The Increased Frequency of Carbapenem Resistant Non Fermenting Gram Negative Pathogens as Causes of Health Care Associated Infections in Adult Cancer Patients

Hadir A. El-Mahallawy¹, Rasha M. Abdel Hamid¹, Safaa Shawky Hassan^1*, Samah Radwan¹, Magdy Saber²

¹Clinical Pathology Department, National Cancer Institute, Cairo University, Giza, Egypt.
²Medical Oncology Department, National Cancer Institute, Cairo University, Giza, Egypt.

DOI: 10.4236/jct.2015.610096                

Abstract

Background and Aim: Multi drug resistant Non fermenting gram negative bacilli (NFGNB) have emerged as a major cause of health-care associated infections especially in immunocompromised hosts. The aim of the study was to investigate the prevalence of NFGNB as a cause of health-care associated infections (HAI) in cancer patients and determine their resistance pattern. Patients and Methods: During the study period, 158 NFGNB isolates were collected. Microscan Walk Away 9 was used for identification and testing for the metallo-β-lactamases (MBLs) was done by Imipenem-EDTA combined disk synergy test (CDST-IPM). Results: NFGNB represented 29.0% of infections caused by gram negative organisms. Carbapenem resistance, the multi-drug resistant (MDR) phenotype, and MBL production were documented in 70%, 63%, and 59% of NFGNB isolates, respectively. MDR-NFGNB rates were significantly higher among hospitalized patients, medical department and those with longer duration of hospital stay (p = 0.034, 0.026, 0.019; respectively) than non MDR-NFGNB. Conclusion: A high level of carbapenem and multi-drug resistance were detected among the non-fermenter pathogens isolated from hospitalized cases and were more frequently encountered in high risk adult cancer patients requiring longer duration of hospitalization. The MDR-NFGNB are constituting important causes of health-care associated infections in cancer patients.

Keywords

Multi Drug Resistant Organisms (MDRO), Non-Fermenting Gram Negative Bacilli (NF-GNB), Metallo-β-Lactamases (MBL), Surgical Site Infections (SSI)

Conflicts of Interest

The authors declare no conflicts of interest.

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