This is the first study in Basrah province/Iraq to detect the geographical distribution of adult oncology patients with bacteremia and the bacterial etiology. From 176 patients’ samples, the highest incidence of cancer cases was recorded in central 62 (35.22%) followed by western 45 (25.56%), northern 34 (19.31%), southern 24 (13.63%) and eastern 11 (6.25%) regions. The majority of cancer with bacteremic episodes (64) were located in the central 23 (35.93%), western 16 (25%) and southern 13 (20.31%) regions, while they were less likely to occur in the northern 7 (10.93%) and eastern 5 (7.81%) regions. Some clinical characteristics, including age (30-60 year), leukemia (64.06%), healthcare exposure (73.43%), neutropenia (71.87%), non-antibiotic administration (81.25%) and fever (100%) were associated with bacteremic episodes. Sixty-three (98.43%) of these episodes were caused by Gram-positive pathogens, especially 48 (75 %) Bacillus spp., these were 21 B. licheniformis, 19 B. cereus, 3 B. subtillus, 3 B. sonorensis, 1 B. aeruius and 1 B. toyonensis. On the other hand, 3 Staphylococcus epidermidis, 1 isolate of S. warneri, Lysinibacillus sphaericus, Lysinibacillus xylanilyticus, Enterobacter cancerogenous and 9 other of Gram-positive bacteria (unidentified). Exclusively, this is the first study isolated Gr-ve Enterobacter cancerogenous from cancer patients with bacteremia. Three isolates Bacillus licheniformis “IRQBAS18”, Bacillus licheniformis “IRQBAS19” and Bacillus licheniformis “IRQBAS20” were reported as new global bacterial strains. RAPD analysis showed four patients from different regions, each two (9.5% for each) had the same strain of Bacillus licheniformis and other four (19.04%) patients from different regions had closely related strains of Bacillus licheniformis, these results confirm that the bacteremic infections were coming from the same source.
Bacteremia, Bacillus, licheniformis, cancer, RAPD
- Abbott, S. L. and Janda, J. M. (1997). “Enterobacter cancerogenus (Enterobacter taylorae) Infections Associated with Severe Trauma or Crush Injuries”. Microbiology and Infectious Disease 359-361.
- Abdallah, S. N. A., Al-dabbag, R. and Baqir, H. I. (2008). “Nosocomial Bacteremia in Leukopenic Patients with Leukemia in Baghdad Teaching Hospital” The Iraqi Postgraduate Medical Journal 7 (4): 327–31.
- Abd Al-Abbas, M. J. (2012). “Antimicrobial Susceptibility of Enterococcus faecalis and a Novel Planomicrobium Isolate of Bacterimia.” International Journal of Medicine and Medical Sciences 4 (2): 19–27.
- Abd Al-Abbas, M. J. and Chemagh, A.A. (2014). “Molecular Genetic Study Confirming the Transmission of Nasopharyngeal Bacteria to Middle Ear in Patients with Chronic Supportive Otitis Media, Including New Global Strains in GenBank: MunaAla1, MunaAla2, IRQBAS5 and IRQBAS6”. International Journal of Pharmaceutical Research and Bioscience 3 (2): 379-97.
- Al-Mulla, N. A., Taj-Aldeen,S. J., El Shafie, S., Janahi, M., Al-Nasser, A. A. and Chandra, P. (2014). “Bacterial Bloodstream Infections and Antimicrobial Susceptibility Pattern in Pediatric Hematology/Oncology Patients after Anticancer Chemotherapy.” Infection and Drug Resistance 7: 289–99.
- Asturias, E. J., Corral, J. E. and Quezada, J. (2010). “Evaluation of Six Risk Factors for the Development of Bacteremia in Children with Cancer and Febrile Neutropenia.” Current Oncology17 (2): 59–63.
- Åttman, E., Aittoniemi, J., Sinisalo, M., Vuento, R., Lyytikäinen, O., Kärki, T., Syrjänen, J. and Huttunen, R. (2015). “Etiology, Clinical Course and Outcome of Healthcare-Associated Bloodstream Infections in Patients with Hematological Malignancies: A Retrospective Study of 350 Patients in a Finnish Tertiary Care Hospital.” Leukemia & Lymphoma 56 (12): 3370–77.
