Prevalence, resistance profile of ESKAPEE pathogens, and molecular detection of PMQR-associated genes among Levofloxacin-resistant gram-negative ESKAPEE isolates from critically-ill patients.

BACKGROUND

ESKAPEE pathogens are characterized with rapid emergence of antibiotic resistance.

AIM: To detect the prevalence, resistance profile of ESKAPEE pathogens, and to analyze the Plasmid-Mediated Quinolone Resistance (PMQR)-associated genes among Levofloxacin-resistant gram-negative ESKAPEE pathogens isolated from critically ill patients in Fayoum University Hospitals, Egypt.

METHODS

A cross-sectional study was conducted from August 2021 to July 2022. Different specimens were collected and cultured on bacteriological media according to their respective sample sources. The identification of ESKAPEE isolates was performed according to standard microbiological methods. Antimicrobial susceptibilities were determined using Kirby-Baur disk diffusion method. The minimum inhibitory concentration (MIC) of levofloxacin was determined by microdilution method. Molecular identification of PMQR genes in Gram negative ESKAPEE isolates was performed by PCR.

RESULTS

Eighty-one samples were collected from 72 patients enrolled in the study. Eighty-four isolates were recovered, from them ESKAPEE pathogens represent 79/84 (94%) of all isolates. Enterococcus faecium was the predominant organism (21.4%). 77.8% of E. faecium were vancomycin-resistant Enterococcus (VRE). Also, 80% of P. aeruginosa, 83.3% of E. coli and 71.4% of K. pneumoniae isolates were extensively drug resistant (XDR). qnrB [78.9% (30/38)] was the most frequently detected gene among ESKAPEE pathogens. Most tested isolates (86.8%) have more than one PMQR gene.

CONCLUSIONS

A high prevalence of ESKAPEE organisms was detected in ICU infected patients. qnrB was the most frequently PMQR detected genes.