ESKAPE Pathogens: Bad Bugs with No Drugs- A Study in Tertiary Care Hospital
Abstract:
ESKAPE
pathogens Enterococcus faecium, Staphylococcus aureus, Klebsiella
pneumoniae, Acinetobacter baumanii, Pseudomonas aeruginosa,
and Enterobacter
species are currently the cause of majority of hospital infections globally and
they also effectively “escape” the effects of antibacterial drugs. The UNSTOPPABLE
SUCCESS of these SUPERBUGS will lead to UNWINNABLE WAR. It has been suggested that
resistance by these organisms are due to mutations, modification of LPS. As the
crisis of antibiotic resistance continues to grow, the latest IDSA(Infectious disease
society of America) "Bad Bugs, No Drugs" report examines the trickle of
new antibiotics in the research and development (R&D) pipeline and proposes
steps to tackle the shortage. The
aim of the study was to characterize the antimicrobial resistance in ESKAPE pathogens
isolated from 430 culture positive clinical sample like urine, pus, blood, wound
swab and sputum,. Antibiotic resistance was determined by VITEK 2 and manual Kirby
Bauer method. MIC was determined by VITEK 2 and E Test according to Clinical and
Laboratory Standards Institute (CLSI). ESKAPE pathogens account for 63%. Except
for S. aureus multiple drug resistance (MDR) index of ESKAPE pathogens revealed
an increasing trend. The statistical analysis was done for hospital acquired and
community acquired MDR infections. Extended spectrum betalactamase (ESBL), Klebsiellaspp.,
carbapenem resistant, A. baumannii and P. aeruginosa were identified mainly in hospital
acquired than in community acquired infections. In conclusion, ESKAPE pathogens
are commonly identified in alarming frequency and knowledge of antimicrobial resistance
will be aided for empirical treatment.
Keywords:
Multi drug Resistant, ESKAPE pathogens, Infections, antibiotics.
References:
[1]. Abdul
Ghafur1, Vidyalakshmi PR1, A Murali. Emergence of Pan-drug resistance amongst gram
negative bacteria! The First case series from India, Journal of Microbiology and
Infectious Diseases / (2014); 4 (3):
86-91 JMID doi: 10.5799/ahinjs
[2]. Anima
Poudyal, Benjamin P. Howden In vitro pharmacodynamics of colistin against multidrug-resistant
Klebsiella pneumonia new Journal of Antimicrobial Chemotherapy (2008) 62, 1311–1318
doi:10.1093/jac/dkn425 Advance Access publication 15 October (2008)
[3]. Azza
Elemam, Joseph Rahimian, and William Mandell. Infection with Panresistant Klebsiella
pneumoniae: A Report of 2 Cases and a Brief Review of the Literature Clin Infect
Dis. (2009) 49 (2): 271-274. doi: 10.1086/600042
[4]. Brooke
A. Napier,a, b Eileen M. Burd, c, f Sarah W. Satola, c, d, e Stephanie M. Cagle,
c, e Susan M. Ray,c, e, i Patrick McGann, g Jan Pohl, h Emil P. Lesho, g David S.
Weiss a, b, c Clinical Use of Colistin Induces Cross-Resistance to Host Antimicrobials
in Acinetobacter baumannii (2013) 4 (3).
[5]. Chua
SL, Yam JKH, Sze KS, Yang L (2016).”Selective
labelling and eradication of antibiotic-tolerant bacterial populations in Pseudomonas
aeruginosa biofilms". Nat Commun. 7:10750. doi:10.1038/ncomms10750. PMID 26892159.
[6]. Ching
Jou Lim, Allen C. Cheng Prevalence of multidrug resistant organisms and risk factors
for carriage in long-term care facilities: a nested case–control study. Antimicrob
Chemother(2014); 69: 1972–1980 doi:10.1093/jac/dku077
Advance Access publication 7 April 2014
[7]. Rafael
López-Rojas,a,c Michael J. McConnell,a,c Manuel Enrique Jiménez-Mejías, Colistin
Resistance in a Clinical Acinetobacter baumannii Strain Appearing after Colistin
Treatment: Effect on Virulence and Bacterial Fitness. Antimicrobial agents chemother
(2013) sep; 57 (9). Federico Perez, Andrea
M. Hujer, Kristine M. Hujer, Brooke K. Decker, Philip N. Rather, and Robert A. Bonomo.
Global Challenge of Multidrug-Resistant Acinetobacter baumannii ANTIMICROBIAL AGENTS
AND CHEMOTHERAPY, Oct. (2007), p. 3471–3484
Vol. 51, No. 10 0066-4804/07/$08.000 doi:10.1128/AAC.01464-06 Copyright © 2007,
American Society for Microbiology.
[8]. Giske CG, Monnet DL, Cars O, Carmeli Y. Clinical and economic impact of common multidrug-resistant
gram-negative bacilli. Antimicrob Agents Chemother (2009);52:813-21.
[9]. National Nosocomial Infections Surveillance
System Report, data summary from January 1992 through June (2004) issued October 2004. Am J Infect Control 2004;32:470-85.
[10]. Rice LB. Federal funding
for the study of antimicrobial resistance in nosocomial pathogens: no ESKAPE. J
Infect Dis (2009);197:1079-81.
[11]. Spellberg B, Guidos R, Gilbert D The epidemic of antibiotic-resistant infections:
a call to action for the medical community from the Infectious Diseases Society
of America. Clin Infect Dis (2009);46:155-64.