Multidrug-Resistant Gram-Negative ESKAPE Pathogens from a Tertiary-Care Hospital: Prevalence and Risk Factors

Abstract

Antibiotic-resistant ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) are commonly implicated in health-care associated infections (HAIs). Objectives: The purpose of this study is to assess the antimicrobial susceptibility profile of Gram-negative ESKAPE pathogens, with prime emphasis on the prevalence and risk factors for infections by multidrug-resistant (MDR) strains. Methodology: In this retrospective cohort study, we reviewed the electronic medical and laboratory records of our tertiary health-care facility throughout the period from January 2019 to December 2020. Adult patients identified with infections by any of the Gram-negative ESKAPE bacteria were eligible for our study. The risk factors associated with acquisition of MDR organisms were analyzed using univariate and multivariate models. Results: During the period of interest, a total of 614 Gram-negative ESKAPE isolates were identified, of which 121 were found to be MDR (19.7%). A. baumannii was the leading MDR organism (43.1%), whereas MDR P. aeruginosa was the least common (10.7%). The independent risk factors associated with acquisition of MDR infections included long hospital stays (P < 0.0001), undergoing surgical procedures (P= 0.001), ischemic heart disease (P= 0.005), mechanical ventilation (P= 0.005), and presence of indwelling urinary catheter (P= 0.03). Conclusions: Infections with MDR Gram-negative ESKAPE organisms have an alarming magnitude in our institution. Continued vigilance by the involved health-care workers, stringent compliance to the infection control guidelines, and effective implementation of the antimicrobial stewardship programs are critical measures to decrease the burden of this health problem.

Prevalence of Antimicrobial Resistance of &lt;i&gt;ESKAPE&lt;/i&gt; Pathogens before and during Pandemic COVID-19 Pandemic in a University Affiliated Hospital in Tangerang, Indonesia

“…The resistance against levofloxacin, amikacin, meropenem, and fosfomycin were 0.0% in the four-year study. El-Kadystated that in the past decade, there was an emergence of carbapenem-resistant Enterobacteriaceae [8], but in the present study this phenomenon did not occur. In the study above, the rate of MDR in Enterobacter spp.…”

“…Kady et al in 2019Kady et al in -2021.6% -42.3%)[8], but in 2022 the rates were comparable. El-Kady also found that the MDR rate of K. pneumoniae of 21.4%, which is comparable to this study (24.7%) Musyoki et al showed the rate of MDR A. baumannii was 85%, and amikacin…”