Friday, 12 February 2010

The ESKAPE Pathogens


From Medscape Infectious Diseases

Emerging Antibiotics: Will We Have What We Need?



" * More US patients die of MRSA infections than HIV/AIDS and tuberculosis combined.
* Only 2 new antibiotics -- doripenem and telavancin -- have been approved in the past 3 years.
* We have no drugs to treat infections with some strains of multi-drug-resistant gram-negative bacilli, like Pseudomonas aeruginosa and Acinetobacter baumannii.

We may finally have arrived at the era of the untreatable bacterial infection."

The ESKAPE ( they effectively escape the effects of antibacterial drugs)
E Enterococcus faecium Third most common cause of HCA BSI. Increasing resistance to vancomycin.
S Staphylococcus aureus (MRSA) Emerging resistance to current drugs and significant drug toxicities. Lack of oral agents for step-down therapy
K Klebsiella
Escherichia coli
K pneumoniae
ESBL-producing organisms increasing in frequency and severity; associated with increasing mortality. K pneumoniae carbapenemases causing severe infections in LTCF. Few active agents; nothing in development
A Acinetobacter baumannii Increasing worldwide, recent surge reported in hospitals. Very high mortality. Carbapenem-resistant.
P Pseudomonas aeruginosa Increasing P. aeruginosa infections in US and worldwide. Resistant to carbapenems, quinolones, aminoglycosides
E Enterobacter species MDR HCA infections increasing; resistance via ESBLs, carbapenemases, and cephalosporinases

HCA = healthcare associated; BSI = bloodstream infection; MRSA = methicillin resistant S aureus; ESBL = extended-spectrum beta-lactamase; LTCF = long-term care facility; MDR = multiple drug-resistant