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Characterization and anti-microbial susceptibility of gram-negative bacteria isolated from bloodstream infections of cancer patients on chemotherapy in Pakistan.
Indian J Med Microbiol. 2009 Oct-Dec; 27(4):341-7.IJ

Abstract

PURPOSE

Bloodstream infection remains a major cause of morbidity and mortality in patients undergoing treatment for cancer. Severe infections due to Gram-negative bacilli & staphylococci are common in cancer patients. Altered gut flora because of frequent antibiotic administration and damage of epithelial surfaces contribute to the development of infection. To access the use of new potent antibiotics against bloodstream infection in cancer patients and to determine the cross resistance of Gram-negative bacterial strains.

MATERIALS AND METHODS

We studied the bacterial spectrum & antimicrobial susceptibility pattern of cephalosporins, fluoroquinolones, carbapenems and aminoglycosides against Gram-negative bacterial strains in cancer patients. The susceptibility was determined by broth dilution method according to National Committee for Clinical Laboratory Standards (NCCLS) now called Clinical Laboratory Standards Institute (CLSI) during study period (July 2006 to Jan 2007).

RESULTS

A total of 60 Gram-negative bacterial blood cultures were examined. Among these, Pseudomonas aeruginosa was the most common (38%). The Minimum Inhibitory Concentration at which 50% (MIC 50) and 90% (MIC 90) of Enterobacteriaceae and P. aeruginosa inhibited were found. Resistance in P.aeruginosa against cefepime, meropenem, ciprofloxacin, ceftriaxone, tobramycin, cefoperazone and imipenem was 60%, 13%, 80%, 67%, 40%, 90% and 10% respectively while for Enterobacteriaceae 80%, 20%, 88%, 72%, 20%, 90% and four per cent resistance was observed. Meropenem was found to be the most effective antimicrobial against Gram-negative bacteria.

CONCLUSION

High resistance observed in this study warrants the needs of surveillance of resistant pattern of antimicrobial agents. Due to increased level of drug resistance, carbapenem would be a prudent choice in high- risk cases.

Authors+Show Affiliations

Institute of Biochemistry and Biotechnology, University of the Punjab, Lahore, Pakistan. syra.akif@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19736404

Citation

Saghir, S, et al. "Characterization and Anti-microbial Susceptibility of Gram-negative Bacteria Isolated From Bloodstream Infections of Cancer Patients On Chemotherapy in Pakistan." Indian Journal of Medical Microbiology, vol. 27, no. 4, 2009, pp. 341-7.
Saghir S, Faiz M, Saleem M, et al. Characterization and anti-microbial susceptibility of gram-negative bacteria isolated from bloodstream infections of cancer patients on chemotherapy in Pakistan. Indian J Med Microbiol. 2009;27(4):341-7.
Saghir, S., Faiz, M., Saleem, M., Younus, A., & Aziz, H. (2009). Characterization and anti-microbial susceptibility of gram-negative bacteria isolated from bloodstream infections of cancer patients on chemotherapy in Pakistan. Indian Journal of Medical Microbiology, 27(4), 341-7. https://doi.org/10.4103/0255-0857.55454
Saghir S, et al. Characterization and Anti-microbial Susceptibility of Gram-negative Bacteria Isolated From Bloodstream Infections of Cancer Patients On Chemotherapy in Pakistan. Indian J Med Microbiol. 2009 Oct-Dec;27(4):341-7. PubMed PMID: 19736404.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characterization and anti-microbial susceptibility of gram-negative bacteria isolated from bloodstream infections of cancer patients on chemotherapy in Pakistan. AU - Saghir,S, AU - Faiz,M, AU - Saleem,M, AU - Younus,A, AU - Aziz,H, PY - 2009/9/9/entrez PY - 2009/9/9/pubmed PY - 2009/11/3/medline SP - 341 EP - 7 JF - Indian journal of medical microbiology JO - Indian J Med Microbiol VL - 27 IS - 4 N2 - PURPOSE: Bloodstream infection remains a major cause of morbidity and mortality in patients undergoing treatment for cancer. Severe infections due to Gram-negative bacilli & staphylococci are common in cancer patients. Altered gut flora because of frequent antibiotic administration and damage of epithelial surfaces contribute to the development of infection. To access the use of new potent antibiotics against bloodstream infection in cancer patients and to determine the cross resistance of Gram-negative bacterial strains. MATERIALS AND METHODS: We studied the bacterial spectrum & antimicrobial susceptibility pattern of cephalosporins, fluoroquinolones, carbapenems and aminoglycosides against Gram-negative bacterial strains in cancer patients. The susceptibility was determined by broth dilution method according to National Committee for Clinical Laboratory Standards (NCCLS) now called Clinical Laboratory Standards Institute (CLSI) during study period (July 2006 to Jan 2007). RESULTS: A total of 60 Gram-negative bacterial blood cultures were examined. Among these, Pseudomonas aeruginosa was the most common (38%). The Minimum Inhibitory Concentration at which 50% (MIC 50) and 90% (MIC 90) of Enterobacteriaceae and P. aeruginosa inhibited were found. Resistance in P.aeruginosa against cefepime, meropenem, ciprofloxacin, ceftriaxone, tobramycin, cefoperazone and imipenem was 60%, 13%, 80%, 67%, 40%, 90% and 10% respectively while for Enterobacteriaceae 80%, 20%, 88%, 72%, 20%, 90% and four per cent resistance was observed. Meropenem was found to be the most effective antimicrobial against Gram-negative bacteria. CONCLUSION: High resistance observed in this study warrants the needs of surveillance of resistant pattern of antimicrobial agents. Due to increased level of drug resistance, carbapenem would be a prudent choice in high- risk cases. SN - 1998-3646 UR - https://www.unboundmedicine.com/medline/citation/19736404/Characterization_and_anti_microbial_susceptibility_of_gram_negative_bacteria_isolated_from_bloodstream_infections_of_cancer_patients_on_chemotherapy_in_Pakistan_ L2 - http://www.ijmm.org/article.asp?issn=0255-0857;year=2009;volume=27;issue=4;spage=341;epage=347;aulast=Saghir DB - PRIME DP - Unbound Medicine ER -