Author(s):
Satheesh N, Venkateswaramurthy N, Shankar Ganesh M, Karthick V, Dineshkumar.P
Email(s):
nvmurthi@gmail.com
DOI:
10.52711/2321-5836.2026.00047 
Address:
Satheesh N1, Venkateswaramurthy N2*, Shankar Ganesh M3, Karthick V4, Dineshkumar.P5
1Department of Pharmacy Practice, JKKN college of Pharmacy, The Tamil Nadu Dr. M.G.R. Medical University, Namakkal, Tamil Nadu, India. ORCID: 0009-0003-2390-7609.
2Department of Pharmacy Practice, JKKN College of Pharmacy, The Tamil Nadu Dr. M.G.R. Medical University, Namakkal, Tamil Nadu, India. ORCID: 0000-0002-8623-7898.
3Department of Pharmacy Practice, JKKN College of Pharmacy, The Tamil Nadu Dr. M.G.R. Medical University, Namakkal, Tamil Nadu, India. ORCID: 0009-0007-1322-3413.
4Department of Pharmacy Practice, JKKN College of Pharmacy, The Tamil Nadu Dr. M.G.R. Medical University, Namakkal, Tamil Nadu, India. ORCID: 0009-0007-3068-9290.
5Department of Pharmacy Practice, JKKN College of Pharmacy, The Tamil Nadu Dr. M.G.R. Medical University, Namakkal, Tamil Nadu, India. ORCID: 0009-0009-5882-4022.
*Corresponding Author
Published In:
Volume - 18,
Issue - 4,
Year - 2026
ABSTRACT:
Introduction: Surgical site infections are a significant concern in postoperative care, especially among cancer patients. These infections occur at the site of surgical incisions and are a major subset of healthcare-associated infections. The global incidence of SSIs is around 12.3%, with higher rates observed in developing countries due to disparities in healthcare quality and infection control practices. Cancer patients are at increased risk for SSIs due to immunosuppression from treatments, making effective infection control critical. Objective: This study aims to characterize bacterial isolates and determine their antimicrobial susceptibility patterns in SSIs among cancer patients. Methods: A prospective observational study was conducted over six months at a specialized cancer treatment center. The study included 79 cancer patients who developed SSIs post-surgery. Clinical samples were obtained from infected sites, and bacterial isolates were identified using conventional microbiological methods and advanced molecular techniques. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method and VITEK-2 automated systems, following Clinical and Laboratory Standards Institute guidelines. Results: The study found a slightly higher rate of SSIs in female patients (53.3%) compared to males (46.7%), with the highest infection rates observed in patients aged 61-70 years. All neutropenic patients developed SSIs, highlighting their increased susceptibility. Gram-negative bacteria dominated the microbial profile, with Pseudomonas aeruginosa being the most prevalent (50%), followed by Escherichia coli (16.6%) and Enterobacter cloacae (11.1%). Significant antibiotic resistance was observed, with Escherichia coli showing resistance to piperacillin, ciprofloxacin, and amikacin, but remaining susceptible to gentamicin and meropenem. Pseudomonas aeruginosa displayed partial susceptibility to ciprofloxacin and amikacin, yet full susceptibility to gentamicin, imipenem, and meropenem. Multidrug-resistant (MDR) pathogens such as Acinetobacter spp. and Klebsiella pneumoniae exhibited 100% MDR rates. Conclusions: This study underscores the critical need for comprehensive infection control measures and tailored antibiotic therapies to manage SSIs in cancer patients effectively. The findings highlight the severe impact of MDR organisms on treatment outcomes and emphasize the importance of continuous surveillance and antimicrobial stewardship to mitigate the challenges posed by antimicrobial resistance. Enhanced monitoring and preventive strategies, particularly for high-risk groups like neutropenic and diabetic patients, are essential to improve patient outcomes.
Cite this article:
Satheesh N, Venkateswaramurthy N, Shankar Ganesh M, Karthick V, Dineshkumar.P. Characterization of Bacterial Isolates and Antimicrobial Susceptibility Patterns in Surgical Site Infection of Cancer patients. Research Journal of Pharmacology and Pharmacodynamics. 2026;18(4):349-7. doi: 10.52711/2321-5836.2026.00047
Cite(Electronic):
Satheesh N, Venkateswaramurthy N, Shankar Ganesh M, Karthick V, Dineshkumar.P. Characterization of Bacterial Isolates and Antimicrobial Susceptibility Patterns in Surgical Site Infection of Cancer patients. Research Journal of Pharmacology and Pharmacodynamics. 2026;18(4):349-7. doi: 10.52711/2321-5836.2026.00047 Available on: https://www.rjppd.org/AbstractView.aspx?PID=2026-18-4-3
REFERENCES:
