Bloodstream infection in cancer patients; susceptibility profiles of the isolated pathogens, at Khartoum Oncology Hospital, Sudan

Introduction: Bloodstream infection is one of the major causes of mortality in patients with malignancies. This study aimed to determine the local profile of blood culture isolates and their antibiotic sensitivities in febrile neutropenic cancer patients and todecide if any modifications to antibiotics policies are necessary. Methods: This is a cross-sectional study conducted between the first of October to the end of December 2018 at KhartoumOncology Hospital, Sudan. Blood samples from febrile neutropenic patients were collected for culture. Isolates were identified,and their antimicrobial susceptibility was determined by standard laboratory procedures. Results: Bloodstream infections were confirmed in 12 % (n = 69/569) of total blood cultures. Gram negative bacilli were the dominant causative agents (63.8%) while (36.2%) of infections were caused by gram positive cocci. Escherichia coli was the most common isolate (30.4%).The proportions of resistance among gram negative bacilli were high for cefuroxime, amoxicillin/clavulanic acid, Ceftazidime,and ceftriaxone. Extended-spectrum β-lactamase producing isolates were identified in 34.1% of the positive cultures. Grampositive cocci showed high resistance to tetracycline, penicillin and erythromycin but were completely sensitive to vancomycinand gentamicin. Most of Staphylococcus aureus isolates were methicillin resistant.Conclusion: Gram negative bacilli were the predominant etiologic agents of bloodstream infections in our patients. Both Gram-positive and Gram-negative bacteria showed high levels of resistance for most of the common antibiotics used for empiric treatment. Regular surveillance to study bacterial resistance patterns must be conducted to modify antibiotics stewardshipin our institution.Keywords: Blood stream infection; malignancy; antibiotics sensitivity; Sudan

Evidence of pre-existing active Zika virus circulation in Sudan prior to 2012

Abstract Objective The purpose of this study is to provide the first evidence of Zika virus circulation (ZIK) in Sudan. Zika virus was first isolated in the Zika forest of Uganda in 1947, and in 2016, the World Health Assembly declared it a public health emergency of international concern. The discovery of Zika virus circulation in Sudan came as a secondary finding in a 2012 country-wide yellow fever prevalence study, when laboratory tests were done to exclude cross-reactions between flaviviruses. The study was cross-sectional community-based, with randomly selected participants through multi-stage cluster sampling. A sub-set of samples were tested for the Zika virus using ELISA, and the ones that demonstrated reactive results were subsequently tested by PRNT. Results The prevalence of Zika IgG antibodies among ELISA-tested samples was 62.7% (59.4 to 66.1, 95% CI), and only one sample was found positive when tested by PRNT. This provided the first documented evidence for the pre-existing circulation of Zika virus circulation in Sudan. This evidence provides the foundation for future research in this field, and further structured studies should be conducted to determine the epidemiology and burden of the disease