Detection of bacteremia and MRSA from blood cultures in cancer febrile patients by polymerase chain reaction and conventional microbiological methods / Dina Mohamed Ahmed Elkhashab ; Supervised Hadir Ahmed Elmahalawy , Osman Mohamed Mansour , Samah Aly Loutfy

Thesis (Ph.D.) - Cairo University - National Cancer Institute - Department of Clinical Pathology

Bloodstream infections (BSI) remain a major cause of morbidity and mortality inimmunosuppressed cancer patients undergoing chemotherapy and stem cell transplant recipients are at high risk of life-threatening bacteremic infections. The emergence and spread of methicillin-resistant S. aureus (MRSA) constitutes one of the most serious and major challenges in the treatment of community- and healthcare-associated infections and one of the most common serious bacterial infections worldwide. Panton valentine Leucocidin (PVL) has been reported to be an important marker for the highly pathogenic community acquired S. aureus infections. Early diagnosis of bacteremia is the most important part of care and management of febrile patients. Conventional diagnosis of bacterial infection mainly relies on culture based testing. These cultures usually providedelayed results resulting in prolonged use of unneeded antibiotics. The use of molecular techniques such as universal PCR has been showed tobe effective in identifying bacterium pathogens in septic patients, because it can detect small amount of pathogenic particle (DNA, RNA) in blood. Using Multiplex PCR is a rapid helping tool in detecting MRSA BSI. The Aim of our study was primarily to detect the prevalence of MRSA as cause of bloodstream infections in cancer patients and to evaluate the direct rapid detection of MRSA from blood culture by PCR and our secondary aim was to use the molecular methods in the characterization of MRSA as a BSI pathogen in cancer patients by multiplex PCR and also to detect the presence of PVL toxin as a marker for community acquired MRSA

Issued also as CD