A cross-sectional study on healthcare-associated multidrug-resistant ESKAPE pathogens in critically ill patients of a tertiary care hospital.

JAMES, ELIZABETH RACHAL; JAYAPRAKASH, CHITHRA; Sreekumar, Sreelakshmi; ROY, SNEHA; ABRAHAM, SUJA; ANTONY, SIJI

doi:10.21608/mid.2025.349032.2423

A cross-sectional study on healthcare-associated multidrug-resistant ESKAPE pathogens in critically ill patients of a tertiary care hospital.

Articles in Press

Document Type : Original Article

Authors

¹ Department of Pharmacy Practice, Nirmala College of Pharmacy, Ernakulam, Kerala, India, Affiliated to Kerala University of Health Sciences

² Department of Microbiology, Malankara Orthodox Syrian Church Medical College Hospital, Ernakulam, Kerala, India, Affiliated to Kerala University of Health Sciences.

³ Department of Computer Science, Santhigiri College of Computer Sciences, Vazhithala, Kerala, India

10.21608/mid.2025.349032.2423

Abstract

Background: Healthcare-Associated Infections (HAI) caused by Multi-Drug Resistant (MDR) ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.) are a global issue, especially among critically ill patients. The purpose of this study was to determine the prevalence and resistance pattern of MDR ESKAPE in a tertiary care hospital. Methods: This cross-sectional included patients with MDR ESKAPE infections over the age of 18 whose culture was sent after 48 hours of admission to critical care between February 2023 and March 2024. Results: Among the 204 patients with ESKAPE infections, 116 (56.9%) developed MDR ESKAPE infections. The most common MDR ESKAPE pathogens detected (in the order of decreasing prevalence) were Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli, and Enterococcus faecium, with the majority of pathogens being isolated from endotracheal aspirates. Klebsiella pneumoniae and Acinetobacter baumannii exhibited an antibiotic susceptibility of concern, especially towards cephalosporins. Conclusions: This study underlines the significant issue of MDR ESKAPE infections in critically ill patients, emphasizing the important need for focused antibiotic stewardship, enhanced infection control strategies, and periodic resistance trend monitoring. Previous antibiotic use, and hospitalization within the past 90 days was greater among MDR ESKAPE patients in this study. The findings provide substantial contributions to understanding MDR pathogen dynamics in critical care settings, laying the groundwork for reducing the rising danger of antimicrobial resistance and directing the development of region-specific intervention methods to minimize morbidity and death.

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