Sah Ranjit Kumar, Bhattarai Abhinav, Khadka Priyatam, Sharma Sangita, Mishra Shyam Kumar, Rai Junu Richhinbung, Raut Shristi
Department of Laboratory Medicine, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
Biochemistry and Molecular Biology, SUNY Upstate Medical University, Syracuse, New York, USA.
Can J Infect Dis Med Microbiol. 2025 Mar 27;2025:4426596. doi: 10.1155/cjid/4426596. eCollection 2025.
Antimicrobial-resistant , , , , , (ESKAPE) species pathogens pose a threat to global health by limiting available treatments, escalating the burden of disease, and raising mortality rates. This study investigated the prevalence of ESKAPE pathogens in different infections in a Nepalese hospital and studied their antibiotic resistance pattern. The study was performed from September 2022 to February 2023 at Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal. ESKAPE pathogens were isolated in accordance with standard procedures and subjected to antimicrobial susceptibility testing (AST). Identification was done via biochemical testing. The rates of multidrug resistance (MDR), production of extended-spectrum beta-lactamase (ESBL), and methicillin resistance were studied and statistically compared in terms of the type of pathogen, infection, and hospital admission. Altogether, 7429 different clinical samples were cultured and ESKAPE pathogens were isolated from 503/1564 (32.1%) positive samples. The prevalence of these pathogens was significantly higher in admitted patients ( < 0.001). Higher rates of isolation were from urine and sputum samples. was the most prevalent organism while was the least. A total of 52.3% and 7.4% of the isolates were MDR and ESBL producers, respectively. A significant proportion of MDR isolates were from patients admitted to the Intensive Care Unit (ICU). The prevalence of methicillin-resistant (MRSA) was 36.8%. AST revealed comparatively lower resistance of Gram-negative rods to tigecycline, polymyxin B, and colistin sulfate. Likewise, lower resistance rates to vancomycin and teicoplanin were observed in In various clinical samples, we discovered that ESKAPE pathogens were more prevalent. In order to escape the ESKAPE's torment of antibiotic resistance, our findings urge the urgent implementation of sensible antibiotic use, training healthcare professionals in antibiotic stewardship, developing effective infection control strategies, and conducting effective surveillance.
耐抗菌药物的肠球菌、金黄色葡萄球菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌和肠杆菌科细菌（ESKAPE）病原体通过限制可用治疗方法、加重疾病负担和提高死亡率，对全球健康构成威胁。本研究调查了尼泊尔一家医院不同感染中ESKAPE病原体的流行情况，并研究了它们的抗生素耐药模式。该研究于2022年9月至2023年2月在尼泊尔加德满都的特里布万大学教学医院（TUTH）进行。按照标准程序分离ESKAPE病原体，并进行抗菌药物敏感性试验（AST）。通过生化试验进行鉴定。研究了多重耐药（MDR）率、超广谱β-内酰胺酶（ESBL）产生率和耐甲氧西林率，并根据病原体类型、感染情况和住院情况进行了统计学比较。总共培养了7429份不同的临床样本，从503/1564（32.1%）份阳性样本中分离出ESKAPE病原体。这些病原体在住院患者中的流行率显著更高（P<0.001）。分离率较高的是尿液和痰液样本。粪肠球菌是最常见的病原体，而阴沟肠杆菌是最少见的。分离株中分别有52.3%和7.4%为MDR和ESBL产生菌。相当一部分MDR分离株来自入住重症监护病房（ICU）的患者。耐甲氧西林金黄色葡萄球菌（MRSA）的流行率为36.8%。AST显示革兰氏阴性杆菌对替加环素、多粘菌素B和硫酸粘菌素的耐药性相对较低。同样，在金黄色葡萄球菌中观察到对万古霉素和替考拉宁的耐药率较低。在各种临床样本中，我们发现ESKAPE病原体更为普遍。为了摆脱ESKAPE对抗生素耐药性的折磨，我们的研究结果敦促紧急实施合理使用抗生素、培训医护人员进行抗生素管理、制定有效的感染控制策略以及进行有效的监测。
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