Multidrug-Resistant Bacteria Colonization Among Critically Ill Adults With Cancer in Jordan

Introduction: Colonization with multi-drug-resistant organisms (MDROs) poses a significant threat in intensive care units (ICUs). However, data on critically ill patients with cancer remain limited. This study aimed to evaluate the prevalence and factors for MDROs colonization among patients with cancer admitted to the ICU.


Methods: This was a retrospective study which included adult patients admitted to the ICUs at King Hussein Cancer Center in Jordan, from January to December 2023. The results of nasal and perianal screening swabs taken on ICU admission were recorded. Patients with missing screening samples were excluded. We collected demographics, cancer type and stage, co-morbidities, reason for ICU admission, prior hospital admissions, and recent antibiotic use. Descriptive statistics was used to report patient characteristics and prevalence while univariate analysis was performed to identify factors associated with colonization. Univariate analysis was done for associations and multivariable logistic regression analysis done for predictors.


Results: During the study period, 499 patients were admitted to the ICU. The average age was 59.5 ±14.2 (SD) years and 55.9% were males. The most common primary cancers were gastrointestinal (19.8%), thoracic (17.4%), and breast (13.6%), while 58.5% had metastatic disease. Within 90 days prior to ICU admission, 41.9% received chemotherapy. More than half (56.7%) of the patients had an absolute neutrophilic count below 1000 cells/µL and 31.5% had an ANC below 500 cells/ µL.
Upon admission, colonization with MDROs, was reported in 8.4% of nasal swabs and 7.8% of perianal swabs. Recent hospital admission (>48 hours) (OR 2.14, p=0.027) and presence of a central line (OR 2.27, p=0.049) in the past 90 days were significantly associated with positive perianal swabs. An admission within the past 90 days was predictor for MDRO on perianal swab. There was no association between colonization and in-hospital mortality.


Conclusions: Among critically ill patients with cancer, MDRO colonization on ICU admission was infrequent, with prevalance of less than 10% of cases. Recent hospitalization was a predictor for perianal colnization. Further reserach should evaluate targeted swab screening by identifiying patients who are likley to be colonized.