Abstract :
Introduction: Cancer therapies such as chemotherapy, radiotherapy, and immunotherapy improve outcomes but also suppress immune function, increasing susceptibility to infections. Sepsis remains a critical complication, especially in patients with high Tumor burden or Tumor lysis syndrome (TLS). Timely identification of pathogens and antimicrobial resistance is essential for effective management.Aims and Objectives: This study aimed to identify the most common pathogens responsible for sepsis in cancer patients, determine the primary sites of infection, and evaluate the antibiotic resistance patterns of isolated organisms. Additionally, it sought to analyse the correlation between the type of organism (Gram-positive vs. Gram-negative) and clinical outcomes such as ICU admission and mortality, and to assess variations in causative organisms following chemotherapy or radiotherapy.Materials and Methods: This retrospective observational study was conducted between January 2022 and April 2024 at the Departments of Radiation Oncology and Microbiology, Swami Rama Himalayan University. Cancer patients (18–75 years) who presented with sepsis and had positive cultures from blood, urine, chemo ports, ET secretions, or pus were included. Demographic data, culture results, antibiotic sensitivity, and treatment history were collected and analysed.Results: Out of 112 cancer patients, the mean age was 61.3 years (range: 14–87), with a male-to-female ratio of 1.67:1. Chemotherapy had been administered to 36.6% of patients and radiotherapy to 16.1%, with sepsis typically occurring within weeks of treatment. Positive cultures were found in 34.8% of cases, most frequently from urine and blood. E. coli was the most common organism, followed by Klebsiella pneumoniae and Pseudomonas aeruginosa. Gram-negative bacteria predominated and showed resistance to fluoroquinolone and beta-lactams but retained sensitivity to colistin and carbapenems. The average hospital stay was 6.8 days, with longer durations observed in bloodstream infections and multi drug-resistant cases.Conclusion: Gram-negative organisms predominate in cancer-related sepsis. Regular surveillance of pathogen profiles and resistance trends is critical to guiding empirical treatment and improving outcomes.
Keyword :
Cancer, Sepsis, Antibiotic resistance, Culture and Sensitivity, Bacteraemia, Chemotherapy, Retrospective study.