Table 1.
Proportion of clinical ESKAPE isolates and their proportion segregating in MDR, XDR, and PDR as defined by the CDC/ECDC panel
| Country | Collection period | Study population | E. faecalis | S. aureus | K. pneumoniae | A. baumannii | P. aeruginosa | Enterobacter spp. | E. coli | Refs. |
|---|---|---|---|---|---|---|---|---|---|---|
| India | January to December, 2015 | 5103 resistance records from 4437 patients | 5.9% | 5.5% | 26.9% | 10.2% | 11.6% | 2.6% | 37.4% | 23 |
| MDR/XDR | MDR/XDR | MDR/XDR | MDR/XDR | MDR/XDR | MDR/XDR | MDR/XDR | ||||
| India | April 15 to July 15, 2014 | 1060 bacterial strains from 9304 patients | 4.2% | 23.8% | 18.9% | 4.0% | 20.0% | 2.9% | 24.6% | 24 |
|
28.9% MDR 35.6% XDR. |
49.6% MDR 15.1% XDR |
36% MDR 11% XDR |
45.2% MDR 19% XDR |
37.5% MDR 12.5% XDR |
35.5% MDR 19.4% XDR |
30.3% MDR 8.4% XDR |
||||
| Kuwait | January to December, 2017 | 201 patients with burn injury | 4.9% | 14.6% | 19.5% | 41.5% | 14.6% | – | – | 25 |
| 0% MDR | 66.7% MDR | 50.0% MDR | 100.0% MDR | 16.7% MDR | – | – | ||||
| China | January 2012 to December 2014 | 7579 patients with hospital‐acquired infections | 2.1% | 14.9% | 14.5% | 15.3% | 15.4% | – | 29.0% | 26 |
| 1.3% MDR | 1.3% MDR | 41.9% MDR | 50.7% MDR | 37.6% MDR | – | 55.4% MDR | ||||
| Indonesia | January 2015 to December 2016 | 299 positive blood samples from 2542 pediatric patients | 2.7% | 3.0% | – | 8.0% | 1.7% | 18.1% | – | 27 |
| 75% MDR 25% XDR |
88.9% MDR 11.1% XDR |
– | 83.3% MDR 16.7% XDR | 100% MDR |
87.0% MDR 13.0% XDR |
– | ||||
| South Africa | August 2011 to December 2015 | 64502 ESKAPE clinical isolates | 3.4% | 38.0% | 22.2% | 12.4% | 17.4% | 6.6% | – | 28 |
| – | 24.6% MRSA | – | 79.2% were MDR | – | – | – | ||||
| Nepal | November 2014 to August 2015 | 182 pus and fine needle aspirates collected from patients with clinical features of wound infection | Enterococcus spp. 4.3% | 56.9% | 5.2% | Acinetobacter spp. 5.2% | 4.3% | – | 8.6% | 29 |
| 80% MDR | 80% MDR | 80% MDR | 66.7% MDR | 66.7% MDR | – | 80% MDR | ||||
| India | January 2012 to December 2016 | 993 identified pathogens from 2984 patients with healthcare associated infections | Enterococcus spp. 2.0% | Staphylococcus spp. 6.6% | Klebsiella spp. 15.1% | Acinetobacter spp. 42.9% | Pseudomonas spp. 10.2% | – | 11.7% | 30 |
| – | – | – | 88.0% MDR 61.9% XDR |
88.0% MDR 61.9% XDR |
– | – | ||||
| Spain | – | 203 microbiological confirmations (from 343 patients) | for S. aureus, Enterococcus spp., Enterobacteriaceae (other than Salmonella and Shigella), P. aeruginosa, and Acinetobacter spp. | 31 | ||||||
| 44% MDR, 12% XDR, 3% PDR | ||||||||||
| Saudi Arabia | 2014–2015 | 155 patients positive for E. faecalis infection | 100.0% | – | – | – | – | – | – | 32 |
| 96.1% MDR | – | – | – | – | – | – | ||||
| Ethiopia | May to September, 2016 | 126 bacterial etiologies isolated from 118 patients with healthcare associated infections | – | 20.6% | Klebsiella species, 23.8% | 1.6% | 7.1% | 4.8% | 24.6% | 33 |
| – | 38.5% MDR 38.5% XDR 11.5% PDR |
Klebsiella species; 30% MDR 43.3% XDR 6.7% PDR |
50% XDR 50% PDR |
