Abstract
BackgroundNosocomial infections pose significant threats to hospitalized patients, especially the immunocompromised ones, such as cancer patients.MethodsThis study examined the microbial spectrum of gram-negative bacteria in various infection sites in patients with leukemia and solid tumors. The antimicrobial resistance patterns of the isolated bacteria were studied.ResultsThe most frequently isolated gram-negative bacteria were Klebsiella pneumonia (31.2%) followed by Escherichia coli (22.2%). We report the isolation and identification of a number of less-frequent gram negative bacteria (Chromobacterium violacum, Burkholderia cepacia, Kluyvera ascorbata, Stenotrophomonas maltophilia, Yersinia pseudotuberculosis, and Salmonella arizona). Most of the gram-negative isolates from Respiratory Tract Infections (RTI), Gastro-intestinal Tract Infections (GITI), Urinary Tract Infections (UTI), and Bloodstream Infections (BSI) were obtained from leukemic patients. All gram-negative isolates from Skin Infections (SI) were obtained from solid-tumor patients. In both leukemic and solid-tumor patients, gram-negative bacteria causing UTI were mainly Escherichia coli and Klebsiella pneumoniae, while gram-negative bacteria causing RTI were mainly Klebsiella pneumoniae. Escherichia coli was the main gram-negative pathogen causing BSI in solid-tumor patients and GITI in leukemic patients. Isolates of Escherichia coli, Klebsiella, Enterobacter, Pseudomonas, and Acinetobacter species were resistant to most antibiotics tested. There was significant imipenem -resistance in Acinetobacter (40.9%), Pseudomonas (40%), and Enterobacter (22.2%) species, and noticeable imipinem-resistance in Klebsiella (13.9%) and Escherichia coli (8%).ConclusionThis is the first study to report the evolution of imipenem-resistant gram-negative strains in Egypt. Mortality rates were higher in cancer patients with nosocomial Pseudomonas infections than any other bacterial infections. Policies restricting antibiotic consumption should be implemented to avoid the evolution of newer generations of antibiotic resistant-pathogens.
Highlights
Nosocomial infections pose significant threats to hospitalized patients, especially the immunocompromised ones, such as cancer patients
Patient specimens Non-duplicate clinical specimens from urine, pus, blood, sputum, chest tube, Broncho-Alveolar Lavage (BAL), throat swabs, and skin infection (SI) swabs were collected from patients at the National Cancer Institute (NCI), Cairo, Egypt
Several organisms contributed to Bloodstream Infections (BSI) in leukemic patients
Summary
Nosocomial infections pose significant threats to hospitalized patients, especially the immunocompromised ones, such as cancer patients. Hospital-acquired (nosocomial) infections pose significant threats to hospitalized patients, especially the immunocompromised ones [1]. They cost the hospital managements significant financial burdens [1,2]. Limited information is available regarding the spectrum and microbiology of these infections in sites other than the bloodstream, such as the urinary tract, respiratory tract, gastro-intestinal tract, and the skin. This is despite the fact that these infections are not rare
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