Antimicrobial resistance of bacterial pathogens isolated from cancer patients: a systematic review and meta-analysis

Abstract Background Antimicrobial resistance (AMR) is a major threat to global public health, limiting treatment options for infections. AMR is particularly life-threatening for cancer patients, who are at increased risk of antibiotic-resistant infections. This review presents the first comprehensiv...

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Main Authors: Onyansaniba K. Ntim, Aaron Awere-Duodu, Abdul-Halim Osman, Eric S. Donkor
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Infectious Diseases
Subjects:
Online Access:https://doi.org/10.1186/s12879-025-10481-w
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author Onyansaniba K. Ntim
Aaron Awere-Duodu
Abdul-Halim Osman
Eric S. Donkor
author_facet Onyansaniba K. Ntim
Aaron Awere-Duodu
Abdul-Halim Osman
Eric S. Donkor
author_sort Onyansaniba K. Ntim
collection DOAJ
description Abstract Background Antimicrobial resistance (AMR) is a major threat to global public health, limiting treatment options for infections. AMR is particularly life-threatening for cancer patients, who are at increased risk of antibiotic-resistant infections. This review presents the first comprehensive data on the prevalence of AMR in major bacterial pathogens isolated from cancer patients. Method An extensive search was conducted in PubMed, Scopus, and Web of Science, focusing on studies published in English from 2000 to 2024. A single-group meta-analysis was performed to determine the resistance prevalence of major bacterial species. Results One hundred thirty-two full-text articles were included in the systematic review, and studies on haematological cancer patients were the most common (36.4%). The major bacterial pathogens reported were Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterococcus faecium, Streptococcus pneumoniae and Enterobacter spp. For E. coli, resistance prevalence was highest for penicillins (81.84%), followed by cotrimoxazole (65.79%) and monobactams (61.61%). For K. pneumoniae, the highest prevalence of resistance was observed for penicillins (98.99%), followed by cotrimoxazole (70.92%). Acinetobacter baumannii had high resistance prevalence to multiple antimicrobial classes, including third-generation cephalosporins (84.10%), fourth-generation cephalosporins (80.75%), carbapenems (82.58%), fluoroquinolones (80.37%), beta-lactam-beta-lactamase inhibitors (79.15%), cotrimoxazole (75.77%), and aminoglycosides (64.05%). Enterobacter spp. and Enterococcus faecium showed high resistance prevalence to penicillins at 91.77% and 90.64% respectively. P. aeruginosa had a high prevalence of resistance to third-generation cephalosporins (49.41%) while S. aureus showed high prevalence to macrolides (55.63%) and methicillin (45.29%). Conclusion This review indicated a high prevalence of antimicrobial resistance in bacterial pathogens isolated from cancer patients worldwide. The pronounced resistance prevalence observed, especially among ESKAPE pathogens, underscores the urgent need to improve infection prevention and antimicrobial stewardship in cancer care globally.
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spelling doaj-art-eb8bd13e8ddf47db8b23b028193184dd2025-08-20T02:16:48ZengBMCBMC Infectious Diseases1471-23342025-03-0125111310.1186/s12879-025-10481-wAntimicrobial resistance of bacterial pathogens isolated from cancer patients: a systematic review and meta-analysisOnyansaniba K. Ntim0Aaron Awere-Duodu1Abdul-Halim Osman2Eric S. Donkor3Department of Medical Microbiology, University of Ghana Medical SchoolDepartment of Medical Microbiology, University of Ghana Medical SchoolDepartment of Medical Microbiology, University of Ghana Medical SchoolDepartment of Medical Microbiology, University of Ghana Medical SchoolAbstract Background Antimicrobial resistance (AMR) is a major threat to global public health, limiting treatment options for infections. AMR is particularly life-threatening for cancer patients, who are at increased risk of antibiotic-resistant infections. This review presents the first comprehensive data on the prevalence of AMR in major bacterial pathogens isolated from cancer patients. Method An extensive search was conducted in PubMed, Scopus, and Web of Science, focusing on studies published in English from 2000 to 2024. A single-group meta-analysis was performed to determine the resistance prevalence of major bacterial species. Results One hundred thirty-two full-text articles were included in the systematic review, and studies on haematological cancer patients were the most common (36.4%). The major bacterial pathogens reported were Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterococcus faecium, Streptococcus pneumoniae and Enterobacter spp. For E. coli, resistance prevalence was highest for penicillins (81.84%), followed by cotrimoxazole (65.79%) and monobactams (61.61%). For K. pneumoniae, the highest prevalence of resistance was observed for penicillins (98.99%), followed by cotrimoxazole (70.92%). Acinetobacter baumannii had high resistance prevalence to multiple antimicrobial classes, including third-generation cephalosporins (84.10%), fourth-generation cephalosporins (80.75%), carbapenems (82.58%), fluoroquinolones (80.37%), beta-lactam-beta-lactamase inhibitors (79.15%), cotrimoxazole (75.77%), and aminoglycosides (64.05%). Enterobacter spp. and Enterococcus faecium showed high resistance prevalence to penicillins at 91.77% and 90.64% respectively. P. aeruginosa had a high prevalence of resistance to third-generation cephalosporins (49.41%) while S. aureus showed high prevalence to macrolides (55.63%) and methicillin (45.29%). Conclusion This review indicated a high prevalence of antimicrobial resistance in bacterial pathogens isolated from cancer patients worldwide. The pronounced resistance prevalence observed, especially among ESKAPE pathogens, underscores the urgent need to improve infection prevention and antimicrobial stewardship in cancer care globally.https://doi.org/10.1186/s12879-025-10481-wAntimicrobial resistanceCancer patientsAntimicrobial classesPrevalenceHaematologicalBacteria
spellingShingle Onyansaniba K. Ntim
Aaron Awere-Duodu
Abdul-Halim Osman
Eric S. Donkor
Antimicrobial resistance of bacterial pathogens isolated from cancer patients: a systematic review and meta-analysis
BMC Infectious Diseases
Antimicrobial resistance
Cancer patients
Antimicrobial classes
Prevalence
Haematological
Bacteria
title Antimicrobial resistance of bacterial pathogens isolated from cancer patients: a systematic review and meta-analysis
title_full Antimicrobial resistance of bacterial pathogens isolated from cancer patients: a systematic review and meta-analysis
title_fullStr Antimicrobial resistance of bacterial pathogens isolated from cancer patients: a systematic review and meta-analysis
title_full_unstemmed Antimicrobial resistance of bacterial pathogens isolated from cancer patients: a systematic review and meta-analysis
title_short Antimicrobial resistance of bacterial pathogens isolated from cancer patients: a systematic review and meta-analysis
title_sort antimicrobial resistance of bacterial pathogens isolated from cancer patients a systematic review and meta analysis
topic Antimicrobial resistance
Cancer patients
Antimicrobial classes
Prevalence
Haematological
Bacteria
url https://doi.org/10.1186/s12879-025-10481-w
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