Bacterial Pattern and Susceptibility of Antimicrobial Agents in Cancer Patient with Infection

Abstract

Introduction: Cancer patients are most vulnerable to develop infection during anticancer therapy which could be life threatening. Therefore, prompt administration of appropriate antimicrobial drug therapy is often essential to prevent mortality and morbidity in such patients. Spectrum of the infection causing organisms is continuously changing throughout the world along with their susceptibility to antimicrobials drugs. Aims: The aims of the study were to identify the bacterial pattern and their susceptibility to antimicrobials in cancer patients with infection and to help develop a guideline for the rational and appropriate use of antimicrobial in these patients. Materials and methods: It was an observational study conducted from January 2013 to December 2014 at the National Institute of Cancer Research and Hospital (NICRH), Mohakhali, Dhaka. We evaluated 517 blood and other specimens from cancer patients of both sexes and all ages under anticancer therapy suspected of having infection. Result: Blood culture was done in 53 patients of them 8 (15.09%) were proved to be culture positive. In case of urine and wound culture the rates of positivity were 37.79% & 73.98% respectively. In suspected cases culture for anaerobic organism was done but no such organism was found. Major isolated organisms in different cultures were E. coli, Staphylococcus aureus, Pseudomonas and Proteus. Imipenem, gentamicin, cotrimoxazole were the most sensitive antibiotics. However, in most cases amoxicillin, cephalexin and nalidixic acid were mostly resistant. Conclusion: Empirical use of amoxicillin or cephalexin is usually not useful and routine use of anaerobic culture is not necessary.