ANTIMICROBIAL RESISTANCE OF ESKAPE-PATHOGENS IN CULTURE-POSITIVE PNEUMONIA

The aim of our study was to characterize the antimicrobial resistance in ESKAPE pathogens (E. faecium, S. aureus, Klebsiella spp., A. baumannii, P. aeruginosa and Enterobacter spp.) isolated from 606 culture-positive pneumonia: community-acquired (CAP), healthcare-associated (HCAP), hospital-acquired and ventilator-associated (HAP/VAP). A retrospective analysis was performed in tertiary care settings from Cluj-Napoca (2007-2013). Antibiotic resistance was determined according to Clinical and Laboratory Standards Institute (CLSI) and the trend by multiple antibiotic resistance index (MAR). ESKAPE pathogens (52%) were more likely found in HCAP and HAP/VAP. Co-resistance to ceftazidime, ciprofloxacin and gentamicin was dominant (48%). Highly resistant pathogens, Extended-spectrum beta-lactamase (ESBL)Klebsiella spp., carbapenem-resistant A. baumannii and P. aeruginosa were identified mainly in HAP/VAP versus HCAP (39.3% vs. 2.3%, 92% vs. 7.5% and 40% vs. 1.4%, respectively). Except for S. aureus, multiple antibiotics resistance (MAR) index of ESKAPE pathogens revealed an increasing trend. In conclusion, ESKAPE pathogens are commonly identified in HCAP and HAP/VAP. An alarming frequency of highly resistant pathogens in hospital-acquired and ventilator-associated pneumonia was noticed.