Antimicrobial Susceptibility Pattern of Commonest Gram-Negative Uropathogen among Cancer Patients at a Tertiary Care Hospital in Bangladesh

Abstract

Background: Urinary tract infections (UTIs) is one of the leading causes of morbidity and mortality in cancer patients. The increasing prevalence of multidrug-resistant (MDR) gram-negative bacterial strains as causative agents of urinary tract infection has emerged as a critical challenge in oncological care. Bangladesh is experiencing a rapidly escalating antimicrobial resistance (AMR) burden, yet organism-specific susceptibility data from oncology settings remain critically scarce.

Objective: This study aimed to describe the antimicrobial susceptibility profile of gram-negative uropathogens in cancer patients at Ahsania Mission Cancer and General Hospital (AMCGH), Dhaka, Bangladesh.

Methodology: This was a retrospective cross-sectional study of urine culture and sensitivity data from UTI cancer patients aged ≥3 years attending AMCGH between July 2024 and June 2025. Commonest gram negative uropathogen E. coli, Klebsiella spp. and Pseudomonas spp. positive urine samples were taken as study sample. Antibiotic susceptibility testing (AST) was performed by Kirby-Bauer disc diffusion, interpreted per CLSI 2024 M100 breakpoints. MDR was defined as resistance to ≥3 antimicrobial classes. Ethical approval was taken from the ethical review committee of AMCGH.

Results: Out of 189 culture-positive isolates, E. coli predominated (47.6%), followed by Klebsiella species (40.2%) and Pseudomonas spp. (12.2%). MDR was identified in 94.4% of Escherichia coli, 100% of Klebsiella species, and 56.5% of Pseudomonas spp. isolates. Meropenem retained the best activity against E. coli (81.1% susceptible), but carbapenem susceptibility was low in Klebsiella spp. (44.7%) and Pseudomonas species (43.5%). Ceftazidime–avibactam was found susceptible in 74.3%, 32.1%, and 25% of Escherichia coli, Klebsiella species and Pseudomonas spp., respectively.

Conclusion: Escherichia coli showed high susceptibility to carbapenem but Klebsiella spp. and Pseudomonas species showed very low susceptibility to carbapenem along with ceftazidime -avibactam.

Bangladesh Journal of Medical Microbiology, January 2026;20 (1):46-53