Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter (ESKAPE) Pathogens and Colistin Resistance in Ventilator-Associated Pneumonia: A Prospective Cross-Sectional Study

Abstract

Ventilator-associated pneumonia (VAP) comes under hospital-acquired infections (HAI), which is an ongoing threat to both patients and healthcare workers. In our hospital, Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter (ESKAPE) pathogens play a major role in causing hospital-acquired infections. Out of 100 endotracheal aspirate samples, around 37% (n=37) of the isolates belonged to ESKAPE pathogens. However, only 12% (n=12) of the isolates were multidrug-resistant Gram-negative bacilli, and one isolate showed resistance to the last-resort drug, colistin (polymyxin E). Subsequently, we subjected that one isolate to conventional polymerase chain reaction, which detected the mobile colistin resistance-2 (MCR-2) gene. Unfortunately, by the time we found that isolate was colistin resistant, that patient had died due to multiple organ dysfunction syndrome (MODS). These findings underscore the need to perform antimicrobial susceptibility testing for all drugs according to our standard operating procedure (SOP) guidelines and conduct cascade reporting for all samples.