Bloodstream infection in cancer patients; susceptibility profiles of the isolated pathogens, at Khartoum Oncology Hospital, Sudan

Abstract

Introduction: Bloodstream infection is one of the major causes of mortality in patients with malignancies. This study aimed to determine the local profile of blood culture isolates and their antibiotic sensitivities in febrile neutropenic cancer patients and to decide if any modifications to antibiotics policies are necessary.

Methods: This is a cross-sectional study conducted between the first of October to the end of December 2018 at Khartoum Oncology Hospital, Sudan. Blood samples from febrile neutropenic patients were collected for culture. Isolates were identified, and their antimicrobial susceptibility was determined by standard laboratory procedures.

Results: Bloodstream infections were confirmed in 12 % (n = 69/569) of total blood cultures. Gram negative bacilli were the dominant causative agents (63.8%) while (36.2%) of infections were caused by gram positive cocci. Escherichia coli was the most common isolate (30.4%).The proportions of resistance among gram negative bacilli were high for cefuroxime, amoxicillin/clavulanic acid, Ceftazidime, and ceftriaxone. Extended-spectrum β-lactamase producing isolates were identified in 34.1% of the positive cultures. Gram positive cocci showed high resistance to tetracycline, penicillin and erythromycin but were completely sensitive to vancomycin and gentamicin. Most of Staphylococcus aureus isolates were methicillin resistant.

Conclusion: Gram negative bacilli were the predominant etiologic agents of bloodstream infections in our patients. Both Gram-positive and Gram-negative bacteria showed high levels of resistance for most of the common antibiotics used for empiric treatment. Regular surveillance to study bacterial resistance patterns must be conducted to modify antibiotics stewardship in our institution.

Keywords: Blood stream infection; Sudan; antibiotics sensitivity; malignancy.

Figure 1

Distribution of Bacterial Isolates from the 69 Positive Blood Samples

Figure 2

Antibiotic Susceptibility of the Gram-negative Isolates