Antibiotic Susceptibility Pattern Among Cancer Patients with Urinary Tract Infection at a Tertiary Cancer Hospital in Nepal
Abstract
Background: Cancer patients are at a higher risk of infection due to the nature of treatment modalities used that lead to immunosuppression. Urinary tract infections are the most common cause of morbidity among cancer patients.
Objective: The objective of this study is to determine antibiotic sensitivity and resistance pattern in cancer patients with urinary tract infections at a tertiary cancer hospital in Nepal.
Method: A retrospective analysis was conducted on cancer patients with urinary tract infections from September 2020 to June 2024 at a tertiary cancer hospital in Nepal. Antibiotic susceptibility testing was performed using the Kirby-Bauer disk diffusion method. Data on positive urine cultures were extracted from the medical laboratory system. Bacterial profiles and antibiotic susceptibility test results were assessed. Data were analyzed using R-statistical software.
Result: A total of 613 urine cultures were performed during the study period among which 116 were positive cultures. After excluding ineligible cultures, 102 (16.63%) positive cultures from 97 patients were included. Most of the patients were females (79.38%). The most common cancers were gynecological (43.39%) followed by genitourinary (9.28%), central nervous system (9.28%) and lung (8.25%) cancers. The most isolated bacteria were Escherichia coli (62.88%) followed by Klebsiella pneumonia (14.43%). The most sensitive antibiotics were Amikacin (68.42%), Nitrofurantoin (63.54%), Gentamicin (41.43%), Co-trimoxazole (40.63%), Ofloxacin (38.10%), Amoxicillin/Clavulanate (31.51%), Norfloxacin (26.09%), Ciprofloxacin (20.93%), Cefixime (13.85%) and Amoxicillin (8.33%) while the antibiotics in reverse order were most resistant antibiotics among top 10 tested antibiotics.
Conclusion: The findings of this study can guide clinicians to make an informed decision in the selection of antibiotics and management of urinary tract infections in cancer patients.
References
Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA a Cancer J Clin [Internet]. 2011;61(2):69–90. DOI:10.3322/caac. 20107
International Agency for Research on Cancer. Global Cancer Observatory: Nepal [Internet]. International Agency for Research on Cancer. Cited (2024 August). Available from: https://gco.iarc.fr/today/en. Accessed: 2024 Aug 21.
Sime WT, Biazin H, Zeleke TA, Desalegn Z. Urinary Tract Infection in Cancer Patients and Antimicrobial Susceptibility of Isolates in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Karunasagar I, ed. PLOS ONE. 2020;15(12):e0243474. DOI: 10.1371/ journal.pone.0243474
Singh D, Bonomo RA. Infections in Cancer Patients [Internet]. Oncology Critical Care. InTech; 2016. DOI:10.5772/64372
Kamboj M, Sepkowitz KA. Nosocomial Infections in Patients with Cancer. Lancet Oncol. [Internet]. 2009; 10(6):589-97. DOI: 10.1016/S1470-2045(09)70069-5
Custovic A, Smajlovic J, Hadzic S, Ahmetagic S, TihicN, Hadzagic H. Epidemiological Surveillance of Bacterial Nosocomial Infections in the Surgical Intensive Care Unit. Mater Socio Medica. [Internet]. 2014;26(1):7. DOI: 10.5455/msm.2014.26.7-11
Kaur P, Asea A. Radiation-induced Effects and the Immune System in Cancer. Front Oncol. 2012;2. DOI: 10.3389/fonc.2012.00191
O’Neill J. Tackling Drug-Resistant Infections Globally: Final Report and Recommendations. [(accessed on 30 Sept 2024)]; Available online: https://amr-review.org/sites/default/files/160518_Final paper_with cover.pdf [Ref list]
Basnyat B, Pokharel P, Dixit S, Giri S. Antibiotic Use, Its Resistance in Nepal and Recommendations for Action: A Situation Analysis. J Nepal Health Res Counc. 2015;13(30):102-111.
Cornejo-Juárez P, Vilar-Compte D, Pérez-Jiménez C, Ñamendys-Silva SA, Sandoval-Hernández S, Volkow-Fernández P. The impact of Hospital-acquired Infections with Multidrug-Resistant Bacteria in an Oncology Intensive Care Unit. Int J Infect Dis. 2015;31:31-34. DOI: 10.1016/j.ijid.2014.12.022
Fentie A, Wondimeneh Y, Balcha A, Amsalu A, Adankie B. Bacterial Profile, Antibiotic Resistance Pattern and Associated Factors among Cancer Patients at University of Gondar Hospital, Northwest Ethiopia. Infect Drug Resist. 2018; Volume 11:2169-2178. DOI:
2147/IDR.S183283
Perez F, Adachi J, Bonomo RA. Antibiotic-Resistant Gram-Negative Bacterial Infections in Patients with Cancer. Clin Infect Dis. 2014;59(suppl_5):S335-S339. DOI: 10.1093/cid/ciu612
Fazeli H, Moghim S, Zare D. Antimicrobial Resistance Pattern and Spectrum of Multiple-drug-resistant Enterobacteriaceae in Iranian Hospitalized Patients with Cancer. Adv Biomed Res. 2018;7(1):69. DOI:10.4103/abr.abr_164_17
Hozzari A, Behzadi P, Kerishchi Khiabani P, Sholeh M, Sabokroo N. Clinical cases, Drug Resistance, and Virulence Genes Profiling in Uropathogenic Escherichia coli. J Appl Genet. 2020;61(2):265-273. DOI: 10.1007/s13353-020-00542-y
Erdem I, Kara Ali R, Ardic E, Elbasan Omar S, Mutlu R, Topkaya A. Community-acquired lower Urinary Tract Infections: Etiology, Antimicrobial Resistance, and Treatment Results in Female Patients. J Glob Infect Dis. 2018;10(3):129. DOI: 10.4103/jgid.jgid_86_17
Jorgensen JH, Ferraro MJ. Antimicrobial Susceptibility Testing: A Review of General Principles and Contemporary Practices. Clin Infect Dis. 2009;49 (11):1749-1755. DOI: 10.1086/647952
Shrestha G, Wei X, Hann K, et al. Bacterial Profile and Antibiotic Resistance among Cancer Patients with Urinary Tract Infection in a National Tertiary Cancer Hospital of Nepal. Trop Med Infect Dis. 2021;6(2):49. DOI: 10.3390/tropicalmed6020049
AbuSara A, Tayyeb N, Matalka L, Almomani B, Abaza H, Nazer L. Prevalence and Predictors of MultiDrug Resistant Organisms Among Ambulatory Cancer Patients with Urinary Tract Infections. Infect Drug Resist. 2023; 16:747-753. DOI: 10.2147/IDR.S388680
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Purbanchal University Health Journal
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Purbanchal University Health Journal (PUHJ) allows to read, download, copy, distribute, print, search, or link to the full texts of its articles and allow readers to use them for any other lawful purpose. Copyright is retained by PUHJ. The PUHJ work is licensed under a Creative Commons Attribution-Non-commercial 4.0 International (CC BY-NC 4.0).
