Comparative antibiotic resistance profiles and molecular characterization of uropathogens in cancer and non-cancer patients with urinary tract infections attending national hospital Abuja, Nigeria

Abstract

Cancer patients are generally known to be vulnerable to infections, among which is urinary tract infection (UTI), mostly found in urinary related cancers. This study aimed at comparing bacterial profiles, antibiotic resistance patterns, and molecular characteristics of uropathogens isolated from cancer and non-cancer patients attending the National Hospital Abuja. A total of 200 urine samples were collected for this study, 100 samples each from cancer and noncancer patients. Culture, Gram staining, biochemical assays, and MALDI-TOF method were used in identifing the bacteria isolates. Kirby-Bauer disk diffusion method was used for the antimicrobial susceptibility testing. While, PCR was used to detect the blaCTX-M, sul1, and tetA resistance genes. A phylogenetic tree was generated from sequenced genes. Out of the 200 samples investigated in this study, 55 (27.5%) yielded bacterial growth. Pseudomonas aeruginosa (25%) and Klebsiella pneumoniae (19%) were the most isolated in cancer-positive patients, while Escherichia coli (30%) and Proteus mirabilis (18%) were the most prevalent isolates in cancer-negative patients. Isolates from cancer-positive patients showed high resistance rates  for Amoxicillin (90%) and Nitrofurantoin (65%). PCR analysis revealed the presence of blaCTX-M in 40% of isolates, sul1 in 35%, and tetA in 30%. Gel electrophoresis showed sharp DNA bands at 550 bp (blaCTX-M), 432 bp (sul1), and 210 bp (tetA). Phylogenetic analysis showed the dominace of local Pseudomonas aeruginosa and Klebsiella pneumoniae isolates with globally known multidrug-resistant strains. High levels of multidrug resistance were observed among bacteria isolated from cancer patients, which has also showed high prevelence of resistant genes.