- Japoni, A., Alborzi, A., Rasouli, M. and Pourabbas, B. (2004). "Modified DNA Extraction for Rapid PCR Detection of Methicillin-Resistant Staphylococci." Iranian Biomedical Journal 8 (3): 161-165.
- Bartholomew, F., Aftandilian, C., Andrews, J., Gutierrez, K., Luna-Fineman, S. and Jeng, M. (2015). “Evaluation of Febrile, Nonneutropenic Pediatric Oncology Patients with Central Venous Catheters Who are Not Given Empiric Antibiotics.” The Journal of Pediatrics 166 (1): 157–62.
- Castagnola, E., Fioredda, F., Barretta, M., Pescetto, L., Garaventa, A., Lanino, E., Micalizzi, C., Giacchino, R. and Dini, G. (2001). “Bacillus Sphaericus Bacteraemia in Children with Cancer: Reports, C. and Literature Review.” The Journal of Hospital Infection 48 (2): 142–45.
- Chou, Y., Cheng, S., Hsieh, K., Wang, C., Chen, S. and Lo, W. (2013). “Bacillus Cereus Septicemia in a Patient with Acute Lymphoblastic Leukemia: A Case Report and Review of the Literature.” Journal of Microbiology, Immunology and Infection 49 (3): 4–7.
- CSO, (2014) "Environmental Statistics Report in Iraq for the year 2014" available at http://www.cosit.gov.iq.
- El-Hamshary, O. I. M., Mohammed, H., Sheikh, A. and Khattab, A. A. (2012). “Molecular Characterization of Bacteria Isolated from the Kingdom of Saudi Arabia and Their Uses against Pathogenic Fungi Causing Dermatological Diseases.” African Journal of Biotechnology 11 (89): 15510–15.
- El-mahallawy, H. A., Hassan, S. S., El-wakil, M. and Moneer, M. M. (2015). “Update on Healthcare-Associated Blood Stream Infections in Febrile Neutropenic Pediatric Oncology Patients” Journal of Cancer Therapy 6:504–10.
- Essa, S. S., Habib, O. S., Al-Diab, J. M. A., Al-Imara, K. A. S. and Ajeel, N. A. H. (2007). “Cancer Mortality in Basrah.” The Medical Journal of Basrah University 25: 55–60.
- Fares, S., Lamchahab, M., Zerouali, K., Serhier, Z., Benchekroun, S. and Quessar A. (2013). “Surveillance of Healthcare Associated Infections in Hematology: Prospective Study about 237 Patients.” Blood 122 (21): 1-9
- Feld, R. (2008). “Bloodstream Infections in Cancer Patients with Febrile Neutropenia.” International Journal of Antimicrobial Agents 32 : 30–33.
- Garazzino, S., Aprato, A., Maiello, A., Masse, A., Biasibetti, A., De Rosa, F. G. and Perri, G. Di. (2005). “Osteomyelitis Caused by Enterobacter Cancerogenus Infection Following a Traumatic Injury: Case Report and Review of the Literature.” Journal of Clinical Microbiology 43 (3): 1459–61.
- Gaur, H., Patrick, C. C., McCullers, J., Flynn, P. M., Pearson, T., Razzouk, B. I., Thompson, S. J. and Shenep, J. L. (2001). “Bacillus Cereus Bacteremia and Meningitis in Immunocompromised Children.” Clinical Infectious Diseases: 1456–62.
- Ginsburg, A. S., Salazar, L. G., True, L. D. and Disis, M. L.. (2003). “Fatal Bacillus Cereus Sepsis Following Resolving Neutropenic Enterocolitis during the Treatment of Acute Leukemia.” American Journal of Hematology 72 (3): 204–8.
- Katherason, G. S., Naing, L., Jaalam, K., Musa, K. K. I., Abdullah, N. M. N., Aiyar, S., Bhojwani, K., Harussani, N., Abdul Rahman, A. and Ismail, A. (2010). “Prospective Surveillance of Nosocomial Device-Associated Bacteremia in Three Adult Intensive Units in Malaysia.” Tropical Biomedicine 27 (2): 308–16.