22.2% MDR 44.4% XDR 33% PDR |
33.3% MDR 50% XDR 16.7% PDR | 35.5% MDR 32.3% XDR 22.6% PDR | ||||
| Romania | 2010– 2012 | 1001 bacterial strains (of 1534 samples) from 2404 adult patients | – | 21.8% | 18.8% | 14.1% | 14.2% | 18.4% | 11.3% | 34 |
| – |
66.5% MDR 20.2% XDR |
87.8% MDR 35.6% XDR |
99.3% MDR 41.1% XDR |
69.0% MDR 20.4% XDR |
67.9% MDR 13.0% XDR |
67.9% MDR 13.0% XDR |
||||
| Nigeria | June to September, 2015 | 201 mid‐stream urine samples from asymptomatic pregnant women | – | 10.0% | 22.4% | – | 17.9% | – | 9.0%; 100% MDR | 35 |
| – | 90% MDR | 90% MDR | – | 88.9% MDR | – | |||||
| Ethiopia | September to December, 2016 | 242 swabs of health care workers | – | 12.0% | – | – | – | – | – | 36 |
| – | 48.3% MRSA | – | – | – | – | – | ||||
| China | August to November, 2015 | Swabs from 1834 pregnant women and their neonates | – | 12.1% | – | – | – | – | – | 37 |
| – | 53.0% MDR | – | – | – | – | – | ||||
| China | August to November, 2015 | Serial swabs collected from 1834 mothers and their newborn infants | – | 7.3% in mothers 3.3% in infants | – | – | – | – | – | 38 |
| – | 66.7% MDR in mothers 38.3% in infants | – | – | – | – | – | ||||
| Tanzania | June to October, 2016 | 379 nasal swabs from health care workers | – | 41.4% | – | – | – | – | – | 39 |
| – | 38.9% MDR | – | – | – | – | – | ||||
| Afghanistan | September 2016 to February 2017 | 105 clinical strains of S. aureus isolated from hospitalized patients | – | 100.0% | – | – | – | – | – | 40 |
| – | 91.4% MDR | – | – | – | – | – | ||||
| Mexico | January 1 to June 30, 2018 | 22943 strains from 47 Mexican centers | – | – | Klebsiella spp.: 14.5% | Acinetobacter spp.: 3.8% | 8.7% | 5.8% | 50.9% | 41 |
| – | – | 22.6% MDR | 53.0% MDR, 43.2% possible XDR 8.8% XDR 38.8% possible PDR |
8.8% MDR 8.3% possible XDR 0.2% XDR 4.4% possible PDR |
11.9% MDR |
19.4% MDR 8.1% possible XDR 0.04% possible PDR |
||||
| China | January 1, 2007 to March 31, 2017 | 88 MDR/XDR bacteria from urinary tract specimens in 1569 kidney transplant recipients | – | – | 17.0% | 10.2% | 2.3% | Enterobacter aerogenes 2.3%, Enterobacter cloacae 1.1% | 62.5% | 42 |
| – | – | MDR/XDR | MDR/XDR | MDR/XDR | MDR/XDR | MDR/XDR | ||||
| Egypt | November 2015 to October 2016 | 195 positive culture specimens from 529 febrile neutropenic cancer patients | – | – | 16.4% | 6.2% | 3.1% | Enterobacter cloacae 46.2% | 17.4% | 43 |
| – | – | 75% MDR | 75% MDR | 33.3% MDR | 79.4% MDR | 79.4% MDR | ||||
| China | January 1 2016 to October 1 2017 | 19 in‐patients with ventriculitis caused by A. baumannii or K. pneumonia | – | – | 26.3% | 73.7% | – | – | – | 44 |
| – | – |
80% MDR 20% XDR |
85.7% MDR 14.3% XDR | – | – | – | ||||
| Tunisia | 2010–2017 | 770 patients with community‐acquired urinary tract infections caused by Enterobacteriaceae | – | – | 14.4% | – | – | 100.0% | 72.7% | 45 |
| – | – | 17.2% MDR | – | – | 47.9% MDR | 76.1% MDR | ||||
| Ethiopia | January 1 to May 30, 2017 | 426 Enterobacteriaceae isolates | – | – | 24.10% | – | – | – | 53.50% | 46 |
| – | – | 82.5% MDR | – | – | – | 65.3% MDR | ||||
