Antibiotic Resistance Profile and Detection in ESKAPE Pathogens

Antibiotic resistance indicates the presence of a genetically determined resistance mechanism in bacteria to withstand or combat the lethal or inhibitory antibiotic concentration. Increased antibiotic resistance of bacterial pathogens and their spread in the clinical sector, industry and environment is a grave threat to therapeutic applications and healthcare globally. Owing to uncontrolled spread, antibiotic resistance loomed as a global “imminent pandemic” with higher healthcare costs, longer hospitalization and illness duration, and greater morbidity and mortality. WHO predicted an increase in mortality rate to 7 lakhs annually due to antibiotic resistance and forecasting ten million deaths by 2050. This chapter deals with the antibiotic resistance profile of “ESKAPE” pathogens comprising Gram-positive and Gram-negative bacteria with multidrug resistance (MDR) causing public health crisis and hence designated as highest “priority status” by WHO. Although genetically versatile, the bacterial pathogens share similar resistance strategies including the decreased uptake of antibiotics, alteration in the target site, enzymatic inactivation of antibiotics and activation of multiple efflux pumps. Understanding the antibiotic resistance profile and mechanism in ESKAPE pathogens is a prerequisite not only to limit their spread or to develop newer antibiotics with novel mechanisms but also for the prediction of unknown resistance mechanisms to develop innovative diagnostic strategies. Numerous techniques (phenotypic, genotypic and emerging) have been developed for rapid detection that is crucial in the fight against pathogenic infections but still lacking somewhere. The study provides the background knowledge of various detection methods involved in antibiotic resistance profile, highlighting advantages and drawbacks, which necessitate newer and robust diagnostic strategies for prompt and accurate detection to tackle hard-to-treat fatal infections resulting from ESKAPE pathogens.