- Gupta, A., Singh, M., Singh, H., Kumar, L., Sharma, A., Bakhshi, S., Raina, V. and Thulkar, S. (2010). “Infections in Acute Myeloid Leukemia: An Analysis of 382 Febrile Episodes.” Medical Oncology 27 (4): 1037–45.
- Hadi, Z. J. (2015). "Prevalence of Plasmid-Mediated Quinolones Resistance Genes in Clinical Isolates of Klebsiella Pneumoniae in Najaf Hospitals" PhD. Thesis. Faculty of Medicine. University of Kufa. Iraq.
- Hussain, R. A. (2015). "Cancer in Basrah: Extent, Validation of Registration and Patients Behavior". PhD Thesis, College of Medicine. University of Basrah. Iraq.
- Kalantar, E., Aghabarari, M., Asgari, E., Assadi, M., Marashi, M. A., Hatami, S. and Shakib, A. (2014). “Survey of Enteric Pathogens Causing Bacteremia in Cancer Patients”International jouranl of Enteric Pathogens 2 (2):1-3.
- Kelly M., Vivier, P., Panken, T. and Schwartz, C. (2010). “Bacteremia in Febrile Nonneutropenic Pediatric Oncology Patients Michael.” Pediatric Blood Cancer 54: 83–87.
- Kjellander, C., Björkholm, M., Cherif, H., Kalin, M. and Christian, G. G. (2012). “Hematological: Low All-Cause Mortality and Low Occurrence of Antimicrobial Resistance in Hematological Patients with Bacteremia Receiving No Antibacterial Prophylaxis: A Single-Center Study.” European Journal of Haematology 88 (5): 422–30.
- Lenz, R., Leal, J. R., Church, D. L., Gregson, D. B., Ross, T. and Laupland, K. B. (2012). “The Distinct Category of Healthcare Associated Bloodstream Infections.” BMC Infectious Diseases 12 (1): 85-91
- Maiti, B., Shekar, M., Khushiramani, R., Karunasagar, I. and Karunasagar, I. (2009). “Evaluation of RAPD-PCR and Protein Profile Analysis to Differentiate Vibrio Harveyi Strains Prevalent along the Southwest Coast of India.” Journal of Genetics 88 (3): 273–79.
- Marschall, J., Fraser, V. J, Doherty, J. and Warren, D. K. (2009). “Between Community and Hospital: Healthcare-Associated Gram-Negative Bacteremia among Hospitalized Patients.” Infection Control and Hospital Epidemiology : The Official Journal of the Society of Hospital Epidemiologists of America 30 (11): 1050–56.
- Miyoshi, T., Iwatsuki, T. and Naganuma, T. (2005). “Phylogenetic Characterization of 16S rRNA Gene Clones from Deep-Groundwater Microorganisms That Pass through 0 . 2-Micrometer-Pore-Size Filters”. Applied and Environmental Microbiology 71 (2): 1084–88.
- Moghnieh, R., Estaitieh, N., Mugharbil, A., Jisr, T., Abdallah, D. I., Ziade, F., Sinno, L. and Ibrahim, A. (2015). “Third Generation Cephalosporin Resistant Enterobacteriaceae and Multidrug Resistant Gram-Negative Bacteria Causing Bacteremia in Febrile Neutropenia Adult Cancer Patients in Lebanon, Broad Spectrum Antibiotics Use as a Major Risk Factor, and Correlation W.” Frontiers in Cellular and Infection Microbiology 5 (11): 1-9.
- Montassier, E., Batard, E., Gastinne, T., Potel, G. and De La Cochetière, M. F. (2013). “Recent Changes in Bacteremia in Patients with Cancer: A Systematic Review of Epidemiology and Antibiotic Resistance.” European Journal of Clinical Microbiology and Infectious Diseases 32 (7): 841–50.
- Nesher, L. and Rolston, K. V. I. (2014). “The Current Spectrum of Infection in Cancer Patients with Chemotherapy Related Neutropenia”. Infection 42:5–13.
