ESKAPE pathogen incidence and antibiotic resistance in patients with bloodstream infections at a referral hospital in Limpopo, South Africa, 2014-2019: A cross-sectional study.

BACKGROUND

There is a paucity of research on the incidence and antimicrobial resistance (AMR) of , and spp. (ESKAPE) pathogens in Africa because of the inadequate establishment of AMR surveillance systems.

OBJECTIVE

This study reports on the incidence and AMR of bloodstream ESKAPE pathogens at a referral hospital in northern South Africa.

METHODS

This retrospective descriptive study used routinely collected bloodstream isolates (pathogen identification and antimicrobial susceptibility testing performed using automated systems) from the South African National Health Laboratory Service, from January 2014 to December 2019. Resistant phenotypes analysed included methicillin-resistant and carbapenem-resistant .

RESULTS

The ESKAPE pathogen incidence rate was stable from 2014 to 2019 ( = 0.133). The most isolated pathogens were (268/746; 35.9%) and (200/746; 26.8%). increased from 39 isolates in 2014 to 75 in 2019 ( = 0.132). The incidence rate of increased from 11.9% (16/134) in 2015 to 37.8% (68/180) in 2019 ( = 0.009). Most isolates (417/746; 55.9%) were from the neonatal ward. Carbapenem-resistant increased from 68.8% (11/16) in 2014 to 75.0% (51/68) in 2019 ( = 0.009). Methicillin-resistant decreased from 56.0% (14/25) in 2016 to 17.3% (13/75) in 2019 ( = 0.260).

CONCLUSION

Routine data provide essential information on the incidence of ESKAPE pathogens and AMR phenotypes, serving as a basis for an antibiogram, a surveillance tool in antibiotic stewardship programmes.

WHAT THIS STUDY ADDS

The study provided local information on the incidence and AMR pattern of ESKAPE pathogens, which is essential when developing empiric treatment protocols for appropriate antibiotic prescribing and infection prevention and control practices.