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Updated: May 24, 2026

Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia
Published on: June 28, 2018
Ventilator-associated pneumonia caused by ESKAPE organisms: cause, clinical features, and management
Alberto Sandiumenge1, Jordi Rello
1University Hospital Joan XXIII, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, CIBERES, Tarragona, Spain. asandiumenge@yahoo.com
Purpose Of Review:
Despite important geographical variations, Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter species (ESKAPE) pathogens constitute more than 80% of ventilator-associated pneumonia (VAP) episodes. Their clinical importance relies on their virulence and ability in developing mechanisms to decrease susceptibility to antimicrobials, increasing inappropriate therapy and affecting negatively on ICU patients' outcome. This review updates information on VAP due to ESKAPE pathogens.
Recent Findings:
Although methicillin-resistant Staphylococcus aureus VAP may be clinically similar to that caused by susceptible strains, it is associated with poorer outcomes despite adequate treatment. Local colonization determines treatment options. The contribution of tracheobronchitis is an important issue. Minimum inhibitory concentration should be considered for nonfermentative Gram-negative bacteria VAP to prescribe extended infusion β-lactam treatment due to an increase of resistant strains. Strategies promoting antimicrobial diversity may protect against emergence and spread of resistance by ESKAPE pathogens.
Summary:
VAP due to ESKAPE pathogens represents a global challenge that can be prevented using stewardship programmes promoting diversity.
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