Deciphering the distribution of ESKAPE pathogens in various clinical samples and its pattern of antimicrobial resistance: a study from a tertiary care center in Wayanad, Kerala
DOI:
https://doi.org/10.18203/2320-6012.ijrms20242925Keywords:
ESKAPE pathogens, Nosocomial pathogens, Multidrug resistance, Anti-microbial resistanceAbstract
Background: ESKAPE includes 6 nosocomial pathogens which are capable of ‘escaping’ the biocidal actions of antimicrobial agents. Antimicrobial resistance of ESKAPE pathogens in clinical samples is crucial for effective patient management and development of targeted treatment strategy. So, the present study was designed to investigate the distribution of ESKAPE pathogens across diverse clinical samples and to find out their prevalence in different clinical sample such as pus, sputum and urine. This provides an insight to their varied ecological niches within healthcare settings.
Methods: This was a retrospective study done at Dr. Moopen’s Medical College. A total of 6492 clinical samples were studied to isolate ESKAPE pathogens. Which included urine, sputum and pus samples.
Results: A total of n=6,492 Individual bacteria isolates were recovered from clinical specimens such as sputum (1473), urine (3710) and pus (1309) out of which n=1181 were ESKAPE pathogen. The most frequent clinical sample were pus 580 (49.12%) followed by urine 265 (22.43%) and respiratory samples 336 (28.45%). The most predominant bacteria were found to be Staphylococcus aureus (31.39%) in pus whereas Klebsiella pneumoniae in urine (40.10%) and respiratory samples (40.48%). The average age of the involved patients was approximately 74.8±16.67 years, and the range of ages in the dataset is in 1-97 years, with a gender distribution of 637 (58.28%) males and 470 (42.72%) females.
Conclusions: Our findings reveal that pus serves as a significant reservoir for ESKAPE pathogens, with Staphylococcus aureus and Pseudomonas aeruginosa as predominant organisms.
References
Blair JM, Webber MA, Baylay AJ, Ogbolu DO, Piddock LJ. Molecular mechanisms of antibiotic resistance. Nat Rev Microbiol. 2015;13(1):42-51.
Rice LB. Federal funding for the study of antimicrobial resistance in nosocomial pathogens: No ESKAPE. J Infect Dis. 2008;197(8):1079-81.
Cosgrove SE. The relationship between antimicrobial resistance and patient outcomes: mortality, length of hospital stays, and health care costs. Clin Infect Dis. 2006;42(2):82-9.
Naylor NR, Atun R, Zhu N, Kulasabanathan K, Silva S, Chatterjee A, et al. Estimating the burden of antimicrobial resistance: a systematic literature review. Antimicrobe Resist Infect Control. 2018;7:58.
Ward MM, Diekema DJ, Yankey JW, Vaughn TE, Boots MBJ, Pendergast JF, et al. Implementation of strategies to prevent and control the emergence and spread of antimicrobial-resistant microorganisms in U.S. hospitals. Infect Control Hosp Epidemiol. 2005;26(1):21-30.
Costelloe C, Metcalfe C, Lovering A, Mant D, Hay AD. Effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: systematic review and meta-analysis. BMJ. 2010;340:2096.
Santajit S, Indrawattana N. Mechanisms of antimicrobial resistance in ESKAPE Pathogens. Biomed Res Int. 2016;20:2475067.
Laurentiu TA, Nicoleta M, Octav P, Irina G, Marcela P, Otilia B, et al. Resistance features of Pseudomonas aeruginosa strains isolated from patients with infectious complications of cardiovascular surgery. Bio Interf Res Appl Chem. 2017;7(2):2004-8.
Alsharedeh RH, Yehya A, Beni YO, Alameri O, Alshraiedeh N. Characterization of ESKAPE pathogens in urinary tract infections among Jordanian patients. J Infect Dev C. 2023;17(3):374-80.
Benkő R, Gajdács M, Matuz M, Bodó G, Lázár A, Hajdú E, et al. Prevalence and antibiotic resistance of ESKAPE pathogens in the emergency department of a tertiary care teaching hospital in Hungary: A 5-year retrospective survey. Antibiotics. 2020;9:624.
Arbune M, Gurau G, Niculet E, Iancu AV, Lupasteanu G, Fotea S, et al. Prevalence of antibiotic resistance of ESKAPE pathogens over five years in an infectious diseases hospital from South-East of Romania. Infect Drug Resist. 2021;14:2369-78.
Pandey R, Mishra SK, Shrestha A. Characterization of ESKAPE pathogens with special reference to multidrug resistance and biofilm production in a Nepalese hospital. Infect Drug Resist. 2021;14:2201-12.