1. Bolton L. Surgical Site Infection in Cancer Patients. Wounds. 2021; 33(10): 260-262.
2. Pinchera B, Buonomo AR, Schiano Moriello N, Scotto R, Villari R, Gentile I. Update on the Management of Surgical Site Infections. Antibiotics (Basel). 2022; 11(11):1608. Published 2022 Nov 11. doi:10.3390/antibiotics11111608
3. Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. A Cancer Journal for Clinicians. 2024; 74(3): 229-263. doi:10.3322/caac.21834
4. Ali A, Gebretsadik D, Desta K. Incidence of surgical site infection, bacterial isolate, and their antimicrobial susceptibility pattern among patients who underwent surgery at Dessie Comprehensive Specialized Hospital, Northeast Ethiopia. Sage Open Medicine. 2023; 11: 205031212311723-205031212311723.
5. Maki G, Zervos M. Health Care-Acquired Infections in Low- and Middle-Income Countries and the Role of Infection Prevention and Control. Infectious Disease Clinics of North America. 2021; 35(3): 827-839. doi: 10.1016/j.idc.2021.04.014
6. Curcio D, Cane A, Fernández F, Correa J. Surgical site infection in elective clean and clean-contaminated surgeries in developing countries. International Journal of Infectious Diseases. 2019; 80:34-45. doi: 10.1016/j.ijid.2018.12.013
7. Fuglestad MA, Tracey EL, Leinicke JA. Evidence-based Prevention of Surgical Site Infection. Surgical Clinics of North America. 2021; 101(6): 951-966. doi: https://doi.org/10.1016/j.suc.2021.05.027
8. Delgado A, Guddati AK. Infections in Hospitalized Cancer Patients. World Journal of Oncologyl. 2021; 12(6): 195-205. doi:10.14740/wjon1410
9. Qi F, Wang M, Li B, Lu Z, Nie G, Li S. Reversal of the immunosuppressive tumor microenvironment by nanoparticle-based activation of immune-associated cells. Acta Pharmacologica Sinica. 2020; 41(7): 895-901. doi: https://doi.org/10.1038/s41401-020-0423-5
10. Bucataru A, Balasoiu M, Ghenea AE, et al. Factors Contributing to Surgical Site Infections: A Comprehensive Systematic Review of Etiology and Risk Factors. Clinics and Practice. 2023; 14(1): 52-68. Published 2023 Dec 28. doi:10.3390/clinpract14010006
11. Holmes CL, Anderson MT, Mobley HLT, Bachman MA. Pathogenesis of Gram-Negative Bacteremia. Clinical Microbiology Reviews. 2021;34(2):e00234-20. Published 2021 Mar 10. doi:10.1128/CMR.00234-20
12. Michels R, Last K, Becker SL, Papan C. Update on Coagulase-Negative Staphylococci-What the Clinician Should Know. Microorganisms. 2021; 9(4): 830. Published 2021 Apr 14. doi:10.3390/microorganisms9040830
13. Henwood CJ. Susceptibility of Gram-positive cocci from 25 UK hospitals to antimicrobial agents including linezolid. Journal of Antimicrobial Chemotherapy. 2000; 46(6): 931-940. doi: https://doi.org/10.1093/jac/46.6.931
14. Bharadwaj A, Rastogi A, Pandey S, Gupta S, Sohal JS. Multidrug-Resistant Bacteria: Their Mechanism of Action and Prophylaxis. BioMed Research International. 2022; 2022: 5419874. Published 2022 Sep 5. doi:10.1155/2022/5419874
15. Abbas A, Barkhouse A, Hackenberger D, Wright GD. Antibiotic resistance: A key microbial survival mechanism that threatens public health. Cell Host & Microbe. 2024; 32(6): 837-851. doi: https://doi.org/10.1016/j.chom.2024.05.015
16. Kyriakidis I, Vasileiou E, Pana ZD, Tragiannidis A. Acinetobacter baumannii Antibiotic Resistance Mechanisms. Pathogens. 2021; 10(3): 373. Published 2021 Mar 19. doi:10.3390/pathogens10030373
17. Shrestha NK, Fraser TG, Gordon SM. Methicillin resistance in Staphylococcus aureus infections among patients colonized with methicillin-susceptible Staphylococcus aureus. Clinical Microbiology and Infection. 2019; 25(1): 71-75. doi: https://doi.org/10.1016/j.cmi.2018.03.045
18. Prestinaci F, Pezzotti P, Pantosti A. Antimicrobial resistance: a global multifaceted phenomenon. Pathogens and Global Health. 2015; 109(7): 309-318. doi:10.1179/2047773215Y.0000000030
19. Totty JP, Moss JWE, Barker E, et al. The impact of surgical site infection on hospitalisation, treatment costs, and health-related quality of life after vascular surgery. International Wound Journal. 2021; 18(3): 261-268. doi:10.1111/iwj.13526
