ESKAPE Pathogens: But Without Escape Plan

ESKAPE is an acronym that stands for Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter species, a collection of bacteria that includes both Gram-positive and Gram-negative species. These bacteria are common causes of life-threatening nosocomial infections in immunocompromised and critically ill patients.

These infections are characterized by potential treatment resistance mechanisms and provide a threat to human health on a global scale. Antimicrobial resistance genes can be found on plasmids, transposons or the bacterial chromosome. Drug inactivation/alteration, modification of drug binding sites/targets, changes in cell permeability and biofilm formation are a few broad categories of the resistance mechanisms.

The acquisition of ESKAPE pathogens has resulted in fewer effective treatments for severe infections, a greater burden of disease and higher death rates. This led to development of novel approaches like antivirulence strategies, bacteriophage therapy, probiotics, therapeutic antibodies, synthetic inhibitors specific to resistance enzymes or bacterial efflux pumps inhibition of biofilm formation and use of synthetic flavonoids are good candidates for developing new antimicrobials.

As resistance profiles change, it appears likely that antimicrobial resistance in these pathogens will rise in the near future. For better patient care, this issue has necessitated a coordinated, global response for antibiotic resistance surveillance.

The plan of ESKAPE pathogens that infiltrated healthcare environments without an escape route is to remain and solidify their presence through evolution so thoroughly that they are unable to flee and hide.