Bacteremia in febrile cancer patients in Uganda

• Published in: BMC research notes 2019-07, Vol.12 (1), p.464-464, Article 464
• Main Authors: Lubwama, Margaret, Phipps, Warren, Najjuka, Christine F, Kajumbula, Henry, Ddungu, Henry, Kambugu, Joyce B, Bwanga, Freddie
• Format: Article
• Language: English
• Subjects: Adult; Anti-Bacterial Agents - therapeutic use; Antibacterial agents; Antibiotics; Antimicrobial resistance; Bacteremia; Bacteremia - complications; Bacteremia - drug therapy; Bacteremia - microbiology; Bacteremia - pathology; Bacteria; beta-Lactamases - genetics; beta-Lactamases - metabolism; Biochemistry; Blood Culture; Blood tests; Cancer; Cancer patients; Cancer research; Care and treatment; Chemotherapy; Child; Cross-Sectional Studies; Drug resistance; Drug Resistance, Multiple, Bacterial - genetics; Escherichia coli; Female; Fever - complications; Fever - drug therapy; Fever - microbiology; Fever - pathology; Gene Expression; Gram-negative bacteria; Gram-Negative Bacteria - drug effects; Gram-Negative Bacteria - enzymology; Gram-Negative Bacteria - genetics; Gram-Negative Bacterial Infections - complications; Gram-Negative Bacterial Infections - drug therapy; Gram-Negative Bacterial Infections - microbiology; Gram-Negative Bacterial Infections - pathology; Gram-Positive Bacteria - drug effects; Gram-Positive Bacteria - enzymology; Gram-Positive Bacteria - genetics; Gram-Positive Bacterial Infections - complications; Gram-Positive Bacterial Infections - drug therapy; Gram-Positive Bacterial Infections - microbiology; Gram-Positive Bacterial Infections - pathology; Hospital patients; Humans; Imipenem; Male; Methicillin; Microbial drug resistance; Microbial Sensitivity Tests; Neoplasms - complications; Neoplasms - drug therapy; Neoplasms - microbiology; Neoplasms - pathology; Neutropenia; Neutropenia - complications; Neutropenia - drug therapy; Neutropenia - microbiology; Neutropenia - pathology; Research Note; Uganda; Vancomycin
• ISSN: 1756-0500; 1756-0500
• DOI: 10.1186/s13104-019-4520-9

The aim of this study was to determine the predominant bacterial species causing bacteremia among febrile cancer patients, and their antibacterial resistance profiles at the Uganda Cancer Institute. We enrolled in-patients with a documented fever (≥ 37.5 °C). Bacteria from positive blood cultures were identified using standard methods biochemically. Antibacterial susceptibility testing was performed with the Kirby-Bauer disc diffusion method. From a total of 170 febrile episodes, positive blood cultures were obtained from 24 (14.1%). A positive culture was more likely to be obtained from a patient with neutropenia (P = 0.017). Of 22 (66.7%) Gram-negative bacteria isolated, half were E. coli (n = 11). Gram-negative compared to Gram-positive bacteria were most likely to be isolated from patients with a hematologic malignancy (P = 0.02) or patients with neutropenia (P = 0.006). Of the isolated Enterobacteriaceae 85% (n = 20) were resistant to three or more classes of antibiotic and 41% (n = 7) had extended spectrum beta-lactamases. Of the 11 Gram-positive bacteria isolated, the S. aureus isolate was methicillin resistant but susceptible to vancomycin. Multidrug resistant Gram-negative bacteria are the main cause of bacteremia in febrile cancer patients at the Uganda Cancer Institute. There is need for ongoing microbial surveillance, infection prevention and control, and antibiotic stewardship programs.