CTX-M, TEM, and SHV Genes in , and Isolated from Hematologic Cancer Patients with Bacteremia in Uganda

Overview

Journal Infect Drug Resist

Publisher Dove Medical Press

Date 2024 Feb 22

PMID 38384499

Authors

Margaret Lubwama

David P Kateete

George Katende

Edgar Kigozi

Jackson Orem

Warren Phipps

Freddie Bwanga

Affiliations

Soon will be listed here.

Abstract

Purpose: We determined the phenotypic resistance to third-generation cephalosporins, phenotypic extended spectrum beta-lactamase (ESBL) prevalence, and genotypic prevalence of ESBL-encoding genes and in isolated from hematologic cancer patients with febrile neutropenia and bacteremia at the Uganda Cancer Institute (UCI).

Patients And Methods: Blood cultures from hematologic cancer patients with febrile neutropenia were processed in BACTEC 9120. and . isolates were identified using conventional biochemical methods. Antimicrobial susceptibility tests, phenotypic ESBL characterization, and genotypic characterization of the ESBL-encoding genes , and were determined for pure isolates of and .

Results: Two hundred and two patients were included in the study. Median age of patients was 19 years (IQR: 10-30 years). Majority (N=119, 59%) were male patients. Sixty (30%) of the participants had at least one febrile episode due to Enterobacteriaceae. Eighty-three organisms were isolated with being predominant (45, 54%). Seventy-nine (95%) Enterobacteriaceae were multidrug resistant. The ESBL phenotype was detected in 54/73 (74%) of Enterobacteriaceae that were resistant to third-generation cephalosporins. A higher proportion of Enterobacteriaceae with ESBL-positive phenotype were resistant to piperacillin-tazobactam (p=0.024), gentamicin (p=0.000), ciprofloxacin (p=0.000), and cotrimoxazole (p=0.000) compared to Enterobacteriaceae, which were sensitive to third-generation cephalosporins. The organisms were more susceptible to carbapenems and chloramphenicol than resistant. ESBL-encoding genes ( and ) were detected in 55 (75%) of the 73 Enterobacteriaceae that were resistant to third-generation cephalosporins. , was the most common ESBL-encoding gene identified with 50 (91%).

Conclusion: ESBL-producing Enterobacteriaceae are a predominant cause of bacteremia in hematologic cancer patients at UCI. The most common ESBL-encoding gene identified in the ESBL-PE was . Resistance to imipenem and meropenem was low.

Citing Articles

Etiology, Risk Factors, and Outcomes of Bacteremia in Patients With Hematologic Malignancies and Febrile Neutropenia in Uganda.

Lubwama M, Holte S, Zhang Y, Mubiru K, Katende G, Orem J Open Forum Infect Dis. 2024; 11(12):ofae682.

PMID: 39660025 PMC: 11630766. DOI: 10.1093/ofid/ofae682.

Factors Associated With Death at 30 Days and Evaluation of Clinical Risk Scores Among Patients With Cancer Admitted With Postchemotherapy Infection in Uganda: A Prospective Cohort Study.

Jacinta Ojia A, Lyon S, Birungi J, Owomugisha C, Muhindo R, Sekitene S Open Forum Infect Dis. 2024; 11(11):ofae634.

PMID: 39553287 PMC: 11565409. DOI: 10.1093/ofid/ofae634.

Prevalence and clinical significance of the genotypic carriage among ESBL phenotype-negative and clinical isolates in bacteremia: a study in a Malaysian tertiary center.

Lau C, Neoh H, Periyasamy P, Tg Abu Bakar Sidik T, Tan T, Ramli R Front Cell Infect Microbiol. 2024; 14:1429830.

PMID: 39512590 PMC: 11540778. DOI: 10.3389/fcimb.2024.1429830.

Infections with in Children Undergoing Anticancer Therapy or Hematopoietic Cell Transplantation: A Multicenter Nationwide Study.

Sekowska A, Czyzewski K, Jaremek K, Zalas-Wiecek P, Zajac-Spychala O, Wachowiak J J Clin Med. 2024; 13(14).

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