ESBL Producing ESKAPE Pathogens AndTheir Susceptibility Pattern Against Carbapenem Antimicrobial Agents

Introduction: Antimicrobial resistance poses a major challenge to the healthcare system globally due to micro-organisms with the ability to produce enzymes such as Extended-Spectrum Beta-Lactamases and carbapenemase. They have been categorised by the World Health Organisation in 2017 as ESKAPE pathogens to emphasise their importance as global multidrug-resistant priority pathogens. Aim: the study assessed the prevalence of ESBL positive Gram-negative ESKAPE pathogens and their sensitivity profile against carbapenems. Methods: Retrospective data were retrieved from the National Health Laboratory service through the Academic Affairs and Research Management Systems for patients infected by the gram-negative ESKAPE pathogens Inkosi Albert Luthuli Central and Mahatma Gandhi Memorial Hospital using analysis for five years. Results: A total of 4781 results were obtained with 2414 (50.49%) being K. pneumoniae, 1150 (24.05%) P. aeruginosa, 951 (19.89%) A. baumannii complex, and 266 (5.56%) E. cloacae for both hospitals combined. Only 462 K.pneumoniae isolates were ESBL positive with >90% sensitivity against carbapenems. Seventeen P. aeruginosa and 28 E.cloacae complex isolates were ESBL positive with >70% sensitivity rates against carbapenems. A. baumannii complex had only 6 ESBL positive isolates with 50% sensitivity and 50% resistance rate against carbapenems. Conclusion: In the period of 5 years, ESBL producing Gram-negative ESKAPE pathogens have increased but carbapenem antimicrobial agents still show high efficacy against these pathogens. However, A. baumannii complex shows considerably high resistance rates thus requiring close surveillance to avoid antimicrobial stewardship.