20. Hou Y, Collinsworth A, Hasa F, Griffin L. Incidence and impact of surgical site infections on length of stay and cost of care for patients undergoing open procedures. Surgery Open Science. 2022; 11: 1-18. Published 2022 Nov 8. doi: 10.1016/j.sopen.2022.10.004
21. Monahan M, Jowett S, Pinkney T, et al. Surgical site infection and costs in low- and middle-income countries: A systematic review of the economic burden. PLoS One. 2020;15(6):e0232960. Published 2020 Jun 4. doi: 10.1371/journal.pone.0232960
22. Smith GL, Lopez-Olivo MA, Advani PG, et al. Financial Burdens of Cancer Treatment: A Systematic Review of Risk Factors and Outcomes. Journal of the National Comprehensive Cancer Network. 2019; 17(10): 1184-1192. doi:10.6004/jnccn.2019.7305
23. Sharma A, Singh A, Dar MA, et al. Menace of antimicrobial resistance in LMICs: Current surveillance practices and control measures to tackle hostility. Journal of Infection and Public Health. 2022; 15(2): 172-181. doi: https://doi.org/10.1016/j.jiph.2021.12.008
24. Ballus J, Lopez-Delgado JC, Sabater-Riera J, Perez-Fernandez XL, Betbese AJ, Roncal JA. Surgical site infection in critically ill patients with secondary and tertiary peritonitis: epidemiology, microbiology and influence in outcomes. BMC Infectious Diseases. 2015; 15(1). doi: https://doi.org/10.1186/s12879-015-1050-5
25. Adzitey F, Huda N, Ali GR. Molecular techniques for detecting and typing of bacteria, advantages and application to foodborne pathogens isolated from ducks. 3 Biotech. 2013; 3(2): 97-107. doi:10.1007/s13205-012-0074-4
26. Dey P. Polymerase Chain Reaction: Principle, Technique and Applications in Pathology. 2022: 215-228. doi: https://doi.org/10.1007/978-981-19-6616-3_20
27. Bauer AW, Kirby WM, Sherris JC, Turck M. Antibiotic susceptibility testing by a standardized single disk method. American Journal of Clinical Pathology. 1966;45(4):493-496.
28. Yin D, Guo Y, Li M, et al. Performance of VITEK 2, E-test, Kirby–Bauer disk diffusion, and modified Kirby–Bauer disk diffusion compared to reference broth microdilution for testing tigecycline susceptibility of carbapenem-resistant K. pneumoniae and A. baumannii in a multicenter study in China. European Journal of Clinical Microbiology & Infectious Diseases. Published online January 7, 2021. doi: https://doi.org/10.1007/s10096-020-04123-z
29. Han C, Chen W, Ye X, et al. Risk factors analysis of surgical site infections in postoperative colorectal cancer: a nine-year retrospective study. BMC Surgery. 2023; 23(1). doi: https://doi.org/10.1186/s12893-023-02231-z.
30. Biffi R, Fattori L, Bertani E, et al. Surgical site infections following colorectal cancer surgery: a randomized prospective trial comparing common and advanced antimicrobial dressing containing ionic silver. World Journal of Surgical Oncology. 2012; 10(1). doi: https://doi.org/10.1186/1477-7819-10-94
31. Zafrani L, Azoulay E. How to treat severe infections in critically ill neutropenic patients?. BMC Infectious Disease. 2014; 14:512. Published 2014 Nov 28. doi:10.1186/1471-2334-14-512
32. Zhu J, Zhou K, Jiang Y, et al. Bacterial Pathogens Differed Between Neutropenic and Non-neutropenic Patients in the Same Hematological Ward: An 8-Year Survey. Clinical Infectious Diseases. 2018; 67(suppl_2): S174-S178. doi: https://doi.org/10.1093/cid/ciy643
33. Bodey GP. Pseudomonas aeruginosa infections in cancer patients: have they gone away? Current Opinion in Infectious Diseases. 2001;14(4):403-407. doi: https://doi.org/10.1097/00001432-200108000-00001
34. Ribeiro ÁCDS, Crozatti MTL, Silva AAD, Macedo RS, Machado AMO, Silva ATA. Pseudomonas aeruginosa in the ICU: prevalence, resistance profile, and antimicrobial consumption. Revista da Sociedade Brasileira de Medicina Tropical. 2019; 53: e20180498. Published 2019 Dec 20. doi:10.1590/0037-8682-0498-2018
35. Driscoll JA, Brody SL, Kollef MH. The Epidemiology, Pathogenesis and Treatment of Pseudomonas aeruginosa Infections. Drugs. 2007; 67(3): 351-368. doi: https://doi.org/10.2165/00003495-200767030-00003
