Measurement of Some Inflammatory Biomarkers and Genotyping of GramNegative Bacteria Isolated from Acute Leukemia Patients

Abstract

This study detected the prevalence of gram-negative bacteria (GNB) among Iraqi acute leukemia patients and measured their serum levels for C- reactive protein (CRP), procalcitonin (PCT) and lipopolysaccharide- binding protein (LBP). Besides, random amplification of polymorphic DNA )RAPD ( typing was utilized to investigate the genetic relationship among GNB isolates. Out of 458 clinical samples collected from 260 acute leukemia patients, 70 (15%) isolates of GNB were diagnosed as Klebsiella pneumoniae 23 (33%), Escherichia coli 21 (30%), Pseudomonas aeruginosa 18 (26%) and Acinetobacter baumannii 8 (11%). These isolates were collected from urine (39 (57%)), blood (23 (32%)) and swabs (8 (11%)). Furthermore, GNB infections were higher among patients with acute myeloblastic leukemia (AML) (40 (57%)) than those with acute lymphoblastic leukemia (ALL) (30 (43%)). The concentrations of CRP, PCT and LBP recorded higher levels among men, women and children groups than control groups. Most of
GNB isolates were highly resistant to ticarcillin, piperacillin, ceftazidime and cefepime, followed by gentamicin, tobramycin and ciprofloxacin. Imipenem and meropenem were more effective against GNB isolates, except for A. baumannii. Multidrug resistant (MDR) pattern was noticed among all isolates of K. pneumonia (23 (100%)) and A. baumannii (8 (100%)), whereas 18 (85%) and 12 (66%) of E. coli and P. aeruginosa respectively showed MDR pattern. RAPD typing yielded different genotypic patterns among GNB isolates exceeded 14, 12, 11 and 9 in P. aeruginosa, E. coli, K. pneumoniae and A. baumannii respectively. The increased serum levels of CRP, PCT and LBP indicated the possible vital role of these markers in predicting the severe infections of GNB in acute leukemic population. The genetic diversity among GNB isolates surveyed by RAPD typing requires the continuous monitoring of the prevalence of pathogenic GNB associated with specific genotypic pattern.