Prevalence and Antimicrobial Resistance of Bloodstream Infections Caused by ESKAPEEc Pathogens: A Five-year Analysis

Abstract

Background: Antimicrobial resistance in ESKAPEEc (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter species, and Escherichia coli) pathogens causing bloodstream infections (BSIs) is a growing threat to clinicians and public health. Objectives: Our purpose was to determine the prevalence and susceptibility of ESKAPEEcs causing BSI over five years (2016 to 2020) at a large tertiary hospital in Istanbul, Turkey. Methods: Of 2591 unique isolates obtained from blood culture specimens, 1.281 (49.4%) were positive for ESKAPEEc pathogens. The ESKAPEEc rates increased from 2016 to 2019 and decreased during the COVID-19 pandemic. Results: The most common pathogen was K. pneumoniae (34.3%). Carbapenem resistant (CR) K. pneumoniae was 61.8% and A. baumannii was 90.4%. The percentages of methicillin-resistant S. aureus (MRSA) and vancomycin-resistant E. faecium (VRE) were 38.6% and 29.4%, respectively. Conclusions: Our findings showed a high incidence of ESKAPEEc and AMR in BSIs. Antibiotic policies and restrictions in health care settings and the community will play an essential role in the solution in the future.