Prevalence and Antimicrobial Resistance Patterns in ESKAPE Pathogens in Iran

Background: The spread of resistant bacteria has caused serious concern worldwide. The spread of multidrug-resistant (MDR) and extensive drug-resistant (XDR) limits the choice of antibiotics, making available antibiotics less effective. Objectives: This study aimed to investigate resistance patterns to seven global threatening organisms announced by the Centers for Disease Control and Prevention (CDC) for one year in Iran, called ESKAPE bacteria (Enterococcus spp., Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.). Methods: Clinical isolates were collected from 10 selective hospitals in nine provinces. Antibiotic susceptibility testing was performed according to the Clinical and Laboratory Standards Institute for each bacterium. Results: A total of 5522 bacterial species were considered, of which 30% were ESKAPE. Multidrug-resistant A. baumannii and Staphylococcus aureus methicillin-resistant Staphylococcus aureus (MRSA) were the most identified in Gram-negative and -positive bacteria, with the frequency of 44% and 39%, respectively. The remaining bacteria, including E. coli, K. pneumoniae, Enterobacter spp. P. aeruginosa, and Enterococcus spp., had the frequency of 30%, 32%, 21%, 20%, and 22%, respectively. Conclusions: The determined patterns for the antibiotic resistance of the ESKAPE bacteria can help determine antibiotic stewardship. Also, the high rates of the ESKAPE bacteria in Iran could be alarming for healthcare centers not to misuse broad-spectrum antibiotics.