Bacteremia due to ESKAPE pathogens: An emerging problem in cancer patients.
OBJECTIVE
In recent years, a few of the antibiotic-resistant bacteria, known as ESKAPE pathogens, have been found responsible for serious infections. We investigated the risk factors, and impact of ESKAPE pathogens on course of blood stream infections (BSIs) in cancer patients in comparison to coagulase negative Staphylococci (CoNS).


METHODS
The data of patients with ESKAPE positive blood cultures at National Cancer Institute, Cairo University were analyzed. Identification and antimicrobial susceptibility of isolates were done using Microscan Walk Away 96.


RESULTS
In a 6month period, ESKAPE pathogens were isolated from non-duplicate blood cultures in 81 episodes of 72 cases of pediatric cancer patients, while CoNS were isolated from 135 blood cultures of 116 patients. The ESKAPE pathogens isolated were Enterobacter spp., methicillin-resistant Staphylococcus aureus (MRSA), Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterococci in 12%, 23%, 37%, 10%, 9%, and 9% of episodes, respectively. Health-care acquired infections constituted 75% of ESKAPE infections. Duration of episodes and overall mortality were significantly higher in ESKAPE BSIs when compared to CoNS (14.5±7.6 versus 09.9±6.9), and (26% versus 4%); respectively, p value <0.001.


CONCLUSIONS
ESKAPE pathogens were significantly associated with higher rates of morbidity and mortality indicating the need for improving the means of prevention of these types of infections within health care premises. Microbiology laboratories have a role in defining more dangerous infections and rapid diagnostics are required in the era of resistance.
Clinical Pathology Department, National Cancer Institute, Cairo University, Cairo, Egypt.
Hadir A
HA
El-Mahallawy
Clinical Pathology Department, National Cancer Institute, Cairo University, Cairo, Egypt. Electronic address: safaa_shawky@hotmail.com.
Safaa Shawky
SS
Hassan
Clinical Oncology Department, Faculty of Medicine, Beni Suef University, Beni Suef, Egypt.
Mohamed
M
El-Wakil
Biostatistics and Cancer Epidemiology Department, National Cancer Institute, Cairo University, Cairo, Egypt.
Manar M
MM
Moneer
D040981:Acinetobacter baumannii / Q000302:isolation & purification / Q000472:pathogenicity; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000150:complications / Q000382:microbiology* / Q000473:pathology; D003428:Cross Infection / Q000150:complications / Q000382:microbiology* / Q000473:pathology; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D004754:Enterobacter / Q000302:isolation & purification / Q000472:pathogenicity; D005260:Female; D006801:Humans; D007711:Klebsiella pneumoniae / Q000302:isolation & purification / Q000472:pathogenicity; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification / Q000472:pathogenicity; D009369:Neoplasms / Q000150:complications / Q000382:microbiology* / Q000473:pathology; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification / Q000472:pathogenicity; D012307:Risk Factors
D000900:Anti-Bacterial Agents
Blood stream infection; Cancer patients; ESKAPE