*1,2Boni, C., 1Kouakou, C., 2Gnegouri, R., 2Benié Ackah, J., and 1Koffi, K. S.
1Department of Fundamental and Biological Sciences, Faculty of Medical Sciences, Félix Houphouët-Boigny University, Abidjan, Côte d’Ivoire
2Laboratory Department, Alassane Ouattara National Center of Oncology and Radiotherapy (CNRAO), Abidjan, Côte d’Ivoire
*Correspondence to: boni.cho@ufhb.edu.ci; +2250505083523
Abstract:
Background: Febrile episodes in patients undergoing chemotherapy pose a major risk for bloodstream infections (BSIs). Prompt microbiological diagnosis is essential to guide targeted therapy and minimize the emergence of antimicrobial resistance.
Methodology: A six-month cross-sectional study (July–December 2024) was conducted at the Alassane Ouattara National Center of Oncology and Radiotherapy (CNRAO), Abidjan, Côte d’Ivoire. All chemotherapy patients presenting with fever (≥38.5°C) were included. Blood cultures were processed using the BACT/ALERT system, and bacterial identification with antimicrobial susceptibility testing followed CA-SFM 2022 guidelines. ESBL and carbapenemase production in Gram-negative isolates was detected in line with CA-SFM/EUCAST guidelines while methicillin resistance (MR), macrolide-lincosamide-streptogramin B (MLSB), and kanamycin-tobramycin-genta- micin (KTG) resistance phenotypes in Gram-positive isolates were detected in line with CLSI/CA-SFM standard.
Results: Fifty patients were enrolled (mean age of 53.7±12.2 years; 82.0% females). Breast cancer was the most frequent malignancy (64.0%). Blood cultures were positive in 8.0% (4/50) of cases, with 2 (50.0%) Staphylococcus aureus and 2 (50.0%) Salmonella spp isolates. All isolates were fully susceptible to tested antibiotics, with no resistance phenotypes observed. Clinical outcomes were favorable in all cases after targeted antimicrobial therapy.
Conclusion: The prevalence of bacteremia among febrile chemotherapy patients at CNRAO was 8.0%, which is lower than previously reported prevalence in the general populations in Côte d’Ivoire. However, due to the small sample size, this finding should be interpreted with caution. Nevertheless, routine blood culture remains crucial for optimizing antimicrobial management, preventing resistance, and improving outcomes in oncology care, as highlighted in this study.
Keywords: Bacteremia, Chemotherapy, Blood culture, Antimicrobial resistance, Côte d’Ivoire
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