A study on distribution of ESKAPE group of pathogens and their drug resistance pattern in Intensive Care Unit patients in a Tertiary care hospital

INTRODUCTION: Over the last decade, the unrelenting proliferation of antibiotic-resistant bacteria has escalated, led predominantly by a formidable group of bacteria designated as “ESKAPE” pathogens-.Enterococcus species, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeroginosa and Enterobacter spp-acronymically termed as “ESKAPE” pathogens. These pathogens are capable of “escaping” the biocidal action of antibiotics and mutually representing new paradigms in pathogenesis, transmission and resistance. These “ESKAPE” pathogens are responsible for significant proportion of drug resistant hospital infections. AIM OF THE STUDY: To study the distribution of “ESKAPE” (Enterococcus species, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter species) group of pathogens and determine their Antimicrobial susceptibility and resistance pattern in Intensive Care Unit Patients. MATERIALS AND METHODS: A total of 400 consecutive, non duplicate samples were enrolled in the study. The isolates were from various clinical specimens which were sent to the Microbiology Laboratory for bacteriological culture and antibiotic susceptibility testing. Isolates included in this study were obtained from blood, sputum, endotracheal aspirate, bronchial wash, pleural fluid, ascitic fluid, cerebrospinal fluid, urine and wound swabs. The resistance pattern were then identified using standard guidelines in culture positive samples. RESULTS: Among the 400 samples included in the study, 148 (37%) showed culture positivity. Out of the 148 culture positive samples, 120 (81%) were ESKAPE group of pathogens .Among the ESKAPE pathogens, 51.6% were resistant ESKAPE pathogens. The predominant individual resistant pathogen was MRSA (29%) and Carbapenemase producing Acinetobacter baumannii (26%). MRSA was highest associated with Blood stream infections and Carbapenemase producing Acinetobacter baumannii was coomonly associated with Lower respiratory tract infections. Among the non-ESKAPE group, ESBL producing Escherichia coli and ESBL producing Klebsiella oxytoca were the predominant isolates. CONCLUSION: The prevalence of ESKAPE group of pathogens represent the stage of limited treatment options available for the treatment of patients in critical care units. The knowledge about the prevalence and distribution of ESKAPE pathogens aids in formulating hospital policies and guidelines in areas of infection control and antibiotic management practices