Resistance Landscape and Clonal Dynamics of ESKAPE Pathogens in Bloodstream Infections: A Multicenter Study from...

Area of Science:

• Infectious Diseases
• Microbiology
• Global Health

Background:

• Antimicrobial resistance (AMR) in healthcare-associated infections (HAIs) is a major global health concern.
• The COVID-19 pandemic potentially exacerbated AMR by disrupting infection control and antimicrobial stewardship.
• ESKAPE pathogens are a leading cause of HAIs and contribute significantly to AMR.

Purpose of the Study:

• To investigate the prevalence, antimicrobial resistance, and clonal dissemination of ESKAPE pathogens causing bloodstream infections in Mexican hospitals during the second year of the COVID-19 pandemic.
• To identify specific resistance mechanisms and circulating clones among these pathogens.

Main Methods:

• Analysis of 926 bacterial isolates from bloodstream infections in four tertiary-care hospitals in Mexico.
• Identification of ESKAPE pathogens and antimicrobial susceptibility testing.
• Detection of resistance genes (β-lactamases, carbapenemases) and molecular typing (pulsed-field gel electrophoresis).

Main Results:

• High rates of multidrug resistance (MDR) and extensively drug resistance (XDR) were observed, particularly in Acinetobacter baumannii and Klebsiella pneumoniae.
• Specific resistance genes like blaSHV, blaCTX-M, blaTEM, blaOXA, blaNDM, and blaVIM were identified.
• Endemic circulation of Acinetobacter baumannii clones and interhospital dissemination of Staphylococcus aureus and Klebsiella pneumoniae clones were detected.

Conclusions:

• The study highlights the significant epidemiological burden of MDR ESKAPE pathogens in Mexican hospitals during the COVID-19 pandemic.
• Urgent need for optimized empirical antimicrobial therapy and continuous genomic surveillance to improve infection control.
• Findings underscore the ongoing threat of AMR and the importance of robust infection prevention strategies.