Ntim Onyansaniba K, Awere-Duodu Aaron, Osman Abdul-Halim, Donkor Eric S
Department of Medical Microbiology, University of Ghana Medical School, P.O. Box, Accra, KB, 4236, Ghana.
BMC Infect Dis. 2025 Mar 1;25(1):296. doi: 10.1186/s12879-025-10481-w.
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.
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.
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%).
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.
抗菌药物耐药性（AMR）是全球公共卫生面临的重大威胁，限制了感染的治疗选择。AMR对癌症患者尤其具有生命威胁，这些患者发生抗生素耐药性感染的风险更高。本综述呈现了从癌症患者中分离出的主要细菌病原体中AMR流行率的首个全面数据。
在PubMed、Scopus和Web of Science中进行了广泛检索，重点关注2000年至2024年以英文发表的研究。进行了单组荟萃分析以确定主要细菌种类的耐药流行率。
系统综述纳入了132篇全文文章，其中关于血液系统癌症患者的研究最为常见（36.4%）。报告的主要细菌病原体为大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、鲍曼不动杆菌、铜绿假单胞菌、粪肠球菌、肺炎链球菌和肠杆菌属。对于大肠埃希菌，青霉素的耐药流行率最高（81.84%），其次是复方新诺明（65.79%）和单环β-内酰胺类（61.61%）。对于肺炎克雷伯菌，青霉素的耐药流行率最高（98.99%），其次是复方新诺明（70.92%）。鲍曼不动杆菌对多种抗菌药物类别具有较高的耐药流行率，包括第三代头孢菌素（84.10%）、第四代头孢菌素（80.75%）、碳青霉烯类（82.58%）、氟喹诺酮类（80.37%）、β-内酰胺-β-内酰胺酶抑制剂（79.15%）、复方新诺明（75.77%）和氨基糖苷类（64.05%）。肠杆菌属和粪肠球菌对青霉素的耐药流行率分别高达91.77%和90.64%。铜绿假单胞菌对第三代头孢菌素的耐药流行率较高（49.41%），而金黄色葡萄球菌对大环内酯类（55.63%）和甲氧西林（45.29%）的耐药流行率较高。
本综述表明全球范围内从癌症患者中分离出的细菌病原体中抗菌药物耐药性普遍存在。观察到的显著耐药流行率，尤其是在ESKAPE病原体中，凸显了全球癌症护理中改善感染预防和抗菌药物管理的迫切需求。
