Antibiotic Resistance Profile of Staphylococcus aureus in Cancer Patients at Laquintinie Hospital in Douala, Littoral Region, Cameroon

Abstract

Cancer and chemotherapy predispose the patients to various bacterial infections. This study is aimed at isolating and establishing the distribution of antibiotic-resistant Staphylococcus aureus from fecal samples in subjects with cancer admitted to the Oncology Department at Laquintinie Hospital in Douala, in the Littoral Region of Cameroon. A cross-sectional study was conducted from October 2021 to March 2023. Cancer and noncancer patients were suffering from Staphylococcus aureus infection. The isolation of Staphylococcus aureus was based on culture on the specific medium. The Kirby-Bauer disk diffusion method was used for drug susceptibility testing. Of the 507 patients studied, 307 (60.55%) were cancer patients, compared to 200 (39.45%) noncancer patients. S. aureus was isolated in 81 (15.97%) participants, among which 62 (76.55%) were cancer patients and 19 (23.45%) were noncancer patients. In the study population, 31.92% of participants had breast cancer, followed by cervical cancer (13.68%) and leukemia (7.17%). Staphylococcus aureus isolates showed high resistance rates in cancer patients compared to noncancer patients to amoxicillin-clavulanic acid (AMC, 77.42% versus 31.58%), cefoxitin (FOX, 80.65% versus 63.16%), ciprofloxacin (CIP, 75.81% versus 26.32%), ofloxacin (OFX, 69.35% versus 31.58%), fusidic acid (FUS, 70.97% versus 53.63%), and tetracycline (TET, 85.48% versus 78.95%). Staphylococcus aureus showed a significant increase in multidrug-resistant (MDR) and methicillin-resistant (MRSA) phenotypes in cancer patients compared to noncancer patients (p < 0.05). The prevalence of MRSA was 76.54%, higher than that of methicillin-sensitive Staphylococcus aureus (MSSA) (23.46%). The frequency of MRSA was significantly higher (p < 0.001) in cancer patients (80.65%) than in noncancer patients (19.35%). This study showed that there is an association between antibiotic resistance and cancer status. Research and interventions must be focused on the cancer population to combat the appearance of MDR bacteria due to the loss of effectiveness of antibiotics.

Figure 1

Distribution of Staphylococcus aureus isolated according to different age groups.

Figure 2

Frequency of occurrence of multidrug-resistant (MDR) and methicillin-resistant Staphylococcus aureus (MRSA) bacteria isolated from cancer and noncancer patients. ^∗p = 0.131; ^∗∗p < 0.001.

Figure 3

Effect of anticancer treatment on the resistance profile of Staphylococcus aureus. AMX: amoxicillin; AMC: amoxicillin-clavulanic acid; CAZ: ceftazidime; FOX: cefoxitin; AMK: amikacin; GEN: gentamicin; TET: tetracycline; CIP: ciprofloxacin; NIT: nitrofurantoin; OFX: ofloxacin; COT: trimethoprim-sulfamethoxazole; FUS: fusidic acid; ERY: erythromycin.