Trends in antibiotic resistance pattern against ESKAPE pathogens from tertiary care teaching institute – South India

Abstract

Introduction: This study aimed to assess the trend in resistance pattern for ESKAPE Pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter, Pseudomonas aeruginosa, and Enterobacter /E.coli species) and to inform the health care providers to choose appropriate infection control measures. Methods: All the mentioned Drug resistant Pathogens were confirmed as per CLSI Guidelines from biological samples during retrospective cohort from 01 Jan 2013 to 31 Dec 2015. Trend in antibiotic resistance was analysed using chi square for trend. Results: During the reference period, Vancomycin resistant Enterococci (VRE) prevalence reduced over the years from 6.0% in 2013 to 2.6%in 2014 and 1.2% in 2015 (p for trend=0.04). Similarly, Methicillin Resistant Staphylococcus aureus resistance was 41.2%, 25% and 20% respectively from 2013-15 (p for trend >0.05) and for ESBL Klebsiella pneumoniae 89%, 74% & 51% ( p for trend is <0.0001).Despite, the prevalence of MDR Acinetobacter resistance was high at baseline over the years it followed a declining trend: 52%, 71%, 25%, though not significantly so (p for trend >0.05).Of all the samples tested for ESKAPE organisms, Klebsiella & Pseudomonas showed least proportion of resistance (»2%) with a very good susceptibility profile. VRE, MRSA and MDR Acinetobacter were most commonly isolated from UTI (43%), wound swabs (50%) and Respiratory tract infections (76%) respectively. Conclusion: This study shows declining trend in resistance pattern from the recent past on the emerging global threat against ESKAPE organisms. Infection control training for health care providers emphasizes these findings to facilitate better clinical decisions.