Medical Importance of ESKAPE Pathogens

Being the ‘escapers’ from the action of antibiotics, the ESKAPE pathogens—Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp.—a group of nosocomial pathogens are presently considered greatly by the health sector because of their highly infective nature and influence on mortality and morbidity. It is crucial to know their priority ranks as pathogens, resistant mechanisms, transmission of resistance and strategies to compete against these pathogens. All of these pathogens fall under the critical or high priority tier according to WHO’s Global Priority Pathogens List (GPP) and are characterized by high resistance to different first-line to last-hope antibiotic classes. Resistant strains of these organisms are isolated frequently from clinical samples. In general, ESKAPE pathogens are associated with hospital-acquired infections including skin and soft tissue infections (SSTIs), pneumonia, endocarditis, and other bloodstream infections (BSI), surgical site infections (SSI) and urinary tract infections (UTIs). Each of these organisms has unique mechanisms of pathogenesis and resistance. This chapter discusses in detail how and why ESKAPE pathogens are medically relevant, what is their role in antibiotic resistance, mechanism and transmission and their current status as infectious pathogens as per various priority lists and reports.