Breast Cancer and Associated Bacterial Pathogens: Study of Breast Cancer Ulcers in Patients from National Hospital Cancer Center, Abuja, and their Antibiotic Sensitivity Profile

Bacterial infections are ubiquitous and promote dysbiosis, resulting in disease conditions that may be resolved through antimicrobial therapy in some hosts but may persist for long durations in others, thereby significantly increasing the carrier's risk of developing cancer over time. The consequences range from immune suppression to the development of acute resistance to anticancer and/or antibacterial therapeutics, and subsequently, a higher risk of progression to active cancers. This study identified the bacterial spectrum implicated in breast cancer wounds or ulcers, their antimicrobial susceptibility profiles, and the resistance genes embedded in their genomes. A total of two hundred and forty breast cancer wound/ulcer swab samples (150 breast wound swabs and 90 endo-cervical swabs) from symptomatic patients attending the National Hospital Cancer Clinic, Abuja, were screened for bacterial infection, using standard microbiological cultural methods, and biochemical tests for the identification of isolates. Randomly selected samples (36 breast wound swabs and 19 endocervical swabs) were also analyzed using next-generation gene sequencing for the identification and detection of resistant genes within the sequenced genome.Prevalence of one hundred and twenty-three bacterial species were observed: Escherichia coli, 25(20.3%) > Staphylococcus aureus. 21(17.1%) > Klebsiella pneumoniae, 19(15.4%), Pseudomonas aeruginosa, 15(12.2%) > Enterococcus faecalis 7(5.7%), and Staphylococcus epidermidis 5(4.1%). Among the array of antibiotics tested, Ciprofloxacin was the most effective against both Gram positive with sensitivity percentage of S. epidermidis (83.3 %); S. aureus (81%); E. faecalis (80%) and Gram-negative organisms P. aeruginosa (86.7%); K. pneumoniae (78.9%); E. coli (60%) while Ceftriaxone had the least activity with resistance percentage of K. pneumoniae (78.9%); E. coli (72%); P. aeruginosa (66.7%) Gram-negative isolates and for the Gram-positive isolates S. epidermidis (83.3 %); E. faecalis (80.0%); S. aureus (71.4%). For the sequenced samples, the prevalent pathogens were Acinetobacter baumannii (53%) > Alcaligenes faecalis (30%) > Pseudomonas aeruginosa (7%) > Enterococcus faecalis, Corynebacterium striatum (4% respectively) > Proteus mirabilia (2%) for breast cancer lesions while for cervical cancer lesions, Staphylococcus epidermidis (16%) > Pseudomonas mendocina (14%) > Enterococcus faecalis(13%) > Bacillus cereus(11%) > Escherichia coli, Staphylococcus aureus and Ligilactobacillus agilis (10% respectively) > Gardnerella vaginalis and Pseudomonas aeruginosa (8% respectively) were prevalent. This study reveals that bacterial pathogens involved with breast cancer infection and resistance to commonly used antibiotics could cause prolonged cancer therapy treatment and a huge threat to successful eradication of cancer, and the need for regular checks for bacterial infection as a means of effective infection and cancer management.