Antibiotic resistance trends of ESKAPE pathogens in Kwazulu-Natal, South Africa: A five-year retrospective analysis

Abstract

BackgroundTo combat antimicrobial resistance, the World Health Organization developed a global priority pathogen list of antibiotic-resistant bacteria for prioritisation of research and development of new, effective antibiotics.ObjectiveThis study describes a five-year resistance trend analysis of the ESKAPE pathogens: Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp., from Kwazulu-Natal, South Africa.MethodsThis retrospective study used National Health Laboratory Services data on 64 502 ESKAPE organisms isolated between 2011 and 2015. Susceptibility trends were ascertained from minimum inhibitory concentrations and interpreted using Clinical and Laboratory Standards Institute guidelines.ResultsS. aureus was most frequently isolated (n = 24, 495, 38%), followed by K. pneumoniae (n = 14, 282, 22%). Decreasing rates of methicillin-resistant S. aureus (28% to 18%, p < 0.001) and increasing rates of extended spectrum beta-lactamase producing K. pneumoniae (54% to 65% p < 0.001) were observed. Carbapenem resistance among K. pneumoniae and Enterobacter spp. was less than 6% during 2011–2014, but increased from 4% in 2014 to 16% in 2015 (p < 0.001) among K. pneumoniae. P. aeruginosa increased (p = 0.002), but resistance to anti-pseudomonal antimicrobials decreased from 2013 to 2015. High rates of multi-drug resistance were observed in A. baumanni (> 70%).ConclusionThis study describes the magnitude of antimicrobial resistance in KwaZulu-Natal and provides a South African perspective on antimicrobial resistance in the global priority pathogen list, signalling the need for initiation or enhancement of antimicrobial stewardship and infection control measures locally.

An Evaluation of the Antibacterial Properties of Tormentic Acid Congener and Extracts From Callistemon viminalis on Selected ESKAPE Pathogens and Effects on Biofilm Formation

“…ESKAPE pathogens are responsible for two-thirds of all healthcare-associated infections [ 1 ]. The Infectious Diseases Society of America (ISDA) formulated an acronym ESKAPE to emphasize the group of pathogens that cause hospital infections and effectively “escape” the effects of antibacterial drugs [ 2 ].…”

<p>High Expression of Metallo-β-Lactamase Contributed to the Resistance to Carbapenem in Clinical Isolates of <em>Pseudomonas aeruginosa</em> from Baotou, China</p>

“…11 Data from South Africa from 2011 to 2015 demonstrated that the clinical isolation rate for PA was 17.4%, lower than that of Staphylococcus aureus (38%) and Klebsiella pneumoniae (22.2%). 12 In our study, the detection rate for PA was 15% in 2015, second only to E. coli (26%). The emergence of CRPA makes it very difficult to treat infectious diseases and limits the choice of appropriate antibiotic therapy.…”

Ascorbic acid inhibitory activity on resistant strains of Enterobacter spp.: in vitro study

“…ESKAPE are pathogens that responsible for many nosocomial infections and are capable of "escaping" the biocidal effect of antimicrobial agents. 20 Therefore, updating knowledge about resistance rates of those infectious agents has become an important role to achieve success with antibiotics treatment.…”