The Prevalence of ESKAPE Pathogens and Their Drug Resistance Profiles in Aquatic Environments Around the World

Antimicrobial-resistant bacteria (ARB) in the ESKAPE group include Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. These pathogens continue to pose a global threat to human health. Urban and non-urban rivers affected by anthropogenic activities such as farming can act as reservoirs for ARB. The influx of wastewater from animal farms and irrigation processes can affect the normal microbiota in surrounding waterbodies. New bacteria, such as those in the ESKAPE family, may be introduced into these waterbodies, since most ESKAPE pathogens are domiciled in humans and animals. There is a dearth of information on the persistence of ESKAPE isolates and their associated health hazards in non-nosocomial settings. Therefore, this review aimed to collect data on the global distribution of ESKAPE pathogens in aquatic systems. PubMed and Google Scholar were searched for articles published from 2009 to 2025. A total of 76 studies published in peer-reviewed journals were included. Data were collected from 21 papers for E. faecium/faecalis, 12 for S. aureus, 15 for K. pneumoniae, 11 for A. baumannii, 8 for P. aeruginosa, and 9 for Enterobacter spp. The findings in this review will increase public health awareness on the significance of ESKAPE pathogens in aquatic systems.