Nasal colonization by potentially pathogenic bacteria, their antimicrobial susceptibility patterns, and risk factors for colonization among cancer patients at Dessie comprehensive specialized hospital, Northeast Ethiopia

Abstract

Nasal colonisation by bacteria occurs more frequently in immunocompromised patients than in healthy individuals. These colonizing bacteria can potentially lead to infections in cancer patients, especially as these patients tend to be immunocompromised. To determine the prevalence of nasal bacterial colonization, antimicrobial susceptibility patterns, and risk factors for colonization among cancer patients at the Dessie Comprehensive Specialized Hospital in Ethiopia. A hospital-based cross-sectional study was conducted, from March 01 to June 30 2024. Socio-demographic and other data were collected using structured questionnaires and reviewing patient cards. Each nasal swab sample was cultivated on blood agar, chocolate agar, MacConkey agar, and mannitol salt agar, at 37 °C. Bacterial species were identified using gram stain, colony morphology, and standard biochemical tests. Kirby Bauer’s disc diffusion method was performed using Mueller Hinton agar to test for antimicrobial sensitivity. Data were collected, cleaned, entered into Epi-data 3.1, and analyzed using SPSS version 26. Descriptive statistics were presented with tables and figures, while logistic regression identified significant associations using odds ratios and 95% confidence intervals (p < 0.05). Nasal carriage rate of bacterial isolates were, 112/260, 43.1% (95% confidence interval 37.7%-49.2%). Out of the total nasal isolates, Staphylococcus aureus was the most common bacterial species (24.1%), followed by coagulase-negative staphylococci (21.4%), Streptococcus pneumoniae (14.3%), and Pseudomonas aeruginosa (10.7%). Multidrug resistance (MDR) was observed in 45.5% of isolates, with Klebsiella ozaenae and Acinetobacter species showing particularly high resistance rates. Notably, K. ozaenae exhibited complete resistance to all tested drugs, while Acinetobacter species demonstrated an 80% MDR rate. A history of hospital admission, smoking, nose and hand washing habits were significantly associated risk factors for the carriage rate. Nasal bacterial colonization in cancer patients may result in significant health issues. The antimicrobial resistance patterns were relatively high, which may reflect the participant’s hospitalization. Regular health education among those patients are recommended to potentially tackle nasal bacterial carriage.