Abstract
Background
 To assess the rates and trends of resistance among ESKAPE pathogens during 2010 – 2019.
 Methods
 A retrospective, single-center study between 2010 –2019, non-duplicate isolates from six sterile sources were studied. Pathogens were processed through the automated VITEK-2. The Clinical Laboratory Standards Institute (CLSI) breakpoints were referenced. The aim was to detect the rates and resistance trends of the ESKAPE pathogens, the rates of ESBL-producing K. pneumoniae, and the carbapenem-resistant (CR)-K. pneumoniae, CRAb, CRPa, VRE, and MRSA for the inpatients. Trends for the prevalence and resistance rates were analyzed by linear regression. Missing values were averaged based on the neighboring values. Data analysis was by SPSS version 25, and statistical significance is considered for one-tailed P < 0.05.
 Results
 The ESKAPE bacteria (4286 isolate) comprised (45.57%) of the inpatients' isolates, the sterile sources consisted of 1421 (33.15%): K. pneumonia 272 isolates, the ESBL-producing K. pneumoniae significantly declined (Pearson R - 0.877, P = 0.001), CR-K. pneumoniae showed no significant trends (P = 0.475). P. aeruginosa 202 isolates; resistance to carbapenem (CRPa) averaged 42%. S. aureus 198 isolates; MRSA rates averaged 45%. A. baumannii 165 isolates; carbapenem-resistance (CRAb) average 93%. Vancomycin-resistant (VR)E. Faecium = 33%, and VRE. faecalis = 15% with a weighted average 17%. Enterobacter spp. resistance rates were: Amikacin 3.6%, Third and fourth generation cephalosporines 28% and 20% respectively, Quinolones 27% ± 3%, Piperacillin/tazobactam resistance 29%, Imipenem 15%, and Meropenem 27.
 Conclusion
 The ESKAPE pathogens were highly resistant, making treatment more complicated, and compromise the initial empiric treatment.
Highlights
The acronym ESKAPE includes six common pathogenic bacteria (Enterococcus faecium, S. aureus, K. pneumoniae, A. baumannii, P. aeruginosa, and Enterobacter spp.)
This study aims to identify the rates of the resistant ESKAPE pathogens over the ten years 2010-2019 and if there are trends in the rates and resistance
Despite there was a surge in the carbapenem-resistant Enterobacteriaceae (CRE) rates between 2012-2016, the years outside this period may have had represented the local rates more accurately as many war trauma patients arrived in Jordan from the Arab countries for treatment, most of them had multiple surgical interventions with antimicrobial exposures, extended length of hospital stay, and highly resistant isolates on arrival [5]
Summary
The acronym ESKAPE includes six common pathogenic bacteria (Enterococcus faecium, S. aureus, K. pneumoniae, A. baumannii, P. aeruginosa, and Enterobacter spp.). They exhibit multidrug resistance (MDR) pattern, virulence, and represent a substantial burden of the nosocomial infections [1]. The rates of the ESKAPE pathogens have been on the rise in our region in the last decades as well as their resistance rates [3]. Their resistance rates may increase with the length of hospital stay of the afflicted patients, especially when several surgical interventions were needed [4]. To assess the rates and trends of resistance among ESKAPE pathogens during 2010-2019
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