36. Breijyeh Z, Jubeh B, Karaman R. Resistance of Gram-Negative Bacteria to Current Antibacterial Agents and Approaches to Resolve It. Molecules. 2020; 25(6): 1340. Published 2020 Mar 16. doi:10.3390/molecules25061340
37. Gharavi MJ, Zarei J, Roshani-Asl P, Yazdanyar Z, Sharif M, Rashidi N. Comprehensive study of antimicrobial susceptibility pattern and extended spectrum beta-lactamase (ESBL) prevalence in bacteria isolated from urine samples. Scientific Reports. 2021; 11. doi: https://doi.org/10.1038/s41598-020-79791-0
38. Almushayqih KM, Alslamah T, Alsalamah YA, Elbehiry A. The prevalence of multidrug-resistant Escherichia coli producing ESBL among male and female patients with urinary tract infections in Riyadh Region, Saudi Arabia. Healthcare. 2022; 10(9): 1778. doi:10.3390/healthcare10091778
39. Nwafia IN, Ohanu ME, Ebede SO, Ozumba UC. Molecular detection and antibiotic resistance pattern of extended-spectrum beta-lactamase producing Escherichia coli in a Tertiary Hospital in Enugu, Nigeria. Annals of Clinical Microbiology and Antimicrobials. 2019; 18(1). doi: https://doi.org/10.1186/s12941-019-0342-9
40. Hrovat K, Molan K, Seme K, Jerneja Ambrožič Avguštin. Molecular characterization of extended-spectrum β-lactamase-producing Escherichia coli isolated from lower respiratory tract samples between 2002 and 2019 in the Central Slovenia region. Annals of clinical microbiology and antimicrobials. 2024; 23(1). doi: https://doi.org/10.1186/s12941-023-00664-1
41. Paitan Y. Current Trends in Antimicrobial Resistance of Escherichia coli. Current Topics in Microbiology and Immunology. 2018: 181-211. doi: https://doi.org/10.1007/82_2018_110
42. Jane Wairimu Maina, Onyambu F, Peter Shikuku Kibet, Abednego Moki Musyoki. Multidrug-resistant Gram-negative bacterial infections and associated factors in a Kenyan intensive care unit: a cross-sectional study. Annals of Clinical Microbiology and Antimicrobials. 2023; 22(1). doi: https://doi.org/10.1186/s12941-023-00636-5.
43. Ruekit S, Srijan A, Serichantalergs O, et al. Molecular characterization of multidrug-resistant ESKAPEE pathogens from clinical samples in Chonburi, Thailand (2017–2018). BMC Infectious Diseases. 2022; 22(1). doi: https://doi.org/10.1186/s12879-022-07678-8
44. Terefe Hailemichael, Girma L, Paulos Fissiha, Geteneh A, Kassa T. Isolation of virulent phages against multidrug-resistant Acinetobacter baumannii recovered from inanimate objects of Jimma Medical Center, Southwest Ethiopia. BMC Infectious Diseases. 2023; 23(1). doi: https://doi.org/10.1186/s12879-023-08823-7
45. Miwa S, Yamamoto N, Hayashi K, Takeuchi A, Igarashi K, Tsuchiya H. Surgical Site Infection after Bone Tumor Surgery: Risk Factors and New Preventive Techniques. Cancers. 2022; 14(18): 4527. doi: https://doi.org/10.3390/cancers14184527
46. Miwa S, Shirai T, Yamamoto N, et al. Risk factors for surgical site infection after malignant bone tumor resection and reconstruction. BMC cancer. 2019; 19(1). doi:https://doi.org/10.1186/s12885-019-5270-8
47. Avishai E, Yeghiazaryan K, Golubnitschaja O. Impaired wound healing: facts and hypotheses for multi-professional considerations in predictive, preventive and personalised medicine. EPMA Journal. 2017; 8(1): 23-33. Published 2017 Mar 3. doi:10.1007/s13167-017-0081-y
48. Coccolini F, Improta M, Cicuttin E, et al. Surgical site infection prevention and management in immunocompromised patients: a systematic review of the literature. World Journal of Emergency Surgery. 2021; 16(1). doi: https://doi.org/10.1186/s13017-021-00375-y
49. Foschi D, Yakushkina A, Cammarata F, et al. Surgical site infections caused by multi-drug-resistant organisms: a case–control study in general surgery. Updates in Surgery. Published online March 19, 2022. doi: https://doi.org/10.1007/s13304-022-01243-3
50. Atsushi Kuwano, Saito T, Nitta M, et al. Relationship between characteristics of glioma treatment and surgical site infections. Acta Neurochirurgica. 2022; 165(3): 659-666. doi: https://doi.org/10.1007/s00701-022-05474-6