Emergence of multidrug resistant opportunistic pathogens : A study on gram negative isolates from cancer patients

Background In developing countries, Cancer patients are considered the factory of multidrug-resistant organisms (MDROs). They are immunosuppressed because of both the disease status and chemotherapy regimens. This put the microorganisms under selective pressure that favors the development of multidrug resistant bacteria and even the emergence of new multidrug resistant strains. The problem of AMR is more evident in gram negative bacteria because it possesses a dynamic envelope that enables it to resist antibiotics. The aim of this study is to monitor antimicrobial resistance in a main cancer center at Upper Egypt to find gaps in the current knowledge improve the choices of empirical treatment and avoid potential future threats. Methods: This is a retrospective cross sectional study. This study depends on hospital medical records of Microbiology lab at South Egypt Cancer Institute (SECI) in 2- year period (2023-2024). Identification of microorganisms and antibiotic sensitivity tests were done by Vitek II automated system. Results : We found high frequency of infections by opportunistic microorganisms like Sphingomonas paucimobilis (6.2%) and Rauoltella spp (4.7%). Twenty five percent (25%) of Sphingomonas paucimobilis isolates were MDR and 25% of them were XDR .There was a significant increase in MDR and XDR isolates in 2024 compared to 2023 isolates. The most sensitive antibiotics in all specimens were aminoglycosides (resistance rate of amikin 40.6% and gentamicin 47.6%) followed by nitrofurantoin 51.6% resistance. Conclusion: Emergence of multidrug resistant strains of some opportunistic pathogens means urgent need for improving infection control measures and avoiding antibiotic misuse.