Prevalence and antibiotic susceptibility of ESKAPE pathogens in skin and soft tissue infections

Background Skin and soft tissue infections (SSTIs) encompass a wide range of conditions, from superficial infections to life-threatening necrotising fasciitis. Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. (ESKAPE pathogens) are leading causes of SSTIs and are notable for their antimicrobial resistance. Aim This study aims to determine the prevalence of SSTIs and analyze the resistance patterns of ESKAPE pathogens,providing critical insights for effective treatment strategies. Methods A prospective, observational, cross-sectional study was conducted from January to December 2024 in the Bacteriology section of the Department of Microbiology. A total of 2,300 clinical specimens, including pus, pus swabs, and tissue samples, were processed using standard microbiological techniques. Isolates were identified, and antibiotic susceptibility was assessed following the Clinical and Laboratory Standards Institute (CLSI) guidelines. Results Among 2,300 samples, 1,311 (57%) were culture-positive, with ESKAPE pathogens detected in 808 (61.6%) culture-positive isolates. Staphylococcus aureus (59.5%) was the most frequently isolated organism, followed by Pseudomonas aeruginosa (17.8%) and Klebsiella pneumoniae (11.4%). Methicillin-resistant S. aureus (MRSA) was found in 52.2% of isolates. Among Gram-negative bacteria, 15.3% were multidrug-resistant (MDR), but all remained susceptible to colistin. Limitations Conducted at a single center without long-term follow-up, the study may not capture regional differences in resistance, patient demographics, or healthcare practices, nor assess sustained intervention outcomes or relapses. Conclusion ESKAPE pathogens contribute significantly to SSTIs, posing a challenge due to their resistance mechanisms. The high prevalence of MRSA and MDR Gram-negative bacteria highlights the need for continuous surveillance, rational antibiotic use, and alternative treatment strategies to combat antimicrobial resistance effectively.