- Ozkocaman, V., Ozcelik, T., Ali, R., Ozkalemkas, F. and Ozkan, A. (2006). “Bacillus Spp. among Hospitalized Patients with Haematological Malignancies : Clinical Features , Epidemics and Outcomes.”. Journal of Hospital Infection. 1-8
- Parikh, H. R., De, A. S. and Baveja, S. M. (2012). “Comparison of the Lysis Centrifugation Method with the Conventional Blood Culture Method in Cases of Sepsis in a Tertiary Care Hospital,” Journal of Laboratory Physicians 4 (2): 2–6.
- Pereira, Pires, C. A., Marra, A. R., Camargo, L. F. A., Pignatari, A. C. C., Sukiennik, T., Behar, P. R. P., Medeiros, E. A. S. (2013). “Nosocomial Bloodstream Infections in Brazilian Pediatric Patients: Microbiology, Epidemiology, and Clinical Features.” PLoS ONE 8 (7): 8–13.
- Rolston, K. V. I., Yadegarynia, D., Kontoyiannis, D. P., Raad, I. I. and Ho, D. H. (2006). “The Spectrum of Gram-Positive Bloodstream Infections in Patients with Hematologic Malignancies and the in Vitro Activity of Various Quinolones against Gram-Positive Bacteria Isolated from Cancer Patients.” International Journal of Infectious Diseases: 10 (3): 223–30.
- Ronimus, R. S., Parker, L. E., Morgan, H. W. and Mesophilic, B. (1997). “The Utilization of RAPD-PCR for Identifying Thermophilic and Mesophilic Bacillus Species" FEMS Microbiology Letters 147: 75–79.
- Rubinstien, E. M., Klevjer-anderson, P., Smith, C. A., Drouin, M. T. and Patrerson, J. A. N. E. (1993). “New Opportunistic Pathogen: Report of Four Cases”. Journal of Clinical Microbiology. 31 (2): 249–54.
- Samonis, G., Vardakas, K. Z., Maraki, S., Tansarli, G. S., Dimopoulou, D., Kofteridis, D. P., Andrianaki, A. M. and Falagas, M. E. (2013). “A Prospective Study of Characteristics and Outcomes of Bacteremia in Patients with Solid Organ or Hematologic Malignancies.” Supportive Care in Cancer 21 (9): 2521–26.
- Tena, D., Lago, M. R., Sáez-nieto, J. A., Medina, M. J., Lara, N. and Oteo, J. (2015). “Surgical Site Infection Caused by Enterobacter cancerogenus A Case Report and Review of Literature”. Infectious Diseases in Clinical Practice 23 (6): 289–91.
- Tissot, F., Calandra, T., Prod’hom, G., Taffe, P., Zanetti, G., Greub, G. and Senn, L.. (2014). “Mandatory Infectious Diseases Consultation for MRSA Bacteremia Is Associated with Reduced Mortality.” Journal of Infection 69 (3). 226–34.
- Towner, K. J., Levi, K., Vlassiadi, M. and Steering, A. (2008). “Genetic Diversity of Carbapenem-Resistant Isolates of Acinetobacter Baumannii in Europe.” Clinical Microbiology and Infection 14 (2): 161-167.
- Wenzler, E., Kamboj, K. and Balada-Llasat, J. M. (2015). “Severe Sepsis Secondary to Persistent Lysinibacillus sphaericus, Lysinibacillus fusiformis and Paenibacillus amylolyticus Bacteremia.” International Journal of Infectious Diseases 35:93–95.
- Wisplinghoff, H., Seifert, H., Wenzel, R. P. and Edmond, M. B. (2003). “Current Trends in the Epidemiology of Nosocomial Bloodstream Infections in Patients with Hematological Malignancies and Solid Neoplasms in Hospitals in the United States.” Clinical Infectious Diseases 36 (9): 1103–10.
- Woo, P. C. Y., Lau, S. K. P., Teng, J. L. L., Tse, H. and Yuen, K. (2008). “Then and Now : Use of 16S rDNA Gene Sequencing for Bacterial Identification and Discovery of Novel Bacteria in Clinical Microbiology Laboratories.” European Society of Clinical Infectious Diseases 14 (10): 908–34.
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