Prevalence of Antimicrobial Resistance of ESKAPE Pathogens before and during Pandemic COVID-19 Pandemic in a University Affiliated Hospital in Tangerang, Indonesia

Introduction: Antimicrobial resistance is the most important health problems currently. Antibiotic prophylaxis to prevent bacterial co-infections in hospitalized COVID-19 patients, and lack of surveillance were associated with antimicrobial resistance. ESKAPE pathogens consisting of E. faecium, S. aureus, K. pneumoniae, A. baumanii, P. aeruginosa and Enterobacter spp. are associated with healthcare-associated infections. Patients and Methods: This descriptive, retrospective, longitudinal study aims to describe the resistance rates of bloodstream infection due to ESKAPE pathogens from patients admitted in Siloam Hospital Karawaci, before and during COVID-19 pandemic (January 1st, 2019 until December 31st, 2022). Out of 296 ESKAPE pathogens collected from blood samples, S. aureus was the most frequent species, followed by K. pneumoniae, A. baumannii, P. aeruginosa, Enterobacter spp., and E. faecium. Results: Resistance rates of E. faecium were alarmingly high from 2019 until 2021, but in 2022 no sample was found. Resistance rates of S. aureus and MRSA decreased from 2019 until 2021 and then increased again in 2022 while for K. pneumoniae it peaked in 2020 and reached the lowest in 2022. Resistance pattern of A. baumanii was not favorable from 2019 until 2021, but decreased dramatically in 2022. Resistance pattern of P. aeruginosa was quite variable in 2021 and 2022 while for Enterobacter spp. it was variable in 2020 to 2022. Conclusion: The COVID-19 pandemic affected the antimicrobial resistance pattern of ESKAPE pathogens in Banten province, Indonesia. Resistance rates increased as the pandemic peaked in 2020 to 2021, and decreased as the pandemic resolves in 2022.

The antimicrobial susceptibility profile of ESKAPE pathogens from urinary tract infections in a referral laboratory,Northeast Iran

Objective:To assess the antimicrobial susceptibility pattern of ESKAPE pathogens from Neyshabur,Iran during 2013-2015.Methods:A total of 345 isolates including 62 Staphylococcus aureus(S.aureus),38 Enterobacter spp.(including 14 Enterobacter agglomerans,6 Enterobacter aerogenes and other 18 Enterobacter spp.),123 Enterococcus faecium,78 Klebsiella pneumonia,10 Pseudomonas aeruginosa and 34 Acinetobacter baumannii were isolated.The antimicrobial susceptibility pattern of isolates was conducted with Kirby Bauer method.Data were analyzed with SPSS 20.0 software using F-and t-tests.Results:Among S.aureus isolates,the highest resistance was observed against nalidixic acid(81.35%)and cefixime(74.50%).Thirty-three(53.22%)S.aureus isolates were cefoxitin resistant(methicillin-resistant S.aureus).The majority of Enterobacter species was resistant to amikacin(100.00%)and cephalotin(66.60%).Most Enterococcus faecium isolates were resistant to nalidixic acid(89.43%)and amikacin(83.33%),but vancomycin-resistant enterococci isolates were not detected.Moreover,among Klebsiella pneumonia,the highest resistance was observed to nalidixic acid(20.98%)and cotrimoxazole(28.39%).Furthermore,all Pseudomonas aeruginosa isolates were resistant to cefotaxime(100.00%)and majority to nitroforantoin(88.80%).Acinetobacter baumannii isolates showed the highest and the lowest resistance to cefotaxime(100.00%)and cefixime(88.71%),respectively.Conclusions:The prevalence of ESKAPE pathogens from northeast region was low,but majority of them exhibited high rate of antibiotic resistance to common used antimicrobial agents.