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

María Dolores Alcántar-Curiel1, Rayo Morfín-Otero2,3, Ma Dolores Jarillo-Quijada1

  • 1Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico.

Pathogens (Basel, Switzerland)
|November 27, 2025
PubMed

Insights

Antimicrobial resistance in healthcare-associated infections remains a global threat. This study found high rates of multidrug-resistant ESKAPE pathogens in Mexican hospitals during the COVID-19 pandemic, necessitating improved infection control.

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.
Keywords:
ESKAPE bacteriaMexicoantimicrobial resistancebacteremiabloodstream infectionsclonal dissemination

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