Antimicrobial Susceptibility Pattern of Bacterial Isolates and Associated Factors for Bacteriuria among Cancer Patients Attending Ocean Road Cancer Institute, Tanzania

Abstract

Background: Cancer patients are among people at high risk of infection with antibiotic-resistant bacteria causing bacteriuria as a consequence of cancer-induced immunosuppression and complex cancer treatments.

Methodology: A hospital-based cross-sectional study involving the quantitative method of data collection was carried out to determine the prevalence of bacteriuria, antibacterial susceptibility pattern of the causative isolates and associated risk factors among cancer patients attending Ocean Road Cancer Institute. A convenient sampling technique was used to obtain 422 cancer patients. A urine sample was collected to establish the prevalence of bacteriuria and the antibacterial susceptibility pattern of the isolates. Interviews were carried out with study participants using a questionnaire to collect social-demographic data. A clinical record collection form was used to collect clinical data of each participant. Data analysis was performed using descriptive statistics (mean, frequencies and proportions) and binary logistic regression by using SPSS software version 20.

Results: The prevalence of bacteriuria among asymptomatic and symptomatic cancer patients was 3.6% and 14.0%, respectively. Escherichia coli accounted for a large proportion of all Gram-negative bacteria isolates (53%). The other Gram-negative bacteria were Pseudomonas species (16%), Acinetobacter species (15%), Klebsiella species (10%), Enterobacter species (3%), Proteus mirabilis (1.5%), and Aeromonas species (1.5%). Enterococcus species contributed roughly two-thirds of all Gram-positive bacteria isolates (67%). Multidrug resistance (MDR) was found in 27 (75%) of Escherichia coli isolates. The factors associated with bacteriuria in cancer patients were sex, patients’ settings, history of antibiotic use and occupation.

Conclusion: Bacteriuria, particularly that caused by MDR Escherichia coli, is common among cancer patients at Ocean Road Cancer Institute and is associated with sex, patients’ settings and occupation.