| Iran | 2012–2013 | 100 clinical isolates of K. pneumoniae | – | – | 100.0% | – | – | – | – | 47 |
| – | – | 56% MDR | – | – | – | – | ||||
| Spain | January 2014 to December 2016 | 1725 adult patients colonized by K. pneumoniae in an intensive care unit (ICU) | – | – | 100% | – | – | – | – | 48 |
| – | – | 17.9% MDR | – | – | – | – | ||||
| Brazil | January 2014 to May 2015 | 25 K. pneumoniae clinical isolates collected from patients and devices at ICUs | – | – | 100.0% | – | – | – | – | 49 |
| – | – | 84.0% MDR | – | – | – | – | ||||
| India | March 2017 to February 2018 | 357 blood culture samples identified with Acinetobacter sp. during hospitalization | – | – | – | 13.4% | – | – | – | 50 |
| – | – | – | 95.9% MDR 93.8% XDR | – | – | – | ||||
| Lithuania | January 2014 to December 2015 | 60 patients with ventilator‐associated pneumonia in ICU due to drug‐resistant A. baumannii | – | – | – | 100.0% | – | – | – | 51 |
| – | – | – | 13.3% MDR 68.3% XDR 18.3% possible PDR | – | – | – | ||||
| Iran | October 2015 to October 2016 | 147 nonduplicate A. baumannii isolates from clinical specimens | – | – | – | 100.0% | – | – | – | 52 |
| – | – | – | 2.7% MDR 97.3% XDR | – | – | – | ||||
| India | 2011–2014 | 741 clinical Acinetobacter spp. isolates | – | – | – | Acinetobacter spp. 100% | – | – | – | 53 |
| – | – | – | MDR isolates 89.4– 95.9% | – | – | – | ||||
| Iran | January to June, 2015 | 96 samples detected with P. aeruginosa from 120 wound burn samples | – | – | – | – | 80.0% | – | – | 54 |
| – | – | – | – | 95.8% MDR 87.5% XDR | – | – | ||||
| Iran | 2013 | 88 P. aeruginosa isolates from patients | – | – | – | – | 100.0% | – | – | 55 |
| – | – | – | – |
54.5% MDR 33% XDR |
– | – | ||||
| Venezuela | 2009–2016 | 176 strains from patients diagnosed with clinical infections | – | – | – | – | 100.0% | – | – | 56 |
| – | – | – | – | MDR and XDR strains increased from 2009 (24.2 and 4.8%) to 2016 (53.1 and 18.8%) | – | – | ||||
| Global | 1997–2016 | 52 022 clinically P. aeruginosa isolates from ≥200 medical centers | – | – | – | – | 100.0% | – | – | 57 |
| – | – | – | – | 24.9% MDR, 24.9% XDR, and 0.1% PDR | – | – | ||||
| Malaysia | 2015 | 53 clinical isolates of P. aeruginosa | – | – | – | – | 100.0% | – | – | 58 |
| – | – | – | – | 7.5% MDR | – | – | ||||
| China | January 2013 to December 2016 | 157 patients with hospital‐acquired pneumonia caused by P. aeruginosa | – | – | – | – | 100.0% | – | – | 59 |
| – | – | – | – | 43.9% MDR | – | – | ||||
| Asia‐Pacific region | 2012–2015 | 896 clinical isolates of P. aeruginosa | – | – | – | – | 100.0% | – | – | 60 |
| – | – | – | – | 14.8% MDR | – | – | ||||
| U.S. | 2016 | 2039 clinical isolates of P. aeruginosa | – | – | – | – | 100.0% | – | – | 61 |
| – | – | – | – | 29.5% MDR | – | – | ||||
| Iran | March to July, 2015 | 100 isolates of P. aeruginosa from wound infections of burn patients | – | – | – | – | 100.00% | – | – | 62 |
| – | – | – | – |
19% MDR 7 5% XDR |
– | – | ||||
| Thailand | April to December 2014 | 255 adult hospitalized patients with P. aeruginosa infections | – | – | – | – | 100.0% | – | – | 63 |
| – | – | – | – |
12.5% MDR 22% XDR |
– | – | ||||