Impact the Antibiotic Resistance for Staphylococcus aureus in Hospitalized Cancer Patients in Erbil Governate, Iraq

Fattma A. Ali, Hanan Aziz Sabah, Noor Abdulrahman Khalis, Payraw Rzgar Hussien, Sara Muhanad Ghanim
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Abstract

Background: Infection is a continuous problem in cancer patient especially in developing countries. Multidrug-resistant Staphylococcus aureus is among the most frequent complication in immunocompromised cancer patients and poses the greatest risk to immunocompromised cancer patients. Objectives: Our study aimed to carry out a study on isolated Staphylococcus aureus from various clinical samples among cancer patients in Erbil city and analyze its epidemiology and antibiotics susceptibility pattern tests and multi-drug resistance. Materials and Methods: A total of 865 from 2016 until 2020 were isolated Staphylococcus aureus from 6 clinical samples (Urine, Sputum, Wound swab, Nasal swab, Bloodand, Stool) from patient attending Nanakaly Hospital and from both males and females. Only 100 cases had been identified as isolates of S. aureus which was identified by using macroscopical, microscopical, biochemical tests and Vitek 2 compact system. Also antibiotic susceptibility test were performed by Vitek 2 compact on 19 antibiotics. Results: Only 100 S. aureus isolates were isolated from 865 samples distributed according to their source of isolation in the cancer patient, urinary tract infection is the most our specimen followed by wound infection, respiratory tract infection, blood infection and gastrointestinal infection. Breast cancer is the most common in our study followed by Colon cancer and Multiple myeloma, with  the percentage of females infected with S. aureus more than the males, with  females being 74/865(8.5%) and males being 28/865(3.2%), after 2016 infections by S. aureus was increased in young and middle-aged people being 52/100(52%) in total, from 2016-2020 S. aureus infected patients with breast cancer was 47/100(47%), colon was 27/100(27%) and multiple myeloma was 26/100(26%). Although (Aztreoman, Ertapenem, Ticarcillin-clavulanic acid) can be considered effective for MDR strains for empirical antibiotic therapy in cancer patients. S. aureus isolates had resistance to more than six antibiotics. Conclusions: The study findings showed a significant distribution of MDR S. aureus which may increase the burden of healthcare-associated infections in cancer patients. Moreover, mechanisms of resistance should also be investigated for better characterization of the multi-drug resistance of S. aureus isolates.
伊拉克埃尔比勒省住院癌症患者中金黄色葡萄球菌耐药性的影响
背景:感染是癌症患者持续存在的问题,特别是在发展中国家。耐多药金黄色葡萄球菌是免疫功能低下的癌症患者中最常见的并发症之一,对免疫功能低下的癌症患者构成最大的风险。目的:对埃尔比勒市癌症患者临床不同样本分离的金黄色葡萄球菌进行研究,分析其流行病学、抗生素药敏型试验及多重耐药情况。材料与方法:从2016 - 2020年在Nanakaly医院就诊的患者的6份临床样本(尿液、痰液、伤口拭子、鼻拭子、血液和粪便)中分离出865株金黄色葡萄球菌。经宏观、显微、生化及Vitek 2紧凑系统鉴定,仅有100例分离出金黄色葡萄球菌。并用Vitek 2 compact对19种抗生素进行药敏试验。结果:从肿瘤患者按来源分布的865份标本中仅分离出100株金黄色葡萄球菌,其中以尿路感染最多,其次是伤口感染、呼吸道感染、血液感染和胃肠道感染。我们的研究中以乳腺癌最常见,其次是结肠癌和多发性骨髓瘤,女性感染金黄色葡萄球菌的比例高于男性,女性为74/865(8.5%),男性为28/865(3.2%),2016年后中青年金黄色葡萄球菌感染增加,总数为52/100(52%),2016-2020年金黄色葡萄球菌感染的乳腺癌患者为47/100(47%),结肠癌为27/100(27%),多发性骨髓瘤为26/100(26%)。虽然(阿特曲曼、厄他培南、替卡西林-克拉维酸)可被认为对耐多药菌株有效,可用于癌症患者的经经验抗生素治疗。金黄色葡萄球菌分离株对6种以上抗生素有耐药性。结论:研究结果显示耐多药金黄色葡萄球菌的显著分布可能会增加癌症患者卫生保健相关感染的负担。此外,为了更好地表征金黄色葡萄球菌的多重耐药,还应研究耐药机制。
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