Burden of MDR ESKAPE pathogens in a Tertiary Care Hospital, Nepal
Keywords:
MDR, ESKAPE pathogens, Gram negativeAbstract
INTRODUCTIONThe acronym ESKAPE is used to describe six nosocomial pathogens that exhibit virulence and multidrug resistance, which includes: Staphylococcus aureus, Klebsiella pneumoniae, Enterococcus faecium, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. Among MDR pathogens, ESKAPE pathogens have caused a major concern due to their resistance against antibiotics and other medicine resulting in worse patient outcomes and increased treatment costs.
MATERIAL AND METHODSA retrospective cross-sectional study was conducted at microbiology laboratory of a tertiary care hospital, Nepal. A total of 6583 samples were processed following standard microbiological procedures. Standard microbiological techniques were used for isolation and identification of pathogens and antibiotic susceptibility test was performed as per clinical and laboratory standard institute (CLSI) guidelines. Phenotypic detection of multidrug resistance (MDR), methicillin resistant Staphylococcus aureus (MRSA), and vancomycin resistant Enterococcus faecium (VRE) was performed.
RESULTSDuring the period, a total of 1583 (24.05%) ESKAPE pathogens were identified. Amongst gram negative ESKAPE pathogens, multidrug resistant (MDR) were more predominant in Acinetobacter baumannii (67.70%) followed by Klebsiella pneumoniae (65.59%), Enterobacter species (49.36%), Pseudomonas aeruginosa (46.78%). Similarly, in gram positive ESKAPE pathogens, MDR was found to be Staphylococcus aureus (65.35%), and Enterococcus faecium (69.23%). MRSA was found to be 42.51% (n=54) and VRE 3.08% (n=2).
CONCLUSIONDue to increasing burden of MDR ESKAPE pathogens in hospital settings, periodic surveillance of resistant bacteria in hospital settings is strongly recommended to minimize the problem by formulating the antibiotic policy and antibiotic stewardship program.
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