Clinical Characteristics, Etiology and Phylogenetic Distribution of Bacteremia in Patients with Malignancies in Basrah Province

This is the first study in Basrah province/Iraq to detect the geographical distribution of adult oncology patients with bacteremia and the bacterial etiology. From 176 patients’ samples, the highest incidence of cancer cases was recorded in central 62 (35.22%) followed by western 45 (25.56%), northern 34 (19.31%), southern 24 (13.63%) and eastern 11 (6.25%) regions. The majority of cancer with bacteremic episodes (64) were located in the central 23 (35.93%), western 16 (25%) and southern 13 (20.31%) regions, while they were less likely to occur in the northern 7 (10.93%) and eastern 5 (7.81%) regions. Some clinical characteristics, including age (30-60 year), leukemia (64.06%), healthcare exposure (73.43%), neutropenia (71.87%), non-antibiotic administration (81.25%) and fever (100%) were associated with bacteremic episodes. Sixty-three (98.43%) of these episodes were caused by Gram-positive pathogens, especially 48 (75 %) Bacillus spp., these were 21 B. licheniformis, 19 B. cereus, 3 B. subtillus, 3 B. sonorensis, 1 B. aeruius and 1 B. toyonensis. On the other hand, 3 Staphylococcus epidermidis, 1 isolate of S. warneri, Lysinibacillus sphaericus, Lysinibacillus xylanilyticus, Enterobacter cancerogenous and 9 other of Gram-positive bacteria (unidentified). Exclusively, this is the first study isolated Gr-ve Enterobacter cancerogenous from cancer patients with bacteremia. Three isolates Bacillus licheniformis “IRQBAS18†, Bacillus licheniformis “IRQBAS19†and Bacillus licheniformis “IRQBAS20†were reported as new global bacterial strains. RAPD analysis showed four patients from different regions, each two (9.5% for each) had the same strain of Bacillus licheniformis and other four (19.04%) patients from different regions had closely related strains of Bacillus licheniformis, these results confirm that the bacteremic infections were coming from the same source.