Prevalence and antibiotic resistance of ESKAPE pathogens isolated from patients with bacteremia in Tehran, Iran

Introduction: The ESKAPE acronym refers to a group of deadly hospital-acquired pathogens, including Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. These organisms can evade antibacterial drugs and pose a significant threat to public health. This study investigated the prevalence and antimicrobial resistance of ESKAPE pathogens in patients with bacteremia. Methods: We collected 412 blood samples from patients diagnosed with bacteremia. The ESKAPE isolates were subjected to multidrug-resistant (MDR), extensively drug-resistant (XDR), extended-spectrum beta-lactamase (ESBL), metallo-β-lactamase (MBL), methicillin-resistant S. aureus (MRSA), and vancomycin-resistant Enterococcus (VRE) by the disk diffusion and E-test methods. In the case of VRE, molecular detection was done for vanA and vanB genes. Results: A total of 270 ESKAPE isolates were identified. The frequency of S. aureus was 30%, A. baumannii 22%, P. aeruginosa 17%, K. pneumoniae 13%, E. aerogenes 10.3%, and E. faecium 7.7%. MRSA was 71% and VRE was 19%. ESBL- and MBL-producing strains of A. baumannii were found to account for 39%, P. aeruginosa for 35.7% and 28.2%, and K. pneumoniae for 25.7% and 17.1%. In total, MDR and XDR were present in 52.2% and 15.5% of isolates and were most prevalent in E. aerogenes, A. baumannii, and P. aeruginosa. The vanA gene was detected in all 19% of E. faecium isolates that were VRE. Conclusions: Antibiotic resistance is widespread among ESKAPE pathogens, particularly in patients with bacteremia. Health-care professionals must consider the increasing rates of antibiotic resistance among ESKAPE pathogens and implement new measures to control infections.