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| title | chunk | source | category | tags | date_saved | instance |
|---|---|---|---|---|---|---|
| ESKAPE | 1/2 | https://en.wikipedia.org/wiki/ESKAPE | reference | science, encyclopedia | 2026-05-05T07:28:42.622581+00:00 | kb-cron |
ESKAPE is an acronym comprising the scientific names of six highly virulent and antibiotic resistant bacterial pathogens including: Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. The acronym is sometimes extended to ESKAPEE to include Escherichia coli. This group of Gram-positive and Gram-negative bacteria can evade or 'escape' commonly used antibiotics due to their increasing multi-drug resistance (MDR). As a result, throughout the world, they are the major cause of life-threatening nosocomial or hospital-acquired infections in immunocompromised and critically ill patients who are most at risk.== Training and awareness manuals == In addition to primary research literature, structured training materials have been developed to support understanding of ESKAPE pathogens in public health and biosecurity contexts. One such manual is Demystifying ESKAPE Pathogens (2017), published by the Institute of Nuclear Medicine and Allied Sciences (INMAS), a laboratory of the Defence Research and Development Organisation (DRDO), India. The manual provides an overview of multidrug-resistant pathogens, including their epidemiology, mechanisms of resistance, transmission, clinical features, and control strategies, and is used in training and awareness programmes in India. P. aeruginosa and S. aureus are some of the most ubiquitous pathogens in biofilms found in healthcare. P. aeruginosa is a Gram-negative, rod-shaped bacterium, commonly found in the gut flora, soil, and water that can be spread directly or indirectly to patients in healthcare settings. The pathogen can also be spread in other locations through contamination, including surfaces, equipment, and hands. The opportunistic pathogen can cause hospitalized patients to have infections in the lungs (as pneumonia), blood, urinary tract, and in other body regions after surgery. S. aureus is a Gram-positive, cocci-shaped bacterium, residing in the environment and on the skin and nose of many healthy individuals. The bacterium can cause skin and bone infections, pneumonia, and other types of potentially serious infections if it enters the body. S. aureus has also gained resistance to many antibiotic treatments, making healing difficult. Because of natural and unnatural selective pressures and factors, antibiotic resistance in bacteria usually emerges through genetic mutation or acquires antibiotic-resistant genes (ARGs) through horizontal gene transfer - a genetic exchange process by which antibiotic resistance can spread. One of the main reasons for the rise in the selection for antibiotic resistance (ABR) and MDR which led to the emergence of the ESKAPE bacteria is from the rash overuse of antibiotics not only in healthcare, but also in the animal, and agricultural sector. Other key factors include misuse and inadequate adherence to treatment guidelines. Due to these factors, fewer and fewer antibiotic treatments are effective in eradicating ABR and MDR bacterial infections, while at the same time there are now no new antibiotics being created due to lack of funding. These ESKAPE pathogens, along with other antibiotic-resistant bacteria, are an interweaved global health threat and are being addressed from a more holistic and One Health perspective.
== Prevalence == From a global perspective, the emergence of multidrug-resistant (MDR) bacteria is responsible for about 15.5% of hospital acquired infection cases and there are currently about 0.7 million deaths from drug-resistant disease. Specifically, the opportunistic nosocomial ESKAPE pathogens correspond with the highest risk of mortality which has the majority of its isolates being MDR. Two pathogens within the ESKAPE group, Carbapenem-resistant Acinetobacter and Carbapenem-resistant Enterobacteriaceae are currently in the top five of the antibiotic resistant bacteria on the CDC's 2019 urgent threat list, and the other 4 pathogens making up the group are on the serious threat list. In addition, the World Health Organization (WHO) created a global priority pathogen list (PPL) of ABR bacteria with the goal to prioritize research and create new effective antibiotic treatments. The global PPL classifies pathogens into 3 categories, critical, high, and medium, and has 4 of the pathogens from the ESKAPE group in the critical priority list and the other 2 pathogens that make up the group in the high priority list.
== Characteristics == ESKAPE pathogens are differentiated from other pathogens due to their increased resistance to commonly used antibiotics such as penicillin, vancomycin, carbapenems, and more. This increased resistance, combined with the clinical significance of these bacteria in the medical field, results in a necessity to understand their mechanisms of resistance and combat them with novel antibiotics. Common mechanisms for resistance include the production of enzymes that attack the structure of antibiotics (for example, β-lactamases inactivating β-lactam antibiotics), modification of the target site that the antibiotic targets so that it can no longer bind properly, efflux pumps, and biofilm production. Efflux pumps are a feature of the membrane of Gram-negative bacteria that allows them to constantly pump out foreign material, including antibiotics, so that the inside of the cell never contains a high enough concentration of the drug to have an effect. Biofilms are a mixture of diverse microbial communities and polymers that protect the bacteria from antibiotic treatment by acting as a physical barrier.