Clinical relevance of the ESKAPE pathogens

Pendleton, Jack Norman; Gorman, Seán; Gilmore, Brendan

doi:10.1586/eri.13.12

Cited by 1,200 publications

(958 citation statements)

References 89 publications

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“…P. aeruginosa is a well-described opportunistic pathogen of immunocompromised non-CF individuals, including oncology patients, burn victims, and ventilated patients. [235][236][237] To our knowledge, there is only 1 case report of transmission of P. aeruginosa to the non-CF household members of a person with CF. Both parents of a 22-year-old woman with CF, infected with the LES, developed pneumonia caused by this strain.…”

Section: Iiib1 P Aeruginosa and Burkholderia Sppmentioning

confidence: 99%

Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update

Saiman

Siegel

LiPuma

et al. 2014

Infect. Control Hosp. Epidemiol.

352

382

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The 2013 Infection Prevention and Control (IP&C) Guideline for Cystic Fibrosis (CF) was commissioned by the CF Foundation as an update of the 2003 Infection Control Guideline for CF. During the past decade, new knowledge and new challenges provided the following rationale to develop updated IP&C strategies for this unique population:1. The need to integrate relevant recommendations from evidence-based guidelines published since 2003 into IP&C practices for CF. These included guidelines from the Centers for Disease Control and Prevention (CDC)/Healthcare Infection Control Practices Advisory Committee (HICPAC), the World Health Organization (WHO), and key professional societies, including the Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA). During the past decade, new evidence has led to a renewed emphasis on source containment of potential pathogens and the role played by the contaminated healthcare environment in the transmission of infectious agents. Furthermore, an increased understanding of the importance of the application of implementation science, monitoring adherence, and feedback principles has been shown to increase the effectiveness of IP&C guideline recommendations.2. Experience with emerging pathogens in the non-CF population has expanded our understanding of droplet transmission of respiratory pathogens and can inform IP&C strategies for CF. These pathogens include severe acute respiratory syndrome coronavirus and the 2009 influenza A H1N1. Lessons learned about preventing transmission of methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant gram-negative pathogens in non-CF patient populations also can inform IP&C strategies for CF.

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Section: Iiib1 P Aeruginosa and Burkholderia Sppmentioning

confidence: 99%

Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update

Saiman

Siegel

LiPuma

et al. 2014

Infect. Control Hosp. Epidemiol.

352

382

View full text Add to dashboard Cite

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“…Of particular concern, complicated S. aureus UTIs are frequently associated with the development of severe sequelae, leading to increased rates of morbidity and mortality (4,6,8,12,13,(16)(17)(18). Additionally, treatment of these infections has become increasingly difficult, as most S. aureus isolates causing complicated UTI are methicillinresistant S. aureus (MRSA) and are refractory to treatment by antibiotics that typically have efficacy in the urinary tract (4,8,12,19,20). This highlights the need for developing a greater understanding of the pathogenesis of complicated UTI for the development of new antibiotic-sparing therapies.…”

mentioning

confidence: 99%

Catheterization alters bladder ecology to potentiate Staphylococcus aureus infection of the urinary tract

Walker

Flores-Mireles

Pinkner

et al. 2017

Proc. Natl. Acad. Sci. U.S.A.

103

164

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Methicillin-resistant Staphylococcus aureus (MRSA) is an emerging cause of catheter-associated urinary tract infection (CAUTI), which frequently progresses to more serious invasive infections. We adapted a mouse model of CAUTI to investigate how catheterization increases an individual's susceptibility to MRSA UTI. This analysis revealed that catheterization was required for MRSA to achieve high-level, persistent infection in the bladder. As shown previously, catheter placement induced an inflammatory response resulting in the release of the host protein fibrinogen (Fg), which coated the bladder and implant. Following infection, we showed that MRSA attached to the urothelium and implant in patterns that colocalized with deposited Fg. Furthermore, MRSA exacerbated the host inflammatory response to stimulate the additional release and accumulation of Fg in the urinary tract, which facilitated MRSA colonization. Consistent with this model, analysis of catheters from patients with S. aureus-positive cultures revealed colocalization of Fg, which was deposited on the catheter, with S. aureus. Clumping Factors A and B (ClfA and ClfB) have been shown to contribute to MRSA-Fg interactions in other models of disease. We found that mutants in clfA had significantly greater Fg-binding defects than mutants in clfB in several in vitro assays. Paradoxically, only the ClfB − strain was significantly attenuated in the CAUTI model. Together, these data suggest that catheterization alters the urinary tract environment to promote MRSA CAUTI pathogenesis by inducing the release of Fg, which the pathogen enhances to persist in the urinary tract despite the host's robust immune response.host-pathogen interactions | MRSA CAUTI | ClfB-fibrinogen interactions

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“…Importantly, only a few resistant pathogens are responsible for the lion's share of nosocomial infections in both the developed and developing countries. Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumonia, Acinetobacter baumanni, Pseudomonas aeruginosa, and Enterobacter species, generally known as the "ESKAPE" pathogens, are those pathogens that cause the majority of nosocomial infections and effectively escape the effects of antibiotics (32,33). It follows that efficient and effective treatment against these six species, or even only a few of them, could significantly reduce fatalities and financial burden caused by resistant pathogen infections.…”

Section: Discussionmentioning

confidence: 99%

Temperate and lytic bacteriophages programmed to sensitize and kill antibiotic-resistant bacteria

Yosef

Manor

Kiro

et al. 2015

Proc. Natl. Acad. Sci. U.S.A.

399

284

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The increasing threat of pathogen resistance to antibiotics requires the development of novel antimicrobial strategies. Here we present a proof of concept for a genetic strategy that aims to sensitize bacteria to antibiotics and selectively kill antibiotic-resistant bacteria. We use temperate phages to deliver a functional clustered regularly interspaced short palindromic repeats (CRISPR)-CRISPRassociated (Cas) system into the genome of antibiotic-resistant bacteria. The delivered CRISPR-Cas system destroys both antibiotic resistance-conferring plasmids and genetically modified lytic phages. This linkage between antibiotic sensitization and protection from lytic phages is a key feature of the strategy. It allows programming of lytic phages to kill only antibiotic-resistant bacteria while protecting antibiotic-sensitized bacteria. Phages designed according to this strategy may be used on hospital surfaces and hand sanitizers to facilitate replacement of antibioticresistant pathogens with sensitive ones.CRISPR-Cas | positive selection | lysogenization | ex vivo treatment

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Clinical relevance of the ESKAPE pathogens

Cited by 1,200 publications

References 89 publications

Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update

Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update

Catheterization alters bladder ecology to potentiate Staphylococcus aureus infection of the urinary tract

Temperate and lytic bacteriophages programmed to sensitize and kill antibiotic-resistant bacteria

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