Abstract:
Background: Infectious diseases are an important cause of death among cancer patients.
The main risk factor for infection is neutropenia associated with chemotherapy.
Objectives: To determine the spectrum and the antimicrobial sensitivity pattern of the
bacteria causing respiratory infections, skin and soft tissue infections (SST) and complicated
Urinary Tract Infections (UTI) in cancer patients.
Methodology: Cancer patients who were given both immunosuppressive therapy and
parenteral antibiotics, presented with respiratory infections, SST and UTI were included
(n=55). Pathogenic bacteria were isolated from sputum, pus, urine, wound swabs and
bronchio-alveolar lavage specimens.
Results and conclusions: Of the 55 patients, 25 (45.4%) had haematological malignancies
and the rest had solid organ tumours. The most common infection was respiratory infection
(43.6%). Majority of the infections were caused by coliform bacteria (61.8%) followed by
Staphylococcus aureus (16.3%) and Pseudomonas species (10.9%). Of the 9 S. aureus
isolates, 5 were methicillin resistant. Extended spectrum of β-lactamase production was
detected in 20.4% of the coliform bacteria. Inducible clindamycin resistance was observed
in one S. aureus isolate. Multi drug resistance Acinetobacter species was isolated from 4
patients with respiratory infections. One Acinetobacter isolate was resistant to all
recommended antibiotics while the other three were only sensitive to colistin. Higher
resistance rates were observed (>50%) for first line antibiotics in coliform bacteria.
Resistance rates of coliform bacteria for imipenem/meropenem and piperacillin-tazobactam
are 48.4% and 74.2% respectively. The highest sensitivity rate of coliform was detected for
amikacin (71%). Coliform bacteria were more prevalent as a pathogen in adult cancer
patients receiving immunosuppressive therapy. Antibiotic resistance is a main problem when
selecting antibiotics for the treatment in this patient group.
