Phenotypic and Genotypic Characterization of Bacterial Species Associated with Nosocomial Infections at Radiation and Isotopes Centre-Khartoum(Rick)-Sudan

Abstract

Background Cancer patients are particularly susceptible to nosocomial infections because of their compromised immune systems and treatment regimens. This study analyzed the distribution and antimicrobial resistance of nosocomial pathogens isolated from cancer patients admitted to the Radiation and Isotopes Centre (RIC) ,Khartoum, Sudan. Also the study analyzed the distribution of pathogens isolated from environmental niches , and from noses of Health care workers. Most of the sites of the isolated nosocomial pathogens were surgical site infection , urinary tract infections , respiratory tract and Blood. Environmental cotton swabs samples were collected from infrastructures , furniture , kitchen , theaters , laboratories , offices of medical staff , and equipment. Objective To investigate the impact of nosocomial infections on developing a secondary infections among patients admitted to the RICK hospital to get medical treatment. Methods A total of 1793 samples were collected from cancer patients , environmental niches , and from noses of heath care workers. The types of samples collected from cancer patients were urine , stool , blood , sputum , and swabs from infected wounds. The samples were inoculated onto different types of media (CLED , Blood agar , MacCKonkey agar , Chocolate blood agar ) incubated aerobically or anaerobically according to the organisms suspected. Biochemical tests were done to all organisms isolated and then the antibiograms were done on Melluler-Hinton agar according to the protocol setting for each types of organisms isolated. In this study we determined the genetic diversity among several isolates from cancer patients and compare with the same isolates from hospital environments using ERIC-PCR.

Results Of 593 cancer patients , 519 (87.5%) were adults , 74 (12.5%) were children. The predominant microorganisms isolated from cancer patients and hospital environment were Pseudomonas aeruginosa , Escherichia coli , Klebsiella pneumoniae , Proteus mirabilis , Proteus vulgaris , Staphylococcus aureus , and Streptococcus pneumoniae. No pathogenic bacteria isolated from stool samples which collected from cancer patients. The majority of isolates from cancer patients and hospital environment were multidrug resistance especially to penicillin and third generation cephalosporins (ceftazidime , cefotaxime , ceftriaxone) , and most of isolates were susceptible for gentamicin , imipenem , meropenem and ciprofloxacin. A total of 120 isolates collected from cancer patients and hospitals environment were examined using ERIC-PCR fingerprinting to compare between different isolates found in both groups. Conclusion The findings indicated that the hospital environment may be one of the sources of infections to the cancer patients at our Oncology Centre.