BACTERIAL INFECTIONS IN CANCER PATIENTS AT BENGHAZI MEDICAL CENTER, LIBYA: EPIDEMIOLOGY AND ANTIMICROBIAL RESISTANCE

Background: Cancer patients are highly susceptible to bacterial infections due to immunosuppressionfrom malignancy and treatment, which significantly increases morbidity, mortality, and hospital stays. Methods: A retrospective observational study was conducted at Benghazi Medical Center, Libya,between January 2023 and December 2024. Clinical specimens from 188 cancer patients withconfirmed infections were processed using the VITEK 2 system, and antimicrobial susceptibility wasinterpreted according to CLSI standards. Results: A total of 227 bacterial isolates were recovered: 159 (70.0%) Gram-negative and 68 (30.0%)Gram-positive. The most common Gram-negative pathogens were Klebsiella spp. (31.4%),Pseudomonas aeruginosa (25.2%), and Escherichia coli (23.9%), while Staphylococcus aureusconstituted 48.5% of Gram-positive isolates. Bloodstream infections were the most frequent (36.7%),followed by respiratory tract infections (27.1%) and urinary tract infections (17.6%). Solid tumorpatients had more bloodstream infections (38.9%), while respiratory infections were slightly morecommon in hematologic malignancy patients (27.0%). ESBL production was observed in 52.0% ofKlebsiella spp. and 50.0% of E. coli. Methicillin-resistant S. aureus (MRSA) accounted for 39.4% ofisolates, with all Gram-positive isolates remaining susceptible to vancomycin. The overall mortalitywas 40.0%, with Neutropenia significantly associated with poor outcomes. Conclusion: Multidrug-resistant bacterial infections, particularly ESBL-producing Gram-negativeorganisms and MRSA, are prevalent among cancer patients in Libya. Strengthened infection control,antimicrobial stewardship, and targeted empirical therapy are crucial to reduce morbidity andmortality.