Comparative Antibiotic Resistance Profiles and Molecular Characterization of Uropathogens in Cancer and Non-Cancer Patients with Urinary Tract Infections Attending National Hospital Abuja, Nigeria

DOI: https://doi.org/10.33003/jobasr

Idris A.

Galdima M.

Adabara N.

Abubakar A.

Gimba Y. A.

Isiyaku S.

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.
References
Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R. L., Torre, L. A., & Jemal, A. (2018). Global cancer statistics 2018: GLOBOCAN estimates. CA: A Cancer Journal for Clinicians, 68(6), 394–424. CLSI. (2023). Performance Standards for Antimicrobial Susceptibility Testing. Clinical and Laboratory Standards Institute. Davin-Regli, A., &Pagès, J. M. (2015). Enterobacter aerogenes and Enterobacter cloacae: Versatile bacterial pathogens confronting antibiotic treatment. Frontiers in Microbiology, 6, 392. https://doi.org/10.3389/fmicb.2015.00392 Flores-Mireles, A. L., Walker, J. N., Caparon, M., & Hultgren, S. J. (2019). Urinary tract infections: Epidemiology, mechanisms of infection, and treatment options. Nature Reviews Microbiology, 13(5), 269–284. https://doi.org/10.1038/nrmicro3432 Foxman B. (2014). Urinary tract infection syndromes: occurrence, recurrence, bacteriology, risk factors, and disease burden. Infectious disease clinics of North America, 28(1), 1–13. https://doi.org/10.1016/j.idc.2013.09.003 Garcia-Clemente, M., et al. (2021). Antimicrobial resistance in cancer patients: An emerging issue. Journal of Global Antimicrobial Resistance, 25, 112–119. Garcia-Clemente, M., et al. (2021). Multidrug-resistant Pseudomonas aeruginosa infections in cancer patients: Epidemiology and treatment. Journal of Infectious Diseases, 224(8), S558–S565. https://doi.org/10.1093/infdis/jiab259 Grace M. I., Abasiubong V. N., Anosike I. K. (2025). Prevalence and antibiotics susceptibility of uropathogens isolated from urinary tract of patients at St. Lukes hospital Anua, Uyo. Journal of Basics and Applied Sciences Research, 3(3), 22–30. DOI: https://dx.doi.org/10.4314/jobasr.v3i3.4 Hooton,T. M. Bradley, S. F. Cardenas D. D., (2009) “Diagnosis, Prevention, and Treatment of Catheter-Associated Urinary Tract Infection in Adults: International Clinical Practice Guidelines from the Infectious Diseases Society of America,” Clinical Infectious Disease, 50(5) 625-663. doi:10.1086/650482 Hooton, T. M., et al. (2019). Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults. Clinical Infectious Diseases, 50(5), 625–663. Hooton, T. M., et al. (2020). Urinary tract infections in adults. The New England Journal of Medicine, 378(6), 562–571. https://doi.org/10.1056/NEJMra1805364 Johnson, J. R., et al. (2020). Uropathogenic Escherichia coli resistance mechanisms and trends. Journal of Infectious Diseases, 221(6), 940–946. Johnson, J. R., et al. (2021). Extended-spectrum beta-lactamases in E. coli UTIs. Clinical Infectious Diseases, 70(8),145-153. https://doi.org/10.1093/cid/ciz463 Livermore D. M. (2002). Multiple mechanisms of antimicrobial resistance in Pseudomonas aeruginosa: our worst nightmare?. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 34(5),634–640. https://doi.org/10.1086/338782 Okeke, O. P. (2022). Identification and characterization of bacteria isolated from cancer patients in Nigeria. Bio-Research, 20(3), 1659–1666. https://doi.org/10.4314/br.v20i3.3 Rolston, K. V. I. (2021). Infections in cancer patients with solid tumors: A review. Infectious Diseases and Therapy, 10(1), 69–83. https://doi.org/10.1007/s40121-021-0146-1 Tamura, K., Stecher, G., & Kumar, S. (2021). MEGA11: Molecular Evolutionary Genetics Analysis version 11. Molecular Biology and Evolution, 38(7), 3022–3027. https://doi.org/10.1093/molbev/msab1200 World Health Organization (WHO). (2021). Global antimicrobial resistance and use surveillance system (GLASS) report. https://www.who.int/publications/i/item/97892400273366
PDF