Abstract

The acronym ESKAPE stands for six antibiotic-resistant bacterial pathogens namely, Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. Monitoring their resistance is an important task for clinical microbiology laboratories. Our aim was to analyze the resistance patterns of these bacteria over ten years in clinical samples of our department. We examined the sample types from which these pathogens were most frequently isolated. The incidence of tests with resistant results for each pathogen in aggregate and the most important subgroups of each was also analyzed. We have also intended to predict the local priorities amongst these pathogens. The results of 1,268,126 antibiotic susceptibility tests performed on a total of 70,099 isolates over this period were examined. Most strains were derived from urine, blood culture, trachea, vagina, wounds, and abscesses. Prevalence of ESKAPE bacteria increased between 2011 and 2020 however, the steepest intensifications were seen in the cases of K. pneumoniae and P. aeruginosa. The number of antibiotic susceptibility tests with resistant results has also increased over the decade but the most notable increase was detected in E. faecium and A. baumannii. Based on the calculation of antimicrobial resistance index for each pathogen, the most serious challenges for us at present are A. baumannii, P. aeruginosa, and E. faecium and their multi-resistant forms. The theoretical prediction of proportion of resistant tests between 2020 and 2030 in our care area draws attention to a worrying trend in the cases of vancomycin-resistant E. faecium and carbapenem-resistant A. baumannii strains.

Highlights

  • The acronym ESKAPE stands for six antibiotic-resistant bacterial pathogens namely, Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp

  • The number of antibiotic susceptibility tests with resistant results has increased over the decade but the most notable increase was detected in E. faecium and A. baumannii

  • Our results demonstrate that A. baumannii, P. aeruginosa, and E. faecium and their multi-resistant forms, as well as ESBL-producing K. pneumoniae, are currently the most challenging ESKAPE pathogens in our care area

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Summary

Introduction

The acronym ESKAPE stands for six highly virulent and antibiotic-resistant bacterial pathogens, including Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species [1]. These bacteria are capable of ‘escaping’ the biocidal action of antibiotics and jointly represent new paradigms in transmission and resistance [2]. In 2017, the World Health Organisation published its list of pathogenic bacteria for which new antimicrobial development is urgently needed, on which the ESKAPE pathogens were designated priority status [3]. Monitoring the antibiotic resistance of ESKAPE pathogens is an important task for clinical microbiology laboratories all over the world

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