Maraki Sofia, Mavromanolaki Viktoria Eirini, Kasimati Anna, Iliaki-Giannakoudaki Evangelia, Stafylaki Dimitra
Department of Clinical Microbiology and Microbial Pathogenesis, University Hospital of Heraklion, PC 71110, Crete, Greece.
Department of Pediatrics, Agios Nikolaos General Hospital, Agios Nikolaos, PC 72100, Crete, Greece.
Diagn Microbiol Infect Dis. 2025 Jul;112(3):116804. doi: 10.1016/j.diagmicrobio.2025.116804. Epub 2025 Mar 15.
The ESKAPE group (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter) is a major cause of life-threatening infections in Intensive Care Unit (ICU) critically ill patients accounting for significant morbidity and mortality. Management of infections by ESKAPE pathogens is complicated due to the remarkable rise in the rates of multidrug resistance (MDR) to most antimicrobial agents. This study investigated the trends of prevalence and antimicrobial resistance profiles of the ESKAPE pathogens isolated from clinical specimens of adult ICU patients.
All ESKAPE isolates collected from clinical specimens of ICU patients during the years 2013-2022 were processed according to routine methods. Identification of the bacterial isolates was performed by matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry and antimicrobial susceptibility testing by Vitek 2 system.
During the ten-year period, a total of 6,132 ESKAPE strains were isolated from 5,338 samples of 1,792 ICU patients. A. baumannii was the most prevalent microorganism, followed by P. aeruginosa, and K. pneumoniae. High resistance to carbapenems was detected for A. baumannii (96.7 %) and K. pneumoniae (57.4 %). Methicillin-resistant were 39.1 % of S. aureus and vancomycin-resistant 38.7 % of the E. faecium isolates. MDR were characterized 39 % of K. pneumoniae and 13.1 % of P. aeruginosa strains, while 19.7 % of A. baumannii were pandrug resistant.
An increased antimicrobial resistance among ESKAPE bacteria was found in our ICU setting. Enhanced antimicrobial surveillance, strict implementation of stewardship programmes and infection control practices are crucial to reduce AMR and develop management strategies to optimize outcomes.
ESKAPE 组（粪肠球菌、金黄色葡萄球菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌、肠杆菌）是重症监护病房（ICU）重症患者危及生命感染的主要原因，导致显著的发病率和死亡率。由于对大多数抗菌药物的多重耐药（MDR）率显著上升，ESKAPE 病原体感染的管理变得复杂。本研究调查了从成年 ICU 患者临床标本中分离出的 ESKAPE 病原体的流行趋势和抗菌耐药谱。
2013 年至 2022 年期间从 ICU 患者临床标本中收集的所有 ESKAPE 分离株均按常规方法处理。细菌分离株的鉴定通过基质辅助激光解吸电离飞行时间（MALDI-TOF）质谱法进行，抗菌药敏试验通过 Vitek 2 系统进行。
在这十年期间，共从 1792 名 ICU 患者的 5338 份样本中分离出 6132 株 ESKAPE 菌株。鲍曼不动杆菌是最常见的微生物，其次是铜绿假单胞菌和肺炎克雷伯菌。检测到鲍曼不动杆菌（96.7%）和肺炎克雷伯菌（57.4%）对碳青霉烯类药物高度耐药。金黄色葡萄球菌耐甲氧西林率为 39.1%，粪肠球菌分离株耐万古霉素率为 38.7%。肺炎克雷伯菌菌株中有 39%和铜绿假单胞菌菌株中有 13.1%具有多重耐药特征，而鲍曼不动杆菌中有 19.7%对所有药物耐药。
在我们的 ICU 环境中发现 ESKAPE 细菌的抗菌耐药性有所增加。加强抗菌监测、严格实施管理计划和感染控制措施对于降低抗菌药物耐药性以及制定优化治疗结果的管理策略至关重要。
