Multidrug-Resistant ESKAPEEc Pathogens From Bloodstream Infections in South Africa: A Cross-Sectional Study Assessing Resistance to WHO AWaRe Antibiotics
Abstract
Background and aims: Multidrug-resistant (MDR) pathogens, particularly members of the ESKAPE group and Escherichia coli (collectively referred to as ESKAPEEc), are major contributors to bloodstream infections (BSIs) and pose significant treatment challenges. This study aimed to characterize the antimicrobial resistance (AMR) profiles of ESKAPEEc isolates from BSIs in public hospitals in the uMgungundlovu District, South Africa, and to assess their resistance to World Health Organization (WHO) Access, Watch, and Reserve (AWaRe) antibiotics.
Methods: Between November 2017 and December 2018, blood samples (n = 195) were collected from adult and paediatric patients with suspected BSIs. Isolates were identified using the VITEK 2 system and confirmed by polymerase chain reaction (PCR). Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method and interpreted according to EUCAST/CLSI guidelines. The multiple antibiotic resistance index (MARI) was calculated. One-way analysis of variance (ANOVA) was used to assess associations between MARI and clinical variables, including ward type and facility level.
Results: Out of 195 presumptive isolates, 159 were confirmed as ESKAPEEc. The most frequently identified pathogens were Klebsiella pneumoniae (28.9%) and Staphylococcus aureus (28.3%). High resistance rates were observed across WHO Access and Watch antibiotics, including ampicillin (76% in E. coli), gentamicin (67.4% in K. pneumoniae), and…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 195 participants or records.
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