One-Year Surveillance of ESKAPE Pathogens in an Intensive Care Unit of Monterrey, Mexico

Abstract

Background: Bacterial species from the ESKAPE group (i.e. Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter species) are frequently resistant to antibiotics. The purpose of this study was to monitor the incidence of ESKAPE pathogens at the intensive care unit (ICU) of a tertiary care hospital in Monterrey, Mexico. Methods: All clinically relevant organisms isolated from June 2011 to June 2012 were included. Identification and susceptibility testing was performed using panels from Sensititre. Resistance to oxacillin, for S. aureus, and the production of extended spectrum β-lactamases (ESBLs), for K. pneumonia, were determined as defined by the Clinical Laboratory Standards Institute. Also, the presence of vanA and vanB genes was determined in E. faecium vancomycin (VAN)-resistant isolates. Results: The majority of pathogens (64.5%) isolated in the ICU unit were from the ESKAPE group. The organisms most frequently isolated were A. baumannii (15.8%) and P. aeruginosa (14.3%). A high resistance to carbapenems was detected for A. baumannii (75.3%) while 62% of S. aureus isolates were confirmed to be methicillin resistant. Of the K. pneumoniae isolates, 36.9% were ESBL producers. We detected three E. faecium VAN-resistant isolates, all of which contained the vanA gene. Conclusion: The presence of the ESKAPE group of pathogens is a major problem in the ICU setting. The results of this study support the implementation of special antimicrobial strategies to specifically target these microorganisms.

Clinical Importance of Emerging ESKAPE Pathogens and Antimicrobial Susceptibility Profile from a Tertiary Care Centre

“…Enterobacter spp., showed higher rate resistance to ampicillin (100%), ciprofloxacin (81.3%), levofloxacin (82.8%), ceftriaxone (81.9%), piperacillintazobactam (79.2%), cefepime (70.2%) and lower resistance to amikacin (8.6%), netilmycin (5.4%), imipenem (16.7%), meropenem (14.3). Similar resistance rate was reported by Anuradha S. De et al, (2015), Daniely M. Silva et al, (2017), Jorge Martín L laca-Díaz et al, (2012 and Rudrajit Paul et al, (2017).…”

“…Daniely M. Silva et al, (2017), Anuradha S De et al, (2015), Jorge Martín L laca- Díaz et al, (2012), Rudrajit Paul et al, (2017) also reported similar rate of resistance.…”

Efficacy of Sulbactam and Its Combination with Imipenem, Colistin and Tigecycline in an Experimental Model of Carbapenem-Resistant <b><i>Acinetobacter baumannii</i></b> Sepsis

“…Carbapenems have been considered the most active agent against multidrug-resistant pathogens. However, carbapenem-resistant isolates have been increasing worldwide [2,12,13,14,15]. In recent years, carbapenem resistance rates were reported to be over 50% [16,17,18,19,20,21], and in our last study it was found to be 92% in intensive care units [18].…”

Clinical Efficacy and Safety of the Combination of Colistin plus Vancomycin for the Treatment of Severe Infections Caused by Carbapenem-Resistant <b><i>Acinetobacter baumannii</i></b>

“…Invariably, one of the most alarming characteristics of this Gram-negative bacillus is its ability to develop resistance to all available antibiotics including carbapenems, which is even higher than in other Gram-negative bacilli included in the ESKAPE group ( Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, A. baumannii, Pseudomonas aeruginosa , and Enterobacter species) [1]. The mechanisms of resistance to antimicrobials are principally acquired through its ability to exchange genetic material.…”