing BSIs in cancer patients from Ethiopia. Gram-positive bacteria (60%) were found to be the predominant pathogens causing BSIs among febrile cancer patients in our study setting.…”

“… 5 , 17 Unlike this fact, in our study setting, almost all cancer patients with febrile episodes start empirical antibacterial therapy, and possible regimen change is done based on the clinical response of patients. Apart from our previous report on rare (uncommon) bacterial infections in the same setting, 18 to our knowledge there has been no comprehensive study to investigate the microbial spectrum and drug-resistance profile of pathogens causing BSIs in cancer patients from Ethiopia. This study determined the microbial spectrum and drug-resistance profile of pathogens causing BSIs in febrile cancer patients at a referral hospital in Ethiopia.…”