Evaluation the Pattern of BSI in Cancer Patients and Their Sensitivity and Resistance toward Antibiotic

ABSTRACT

Background: Bloodstream infections (BSIs) account for large-scale morbidity and mortality among cancer patients requiring a rational antibiotic policy. In Bangladesh, there is a paucity of data regarding incidence and pattern of BSI in such patients. Objective:To evaluate the pattern of BSI in cancer patients and their sensitivity and resistance toward antibiotic.Material & Methods:The present study was a retrospective analysis of BSI patterns among various cancer patients treated at Department of Oncology, Enam Medical College Hospital, Saver, Bangladesh during the period from January to June 2021. Blood culture results and their sensitivity patterns of these cancer patients along with the demographic characteristics were collected from the records and maintained in the structured pro forma. Before starting empirical antibiotics, 10 ml of blood was collected into Bract/ALERT culture media.Results:A total of 82 patients/episodes had confirmed BSI. Gram-negative bacteria accounted for 43 (52.4%) cases, followed by Gram positive 38 (46.4%) cases and 1 case of candida species. The most common organisms isolated were Klebsiella pneumonia and Staphylococcus aureus consisting of 17 cases each. The Gram-negative bacterial isolates (n = 43) were sensitive to cefoperazone plus sulbactam, piperacillin plus tazobactam, carbapenem, and colitis in 18 (41.9%), 19 (44.2%), 29 (67.4%), and 40 (93%) episodes, respectively. The sensitivity of Gram-positive bacteria (n = 38) to vancomycin, linezolid, and teicoplanin was seen in 37 (97.3%), 37 (97.3%), and 35 (92.1%) episodes, respectively. Multidrug-resistant bacteria accounted for 17 (39.5%) cases of Gram-negative isolates and 9 (53%) of which were K. pneumonia. Extended spectrum beta-lactamase activity was seen in 11 of 26 episodes of Enterobacteriaceae. Four of 17 S. aureus and 3 of 11 coagulase-negative Staphylococci were methicillin resistant, and 1 of 2 cases of Enterococcus was vancomycin resistant.Conclusions:Gram-negative bacteria are the predominant cause of BSI in cancer patients and development of a high degree of resistance to commonly used antibiotics is challenging.