ANTIMICROBIAL RESISTANCE OF ESKAPE-PATHOGENS IN
CULTURE-POSITIVE PNEUMONIA
ADRIANA SLAVCOVICI1, CODRUTA MAIER2, AMANDA RADULESCU3*
1“Iuliu Haţieganu” University of Medicine and Pharmacy, Faculty of Medicine, Department Medical Specialties - Infectious
Diseases, 8 Victor Babeş, 400012 – Cluj-Napoca, Hospital of Infectious Diseases, Cluj-Napoca, Romania
2“Iuliu Haţieganu” University of Medicine and Pharmacy, Faculty of Pharmacy, Department 3 – Drug analysis, 8 Victor
Babeş, 400012 - Cluj-Napoca, Romania
3“Iuliu Haţieganu” University of Medicine and Pharmacy, Faculty of Medicine, Department Community Medicine –
Epidemiology, 8 Victor Babeş, 400012 – Cluj-Napoca, Hospital of Infectious Diseases, Cluj-Napoca, Romania
*corresponding author: aradulescu@umfcluj.ro
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Abstract:
The aim of our study was to characterize the antimicrobial resistance in ESKAPE pathogens (E. faecium, S. aureus,
Klebsiella spp., A. baumannii, P. aeruginosa and Enterobacter spp.) isolated from 606 culture-positive pneumonia:
community-acquired (CAP), healthcare-associated (HCAP), hospital-acquired and ventilator-associated (HAP/VAP). A
retrospective analysis was performed in tertiary care settings from Cluj-Napoca (2007-2013). Antibiotic resistance was
determined according to Clinical and Laboratory Standards Institute (CLSI) and the trend by multiple antibiotic resistance
index (MAR). ESKAPE pathogens (52%) were more likely found in HCAP and HAP/VAP. Co-resistance to ceftazidime,
ciprofloxacin and gentamicin was dominant (48%). Highly resistant pathogens, Extended-spectrum beta-lactamase (ESBL)-
Klebsiella spp., carbapenem-resistant A. baumannii and P. aeruginosa were identified mainly in HAP/VAP versus HCAP
(39.3% vs. 2.3%, 92% vs. 7.5% and 40% vs. 1.4%, respectively). Except for S. aureus, multiple antibiotics resistance (MAR)
index of ESKAPE pathogens revealed an increasing trend. In conclusion, ESKAPE pathogens are commonly identified in
HCAP and HAP/VAP. An alarming frequency of highly resistant pathogens in hospital-acquired and ventilator-associated
pneumonia was noticed.






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