ANTIMICROBIAL resistance (AMR) is an escalating global health crisis, posing a severe threat to patients with cancer, who are highly susceptible to antibiotic-resistant infections. A new systematic review and meta-analysis provide the first comprehensive global data on the prevalence of AMR in major bacterial pathogens affecting this vulnerable population.
A systematic literature search was conducted in PubMed, Scopus, and Web of Science, covering studies published between 2000–2024. Full-text articles in English that reported bacterial resistance in cancer patients were included. A single-group meta-analysis was performed to determine the prevalence of resistance in major bacterial species, focusing on haematological and solid tumour patients.
From 132 full-text studies analysed, patients with haematological cancers were the most represented group (36.4%). The most frequently reported pathogens were Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterococcus faecium, Streptococcus pneumoniae, and Enterobacter spp.
Resistance prevalence was particularly high in E. coli for penicillins (81.84%), cotrimoxazole (65.79%), and monobactams (61.61%), while K. pneumoniae showed the highest resistance to penicillins (98.99%) and cotrimoxazole (70.92%). A. baumannii demonstrated extensive resistance across multiple antibiotic classes, including third-generation cephalosporins (84.10%), carbapenems (82.58%), and fluoroquinolones (80.37%). Enterobacter spp. and E. faecium exhibited penicillin resistance at 91.77% and 90.64%, respectively. P. aeruginosa showed a 49.41% resistance rate to third-generation cephalosporins, while S. aureus had high resistance to macrolides (55.63%) and methicillin (45.29%).
These findings reveal alarmingly high rates of AMR among bacterial pathogens affecting patients with cancer worldwide. The significant resistance, particularly among ESKAPE pathogens, highlights the urgent need for improved infection control measures and antimicrobial stewardship in cancer care settings.
Ada Enesco, EMJ
Reference
Ntim OK et al. Antimicrobial resistance of bacterial pathogens isolated from cancer patients: a systematic review and meta-analysis. BMC Infect Dis. 2025;25(1):296.
