Evaluation of Fecal Colonization with Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae and Risk Factors among Cancer Patients in Eastern Iran

Article Type Original Research Authors Parvin Askari, PhD1 Farzane Hakimi, MD2 Marzieh Moghanni, MSc3 Ahmad Reza Sebzari, MD4 Mohammad Hasan Namaei, PhD5* How to cite this article Askari P., Hakimi F. , Moghanni M. , Sebzari AR. , Namaei MH. Evaluation of Fecal Colonization with Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae and Risk Factors among Cancer Patients in Eastern Iran. Infection Epidemiology and Microbiology. 2021;7(4): 277-287 1Department of Microbiology, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran. 2Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran. 3Faculty of Health, Birjand University of Medical Sciences, Birjand, Iran. 4 Radiation Oncology, Clinical Research Development Unit (CRDU), ValiAsr Hospital, Birjand University of Medical Sciences, Birjand, Iran 5Infectious Diseases Research Center, Birjand University of Medical Sciences(BUMS), Birjand, Iran. * Correspondence Address: Infectious Diseases Research Center, Birjand University of Medical Sciences (BUMS), Birjand, South Khorasan Province, Iran. mhnamaei@hotmail.com Article History Received: July 05 2021 Accepted: September 25 ,2021 Published: November 25 ,2021 Background: This research aimed to estimate the prevalence of extended-spectrum b-lactamase-producing Enterobacteriaceae (ESBL-PE) in stool samples of patients with different types of cancer. Materials and Methods: Stool samples or deep rectal swabs were collected from cancer cases from January 2017 to December 2018. After species identification, in order to detect ESBLPE, double-disk synergy test (DD test) was used. Disk diffusion procedure was conducted to determine the susceptibility of bacteria to antimicrobials. Lastly, antibiotic resistance genes including bla genes were characterized via polymerase chain reaction (PCR). Findings: Among 100 patients enrolled in this study, 50 (50%) were ESBL carriers. Escherichia coli was the most prevalent bacterium isolated (85%). Genotyping of EBSL-PE encoding genes using PCR showed that the prevalence rates of blaCTX-M and blaCTX-M-15 genes were 94 (47 of 50) and 90% (45 of 50), respectively, which were higher than those of blaTEM (80%, 40 of 50) and blaSHV genes (34%, 17of 50). There was no significant association between ESBL-PE fecal carriage and age (p= .68), sex (p = .49), time of diagnosis (p= .21), antibiotic therapy for the past three months (p= .77), and history of chemotherapy (p= .49). Finally, it was determined that cancer type was an associated risk factor for ESBL-PE fecal carriage in cancer patients. Conclusion: This research emphasizes regular bacterial monitoring, and that antibiotic stewardship plans ought to be performed among cancer patients to prohibit further spread of ESBL-PE with confined therapeutic options. Copyright© 2021, TMU Press. This open-access article is published under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License which permits Share (copy and redistribute the material in any medium or format) and Adapt (remix, transform, and build upon the material) under the Attribution-NonCommercial terms. 10.52547/iem.7. 4.277