Prevalence and Antimicrobial Resistance Patterns of Multidrug-Resistant Bacterial Pathogens Isolated from Cancer Patients
Keywords:
Multidrug-resistant bacteria, Cancer patients, Antimicrobial resistance, Gram-positive and Gram-negative pathogens, Antibiotic susceptibilityAbstract
Background: Antimicrobial resistance has emerged as a major global health concern, particularly among immunocompromised populations such as cancer patients. Frequent hospitalization, invasive procedures, prolonged antibiotic exposure, and immunosuppressive therapies predispose cancer patients to infections caused by multidrug-resistant (MDR) organisms. These infections are associated with increased morbidity, mortality, and limited therapeutic options, highlighting the need for continuous surveillance of antimicrobial resistance patterns in oncology settings.
Objectives: To isolate and identify Gram-positive and Gram-negative bacterial pathogens from clinical samples obtained from cancer patients and to determine their antimicrobial susceptibility patterns with special emphasis on multidrug-resistant organisms.
Methods: A prospective observational study was conducted from January to March 2014. A total of 51 clinical samples, including pus, urine, blood, body fluids, wound swabs, sputum, tracheal secretions, stool, and central line tips, were processed using standard microbiological techniques. Bacterial identification was performed based on culture characteristics, Gram staining, and biochemical tests. Antimicrobial susceptibility testing was carried out using the modified Kirby-Bauer disc diffusion method according to CLSI guidelines. Multidrug resistance was defined as resistance to three or more classes of antibiotics.
Results: Out of 51 samples, 27 (52.9%) yielded bacterial growth. Gram-negative organisms slightly predominated (51.9%). Escherichia coli (29.6%) was the most frequently isolated pathogen, followed by Staphylococcus aureus (25.9%) and Streptococci spp. (22.2%). Overall, 55.6% of isolates were multidrug resistant. The highest MDR rate was observed among E. coli (87.5%) and Pseudomonas aeruginosa (60.0%). Most isolates remained susceptible to carbapenems, colistin, linezolid, and rifampicin.
Conclusion: The study demonstrates a high prevalence of multidrug-resistant bacterial pathogens among cancer patients, emphasizing the urgent need for rational antibiotic use, continuous resistance surveillance, and effective antimicrobial stewardship programs in oncology care settings.
References
1. Alekshun MN, Levy SB. Molecular mechanisms of antibacterial multidrug resistance. Cell. 2007;128(6):1037-1050. DOI: https://doi.org/10.1016/j.cell.2007.03.004 PMid:17382878
2. Alfonso JA. Resistance to antibiotics: are we in the post-antibiotic era? Arch Med Res. 2005;36(6):697-705. DOI: https://doi.org/10.1016/j.arcmed.2005.06.009 PMid:16216651
3. Fox JL. The business of developing antibacterials. Nat Biotechnol. 2006;24(12):1521-1528. DOI: https://doi.org/10.1038/nbt1206-1521 PMid:17160056
4. Barrett JF. Can biotech deliver new antibiotics? Curr Opin Microbiol. 2005;8(5):498-503. DOI: https://doi.org/10.1016/j.mib.2005.08.007 PMid:16125445
5. Gould IM. Antibiotic stewardship: the past, the present and the future. J Antimicrob Chemother. 2009;63(3):447-448.
6. Kluytmans J, van Belkum A, Verbrugh H. Nasal carriage of Staphylococcus aureus: epidemiology, underlying mechanisms, and associated risks. Clin Microbiol Rev. 1997;10(3):505-520. DOI: https://doi.org/10.1128/CMR.10.3.505 PMid:9227864 PMCid:PMC172932
7. Heymann DL, editor. Control of communicable diseases manual. 19th ed. Washington (DC): American Public Health Association; 2008.
8. Hartstein AI, Rashad AL, Liebler JM, Actis LA, Freeman J, Rourke JW, et al. Multiple intensive care unit outbreak of Acinetobacter baumannii resistant to ampicillin-sulbactam and aminoglycosides. Infect Control Hosp Epidemiol. 2004;25(6):557-560.
9. Chenoweth CE. Enterococcus species. In: Mayhall CG, editor. Hospital epidemiology and infection control. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2004. p. 530-537.
10. Raghunath D. Emerging antibiotic resistance in bacteria with special reference to India. J Biosci. 2011;36(3):447-454.
11. Falagas ME, Koletsi PK, Bliziotis IA. The diversity of definitions of multidrug-resistant (MDR) and pandrug-resistant (PDR) Acinetobacter baumannii and Pseudomonas aeruginosa. J Med Microbiol. 2006;55(Pt 12):1619-1629. DOI: https://doi.org/10.1099/jmm.0.46747-0 PMid:17108263
12. Wattal C, Oberoi JK, Goel N, Raveendran R, Datta S, Prasad KJ. Multidrug resistant gram-negative bacilli in intensive care units: changing trends. Indian J Med Res. 2010;132:599-606.
13. Paterson DL, Doi Y. A step closer to extreme drug resistance (XDR) in gram-negative bacilli. Clin Infect Dis. 2007;45(9):1179-1181. DOI: https://doi.org/10.1086/522287 PMid:17918079
14. Bradford PA. Extended-spectrum β-lactamases in the 21st century: characterization, epidemiology, and detection of this important resistance threat. Clin Microbiol Rev. 2001;14(4):933-951. DOI: https://doi.org/10.1128/CMR.14.4.933-951.2001 PMid:11585791 PMCid:PMC89009
15. Bonomo RA, Szabo D. Mechanisms of multidrug resistance in Acinetobacter species and Pseudomonas aeruginosa. Clin Infect Dis. 2006;43(Suppl 2):S49-S56. DOI: https://doi.org/10.1086/504477 PMid:16894515
16. Frost LS, Leplae R, Summers AO, Toussaint A. Mobile genetic elements: the agents of open source evolution. Nat Rev Microbiol. 2005;3(9):722-732. DOI: https://doi.org/10.1038/nrmicro1235 PMid:16138100
17. Tiwari HK, Sen MR. Emergence of vancomycin resistant Staphylococcus aureus (VRSA) from a tertiary care hospital from northern part of India. BMC Infect Dis. 2006;6:156. DOI: https://doi.org/10.1186/1471-2334-6-156 PMid:17067393 PMCid:PMC1634751
18. Davies J. Origins and evolution of antibiotic resistance. Microbiologia. 1996;12(1):9-16.
19. Drlica K, Malik M, Kerns RJ, Zhao X. Quinolone-mediated bacterial death. Antimicrob Agents Chemother. 2008;52(2):385-392. DOI: https://doi.org/10.1128/AAC.01617-06 PMid:17724149 PMCid:PMC2224783
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2016 Prashant Dumasiya, Kalpesh Chodvadiya
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
The authors retain the copyright of their article, with first publication rights granted to Medsci Publications.
