BMC infectious diseases · 2026
Antimicrobial resistance profiles of ESKAPE pathogens isolated in a microbiology laboratory in Somalia: a two-year retrospective study.
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Orhan Zerife, Doğan Serpil, Mohamud Said Mohamed, Mohamud Rahma Yusuf Haji, Nor Liban Abdi, Doğan Ahmet, Osman Iftin Mohamed, Kayış Arzu
Аннотация
OBJECTIVE: ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.) are major causes of healthcare-associated infections and pose a serious public health threat because of their high antimicrobial resistance potential. This study evaluated the distribution, resistance profiles, and associated factors of ESKAPE pathogens isolated in Somalia.
METHODS: This retrospective single-center laboratory-based study was conducted at Mogadishu Somalia Türkiye Recep Tayyip Erdoğan Training and Research Hospital, a tertiary care center in Mogadishu, Somalia. Only culture-positive clinical specimens yielding ESKAPE pathogens between January 2024 and December 2025 were included. A total of 2,486 ESKAPE isolates were analyzed. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method according to CLSI criteria. Demographic and clinical data were analyzed using SPSS and R software. Associations between selected demographic and clinical factors and specific pathogens were evaluated using univariate binary logistic regression analysis.
RESULTS: Of the isolates, 1,442/2,486 (58.0%) were obtained from male patients, and the most common age group was 18-40 years [952/2,486 (38.3%)]. The most prevalent pathogens were K. pneumoniae [1,033/2,486 (41.6%)] and S. aureus [629/2,486 (25.3%)]. Overall, MDR and XDR phenotypes were detected in 1,633/2,486 (65.7%) and 687/2,486 (27.6%) isolates, respectively. The highest MDR and XDR rates were observed in A. baumannii [135/138 (97.8%) and 97/138 (70.3%)]. High resistance to ceftazidime [128/138 (92.8%)], cefepime [116/138 (84.1%)], ciprofloxacin [115/138 (83.3%)], trimethoprim-sulfamethoxazole [121/138 (87.7%)], and carbapenems [99/138 (71.7%)] was detected in A. baumannii. Susceptibility to vancomycin and linezolid remained largely preserved among Gram-positive pathogens. A. baumannii and Enterobacter spp. were significantly associated with ICU admission, while gender-related differences were observed for P. aeruginosa and S. aureus.
CONCLUSION: A high burden of antimicrobial resistance was observed among ESKAPE pathogens, particularly Gram-negative bacteria, with A. baumannii playing a central role. These findings provide important local surveillance data that may support empirical antibiotic selection, antimicrobial stewardship, and infection control strategies in Somalia.
METHODS: This retrospective single-center laboratory-based study was conducted at Mogadishu Somalia Türkiye Recep Tayyip Erdoğan Training and Research Hospital, a tertiary care center in Mogadishu, Somalia. Only culture-positive clinical specimens yielding ESKAPE pathogens between January 2024 and December 2025 were included. A total of 2,486 ESKAPE isolates were analyzed. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method according to CLSI criteria. Demographic and clinical data were analyzed using SPSS and R software. Associations between selected demographic and clinical factors and specific pathogens were evaluated using univariate binary logistic regression analysis.
RESULTS: Of the isolates, 1,442/2,486 (58.0%) were obtained from male patients, and the most common age group was 18-40 years [952/2,486 (38.3%)]. The most prevalent pathogens were K. pneumoniae [1,033/2,486 (41.6%)] and S. aureus [629/2,486 (25.3%)]. Overall, MDR and XDR phenotypes were detected in 1,633/2,486 (65.7%) and 687/2,486 (27.6%) isolates, respectively. The highest MDR and XDR rates were observed in A. baumannii [135/138 (97.8%) and 97/138 (70.3%)]. High resistance to ceftazidime [128/138 (92.8%)], cefepime [116/138 (84.1%)], ciprofloxacin [115/138 (83.3%)], trimethoprim-sulfamethoxazole [121/138 (87.7%)], and carbapenems [99/138 (71.7%)] was detected in A. baumannii. Susceptibility to vancomycin and linezolid remained largely preserved among Gram-positive pathogens. A. baumannii and Enterobacter spp. were significantly associated with ICU admission, while gender-related differences were observed for P. aeruginosa and S. aureus.
CONCLUSION: A high burden of antimicrobial resistance was observed among ESKAPE pathogens, particularly Gram-negative bacteria, with A. baumannii playing a central role. These findings provide important local surveillance data that may support empirical antibiotic selection, antimicrobial stewardship, and infection control strategies in Somalia.