Prevalence of Antibiotic Resistance of ESKAPE Pathogens Over Five Years in an Infectious Diseases Hospital from South-East of Romania

Figures & data

Figure 1 Annual evolution of the bacterial strain isolates and number of patients.

Table 1 Annual Frequency of ESKAPE Group Species

Genera	No-2016	No-2017	No-2018	No-2019	No-2020	Total	%
Enterococcus spp.	62	27	39	12	8	148	3.55%
Staphylococcus spp.	282	229	249	236	91	1087	26%
Klebsiella spp.	96	94	92	75	41	398	9.55%
Acinetobacter spp.	5	5	5	9	4	28	0.67%
Pseudomonas spp.	88	83	67	82	46	366	8.78%
Enterobacteriaceae
Escherichia coli	372	414	383	313	112	1594	38.26%
Proteus spp.	65	68	54	29	22	238	5.71%
Enterobacter spp.	25	22	22	18	13	100	2.40%
Salmonella spp.	35	42	31	25	13	146	3.50%
Other Enterobacteriaceae	16	21	9	12	3	61	1.46%
Total	1089	1022	967	839	376	4293	100%

Note: % annual frequency.

Table 2 ESKAPE Distribution According to the Biological Product Analyzed (2016–2020)

	Urine Culture		Wound or Abscess		Blood Culture		Catheter Culture		Others		TOTAL
	N	%	N	%	N	%	N	%	N	%
Enterococcus spp.	125	84.4%	16	10.8%	4	2.7%	3	2.0%	0	0	148
Enterococcus spp. untyped	106	86.8%	12	9.8%	2	1.6%	2	1.6%	–	–	122
Enterococcus faecium	0	–	1	–	1	–	0	–	–	–	2
Enterococcus faecalis	19	79.1%	3	12.5%	1	–	1	–	–	–	24
Staphylococcus spp.	6	0.5%	741	68.1%	88	8.1%	35	3.2%	217	19.9%	1087
Staphylococcus aureus	5	0.5%	724	74.8	24	2.4%	23	2.3%	197	20.3%	968
Klebsiella spp.	244	61.3%	80	20.1%	18	4.5%	0	0	56	14.4%	398
Klebsiella pneumoniae	159	77.9%	52	25.4%	13	6.3%	0	0	34	16.6%	258
Acinetobacter spp.	3	10.7%	11	39.2%	2	7.1%	2	7.1%	10	35.7%	28
Acinetobacter baumannii	2	10.5%	10	52.6%	2	10.5%	2	10.5%	3	15.7%	19
Pseudomonas spp.	44	12%	299	81.7%	0	0	0	0	23	6.2%	366
Pseudomonas aeruginosa	39	19.1%	151	74.0%	0	0	0	0	14	6.8%	204
Enterobacteriaceae
Escherichia coli	1346	84.4%	98	6.14%	53	3.3%	0	0	97	6%	1594
Proteus spp.	82	34.4%	145	60.9%	3	1.2%	1	0.4%	7	2.9%	238
Enterobacter spp.	38	38.0%	50	50.0%	2	2%	0	0	10	10%	100
Salmonella spp.	0	0	0	0	3	2%	0	0	143	97.9%	146
Other Enterobacteriaceae	12	19.6%	26	42.6%	2	3.2%	0	0	21	34.4%	61
Total	1900	45.6%	1466	35.89%	175	4.2%	41	0.9%	561	13.4%	4166

Table 3 Susceptibility and MDR of Gram-Positive Cocci from ESKAPE Group

	OXA	AMP	CC	CIP	ERY	GM*	LNZ	TEC	VAN	SXT	MDR
Enterococcus spp. untyped	IR	80		55.2	–	–	100	–	93.3	–	0
Enterococcus faecium	IR	IR	IR	50	IR	IR	100	–	100	IR	0
Enterococcus faecalis	IR	95.7	IR	44.4	IR	IR	100	–	100	IR	0
Staphylococcus aureus	64.3	IR	47.9	72.6	32.9	77.6	99.7	87.8	85.7	86	41.8
MSSA	–	IR	62.6	86.8	47.8	89.2	99.7	88.9	77.8	90.4	16.5
MRSA	–	IR	21.1	46.9	5.7	56	99.6	86.4	100	78.3	86.6

Note: *Except for high level.

Abbreviations: OXA, oxacillin; AMP, ampicillin; CC, clindamycin; CIP, ciprofloxacin; ERY, erythromycin; GM, gentamicin; LNZ, linezolid; TEC, teicoplanin; VAN, vancomycin; SXT, sulfamethoxazole-trimethoprim; MDR, multidrug resistance; MSSA, methicillin sensible Staphylococcus aureus; MRSA, methicillin resistant Staphylococcus aureus.

Figure 2 MRSA rate progression (2016–2020).

Table 4 Susceptibility and MDR of Gram-Negative Bacilli from the ESKAPE Group

	AMC	CXM	CTX	CAZ	FEP	TZP	ERT	MEM	CIP	GM	SXT	MDR
Acinetobacter baumannii	IR*	NT#	NT	27.3	38.5	66.7	IR*	57.1	47.4	55.6	NT	36.8
Pseudomonas aeruginosa	IR*	NT/IR*	NT/IR*	66.5	60.3	73.7	IR*	55.2	64.8	61.6	NT/IR*	29.1
Klebsiella pneumoniae	50.4	63.7	66.1	22.2	38.7	72.5	43.3	73.2	63	74.1	60.4	24.4
Enterobacteriaceae
Escherichia coli	60.2	85.2	87.3	NT	77.8	91.6	95.7	96	75.3	91.5	64.3	9.8
Proteus spp.	57	68.4	82.3	NT	66.3	93.8	98	100	73.8	68.5	44.3	15.1
Enterobacter spp.	15.7	34.9	70	NT	81.8	87	80	73.3	82.2	78.5	70	14.7
Salmonella spp	75	NT	100**	NT	NT	NT	100	100	77.2	77.8	95	4
Other Enterobacteriaceae	14.9	43.5	63.3	NT	50	89.3	87.5	73.3	72.5	75.6	62	22.2

Notes: **For Salmonella spp. 1st and 2nd generation cephalosporins may appear to be as such in vitro, but are not effective clinically and should not be reported as susceptible.

Abbreviations: *IR, intrinsic resistance; ^#NT, not tested; AMC, amoxicillin clavulanate; CXM, cefuroxime; CTX, cefotaximue; CAZ, ceftazidime; FEP, cefepime; TZP, piperacillin- tazobactam; ERT, ertapenem; MEM, meropenem; CIP, ciprofloxacin; GM, gentamicin; SXT, sulfamethoxazole-trimethoprim; MDR, multidrug resistance.

Figure 3 Escherichia coli ESBL+ progression rate (2016–2020).