Occurrence of influenza and bacterial infections in cancer patients receiving radiotherapy in Ghana
Date
2022
Journal Title
Journal ISSN
Volume Title
Publisher
PLOS ONE
Abstract
Abstract
Background
Influenza co-infection with bacteria is a leading cause of influenza-related deaths and severe
respiratory infections, especially among high-risk groups like cancer patients undergoing
treatment. However, acute respiratory infection (ARI)-like symptoms developed by uppertorso
cancer (UTC) patients receiving radiotherapy are considered as side-effects of the radiation.
Hence influenza and bacterial pathogens implicated in ARI are not investigated.
Methods
This prospective cohort study examined 85 in-patients with upper-torso cancers undergoing
radiotherapy at the National Radiotherapy, Oncology and Nuclear Medicine Centre
(NRONMC) of Korle-Bu Teaching Hospital (KBTH) in Accra, Ghana. Eligible patients who
consented were recruited into the study from September 2018 to April 2019. Influenza
viruses A and B in addition to the following bacteria species Streptococcus pneumonia, Haemophilus
influenzae, Neisseria meningitidis and Staphylococcus aureus were detected from
oropharyngeal and nasopharyngeal swab specimens collected at three different time points.
Presence of respiratory pathogens were investigated by influenza virus isolation in cell culture,
bacterial culture, polymerase chain reaction (PCR) and next generation sequencing
(NGS) assays.
Results
Of the 85 eligible participants enrolled into the study, 87% were females. Participants were
17 to 77 years old, with a median age of 49 years. Most of the participants (88%) enrolled had at least one pathogen present. The most prevalent pathogen was N. meningitidis
(63.4%), followed by H. influenzae (48.8%), Influenza viruses A and B (32.9%), S. pneumoniae
(32.9%) and S. aureus (12.2%). Approximately, 65% of these participants developed
ARI-like symptoms. Participants with previous episodes of ARI, did not live alone, HNC and
total radiation less than 50 Gy were significantly associated with ARI. All treatment forms
were also significantly associated with ARI.
Conclusion
Data generated from the study suggests that ARI-like symptoms observed among UTC
patients receiving radiotherapy in Ghana, could be due to influenza and bacterial single and
co-infections in addition to risk factors and not solely the side-effects of radiation as perceived.
These findings will be prime importance for diagnosis, prevention, treatment and
control for cancer patients who present with such episodes during treatment.
Description
Research Article
Keywords
influenza, bacterial, influenza and bacterial infections in cancer patients, radiotherapy, Ghana
Citation
Citation: Arjarquah AK, Obodai E, Anie HA, Osei MA, Odoom JK, Bonney JHK, et al. (2022) Occurrence of influenza and bacterial infections in cancer patients receiving radiotherapy in Ghana. PLoS ONE 17(7): e0271877. https://doi.org/ 10.1371/journal.pone.0271877