Antibiotic resistance trends of ESKAPE pathogens in Kwazulu-Natal, South Africa: A five-year retrospective analysis

Background: To combat antimicrobial resistance, the World Health Organization developed a global priority pathogen list of antibiotic-resistant bacteria for prioritisation of research and development of new, effective antibiotics. Objective: This study describes a five-year resistance trend analysi...

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Main Authors: Yogandree Ramsamy, Sabiha Y. Essack, Benn Sartorius, Miriam Patel, Koleka P. Mlisana
Format: Article
Language:English
Published: AOSIS 2018-12-01
Series:African Journal of Laboratory Medicine
Subjects:
Online Access:https://ajlmonline.org/index.php/ajlm/article/view/887
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author Yogandree Ramsamy
Sabiha Y. Essack
Benn Sartorius
Miriam Patel
Koleka P. Mlisana
author_facet Yogandree Ramsamy
Sabiha Y. Essack
Benn Sartorius
Miriam Patel
Koleka P. Mlisana
author_sort Yogandree Ramsamy
collection DOAJ
description Background: To combat antimicrobial resistance, the World Health Organization developed a global priority pathogen list of antibiotic-resistant bacteria for prioritisation of research and development of new, effective antibiotics. Objective: This study describes a five-year resistance trend analysis of the ESKAPE pathogens: Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp., from Kwazulu-Natal, South Africa. Methods: This retrospective study used National Health Laboratory Services data on 64 502 ESKAPE organisms isolated between 2011 and 2015. Susceptibility trends were ascertained from minimum inhibitory concentrations and interpreted using Clinical and Laboratory Standards Institute guidelines. Results: S. aureus was most frequently isolated (n = 24, 495, 38%), followed by K. pneumoniae (n = 14, 282, 22%). Decreasing rates of methicillin-resistant S. aureus (28% to 18%, p < 0.001) and increasing rates of extended spectrum beta-lactamase producing K. pneumoniae (54% to 65% p < 0.001) were observed. Carbapenem resistance among K. pneumoniae and Enterobacter spp. was less than 6% during 2011–2014, but increased from 4% in 2014 to 16% in 2015 (p < 0.001) among K. pneumoniae. P. aeruginosa increased (p = 0.002), but resistance to anti-pseudomonal antimicrobials decreased from 2013 to 2015. High rates of multi-drug resistance were observed in A. baumanni (> 70%). Conclusion: This study describes the magnitude of antimicrobial resistance in KwaZulu-Natal and provides a South African perspective on antimicrobial resistance in the global priority pathogen list, signalling the need for initiation or enhancement of antimicrobial stewardship and infection control measures locally.
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spelling doaj.art-09dabeed21c240fbbb09e0b143df0aba2022-12-22T02:56:27ZengAOSISAfrican Journal of Laboratory Medicine2225-20022225-20102018-12-0172e1e810.4102/ajlm.v7i2.887209Antibiotic resistance trends of ESKAPE pathogens in Kwazulu-Natal, South Africa: A five-year retrospective analysisYogandree Ramsamy0Sabiha Y. Essack1Benn Sartorius2Miriam Patel3Koleka P. Mlisana4Department of Medical Microbiology, School of Laboratory Medicine and Medical Sciences, Antimicrobial Research Unit, University of Kwazulu-Natal, National Health Laboratory Services, DurbanAntimicrobial Research Unit, College of Health Sciences, University of Kwazulu-Natal, DurbanSchool of Nursing and Public Health, University of Kwazulu-Natal, DurbanAntimicrobial Research Unit, College of Health Sciences, University of Kwazulu-Natal, DurbanNational Health Laboratory Services, University of Kwazulu-Natal, DurbanBackground: To combat antimicrobial resistance, the World Health Organization developed a global priority pathogen list of antibiotic-resistant bacteria for prioritisation of research and development of new, effective antibiotics. Objective: This study describes a five-year resistance trend analysis of the ESKAPE pathogens: Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp., from Kwazulu-Natal, South Africa. Methods: This retrospective study used National Health Laboratory Services data on 64 502 ESKAPE organisms isolated between 2011 and 2015. Susceptibility trends were ascertained from minimum inhibitory concentrations and interpreted using Clinical and Laboratory Standards Institute guidelines. Results: S. aureus was most frequently isolated (n = 24, 495, 38%), followed by K. pneumoniae (n = 14, 282, 22%). Decreasing rates of methicillin-resistant S. aureus (28% to 18%, p < 0.001) and increasing rates of extended spectrum beta-lactamase producing K. pneumoniae (54% to 65% p < 0.001) were observed. Carbapenem resistance among K. pneumoniae and Enterobacter spp. was less than 6% during 2011–2014, but increased from 4% in 2014 to 16% in 2015 (p < 0.001) among K. pneumoniae. P. aeruginosa increased (p = 0.002), but resistance to anti-pseudomonal antimicrobials decreased from 2013 to 2015. High rates of multi-drug resistance were observed in A. baumanni (> 70%). Conclusion: This study describes the magnitude of antimicrobial resistance in KwaZulu-Natal and provides a South African perspective on antimicrobial resistance in the global priority pathogen list, signalling the need for initiation or enhancement of antimicrobial stewardship and infection control measures locally.https://ajlmonline.org/index.php/ajlm/article/view/887antimicrobial resistanceAntimicrobial resistance surveillanceESKAPE pathogenspathogen surveillance
spellingShingle Yogandree Ramsamy
Sabiha Y. Essack
Benn Sartorius
Miriam Patel
Koleka P. Mlisana
Antibiotic resistance trends of ESKAPE pathogens in Kwazulu-Natal, South Africa: A five-year retrospective analysis
African Journal of Laboratory Medicine
antimicrobial resistance
Antimicrobial resistance surveillance
ESKAPE pathogens
pathogen surveillance
title Antibiotic resistance trends of ESKAPE pathogens in Kwazulu-Natal, South Africa: A five-year retrospective analysis
title_full Antibiotic resistance trends of ESKAPE pathogens in Kwazulu-Natal, South Africa: A five-year retrospective analysis
title_fullStr Antibiotic resistance trends of ESKAPE pathogens in Kwazulu-Natal, South Africa: A five-year retrospective analysis
title_full_unstemmed Antibiotic resistance trends of ESKAPE pathogens in Kwazulu-Natal, South Africa: A five-year retrospective analysis
title_short Antibiotic resistance trends of ESKAPE pathogens in Kwazulu-Natal, South Africa: A five-year retrospective analysis
title_sort antibiotic resistance trends of eskape pathogens in kwazulu natal south africa a five year retrospective analysis
topic antimicrobial resistance
Antimicrobial resistance surveillance
ESKAPE pathogens
pathogen surveillance
url https://ajlmonline.org/index.php/ajlm/article/view/887
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