{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:35:23Z","timestamp":1790775323938,"version":"4.1.0"},"reference-count":43,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:00:00Z","timestamp":1762819200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the National Institute of Health Research, Department of Health and Social Care of the United Kingdom"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background: Antibiotic resistance is a significant health problem in healthcare settings, especially intensive care units (ICUs), where patients are critically ill. This study aims to identify the bacterial profile and antibiotic resistance patterns of Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter, and Escherichia coli (ESKAPEE) in blood specimens collected from adult patients admitted to the ICUs of public hospitals in Abu Dhabi, United Arab Emirates. The World Health Organization lists these pathogens as priority pathogens that greatly threaten humans. Methods: This cross-sectional study used routinely collected data through the AMR surveillance system between 2018 and 2022. Results: A total of 838 culture-positive blood specimens were reported during the study period, and 965 ESKAPEE pathogens were isolated. The most frequently isolated bacteria were Klebsiella pneumoniae (31%), Escherichia coli (22%), and Staphylococcus aureus (20%). Acinetobacter baumannii exhibited high resistance to Amikacin (81%), Meropenem (72%), and Imipenem (87%). Escherichia coli demonstrated resistance to Imipenem (42%) and Cefotaxime (54%). Klebsiella pneumoniae showed resistance to Imipenem (37%) and Cefotaxime (39%). Staphylococcus aureus showed resistance to Penicillin G (80%), Oxacillin (4%), and Ciprofloxacin (54%). Conclusions: The study showed a high prevalence of resistance in the most frequently isolated ESKAPEE pathogens in adult ICU patients. This brings into focus the need for appropriate infection control measures and strong antibiotic stewardship programs. The findings of the study support the ongoing efforts to deploy a better diagnostic tool for rapid pathogen identification, which is key in the targeted management of patients with bloodstream infection, especially in ICUs.<\/jats:p>","DOI":"10.3390\/antibiotics14111142","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T10:56:27Z","timestamp":1762858587000},"page":"1142","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Bacterial Profile and Antibiotic Resistance of ESKAPEE Pathogens Isolated in Intensive Care Units from Blood Cultures: A Cross-Sectional Study from Abu Dhabi, United Arab Emirates (2018\u20132022)"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8234-4303","authenticated-orcid":false,"given":"Ayesha Abdulla","family":"Al Marzooqi","sequence":"first","affiliation":[{"name":"Communicable Disease Department, Infectious Diseases Sector, Abu Dhabi Public Health Center (ADPHC), Abu Dhabi P.O. Box 5674, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1738-0276","authenticated-orcid":false,"given":"Maryam Mohammed","family":"Bashir","sequence":"additional","affiliation":[{"name":"Institute of Public Health (IPH), College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8056-9114","authenticated-orcid":false,"given":"Mohammed Ahmed","family":"Khogali","sequence":"additional","affiliation":[{"name":"Institute of Public Health (IPH), College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8906-3590","authenticated-orcid":false,"given":"Abubaker","family":"Suliman","sequence":"additional","affiliation":[{"name":"Institute of Public Health (IPH), College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0997-9799","authenticated-orcid":false,"given":"Collins","family":"Timire","sequence":"additional","affiliation":[{"name":"International Union Against Tuberculosis and Lung Diseases, 75006 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4901-0280","authenticated-orcid":false,"given":"Farida Ismail","family":"Al Hosani","sequence":"additional","affiliation":[{"name":"The Global Institute for Disease Elimination (GLIDE), Abu Dhabi P.O. Box 111999, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2672-9425","authenticated-orcid":false,"given":"Faisal Musleh","family":"Al Ahbabi","sequence":"additional","affiliation":[{"name":"Communicable Disease Department, Infectious Diseases Sector, Abu Dhabi Public Health Center (ADPHC), Abu Dhabi P.O. Box 5674, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1586\/eri.13.12","article-title":"Clinical relevance of the ESKAPE pathogens","volume":"11","author":"Pendleton","year":"2013","journal-title":"Expert Rev. Anti Infect. Ther."},{"key":"ref_2","unstructured":"World Health Organization (2024). WHO Bacterial Priority Pathogens List, 2024: Bacterial Pathogens of Public Health Importance to Guide Research, Development and Strategies to Prevent and Control Antimicrobial Resistance, World Health Organization."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"479","DOI":"10.26719\/2011.17.6.479","article-title":"Rising bacterial resistance to common antibiotics in Al Ain, United Arab Emirates","volume":"17","author":"Tariq","year":"2011","journal-title":"East Mediterr. Health J."},{"key":"ref_4","unstructured":"World Health Organization (2021). Comprehensive Review of the WHO Global Action Plan on Antimicrobial Resistance, World Health Organization."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Sommerstein, R., Damonti, L., Marschall, J., Harbarth, S., Gasser, M., Kronenberg, A., and Buetti, N. (2021). Distribution of pathogens and antimicrobial resistance in ICU-bloodstream infections during hospitalization: A nationwide surveillance study. Sci. Rep., 11.","DOI":"10.1038\/s41598-021-95873-z"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"ftac027","DOI":"10.1093\/femspd\/ftac027","article-title":"Burden of bacterial bloodstream infections and recent advances for diagnosis","volume":"80","author":"Costa","year":"2022","journal-title":"Pathog. Dis."},{"key":"ref_7","first-page":"287","article-title":"Bloodstream infections in intensive care unit patients: Distribution and antibiotic resistance of bacteria","volume":"8","author":"Russotto","year":"2015","journal-title":"Infect. Drug Resist."},{"key":"ref_8","unstructured":"GBD 2021 Antimicrobial Resistance Collaborators (2024). Global burden of bacterial antimicrobial resistance 1990-2021: A systematic analysis with forecasts to 2050. Lancet, 404, 1199\u20131226."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1186\/s13756-022-01130-x","article-title":"A review of national action plans on antimicrobial resistance: Strengths and weaknesses","volume":"11","author":"Willemsen","year":"2022","journal-title":"Antimicrob. Resist. Infect. Control."},{"key":"ref_10","first-page":"337","article-title":"Neonatal bacteriemia isolates and their antibiotic resistance pattern in neonatal insensitive care unit (NICU) at Beasat Hospital, Sanandaj, Iran","volume":"52","author":"Mohammadi","year":"2014","journal-title":"Acta Med. Iran."},{"key":"ref_11","first-page":"618","article-title":"Resistance patterns of bacterial isolates to antimicrobials from 3 hospitals in the United Arab Emirates","volume":"30","author":"Bastaki","year":"2009","journal-title":"Saudi Med. J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1099\/jmm.0.055681-0","article-title":"Characteristics of epidemic and sporadic strains of Acinetobacter baumannii isolated in Abu Dhabi hospitals","volume":"62","author":"Sonnevend","year":"2013","journal-title":"J. Med. Microbiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e00062-17","DOI":"10.1128\/CMR.00062-17","article-title":"Practical Guidance for Clinical Microbiology Laboratories: Implementing a Quality Management System in the Medical Microbiology Laboratory","volume":"31","author":"Bhattacharyya","year":"2018","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Quiros-Roldan, E., Sottini, A., Natali, P.G., and Imberti, L. (2024). The Impact of Immune System Aging on Infectious Diseases. Microorganisms, 12.","DOI":"10.3390\/microorganisms12040775"},{"key":"ref_15","unstructured":"Fintech Career Accelerator Scheme (FCAS) (2025, January 05). UAE Statistics UAE2024, Available online: https:\/\/uaestat.fcsc.gov.ae\/en."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1186\/s13756-019-0545-z","article-title":"Antimicrobial resistance trends in bloodstream infections at a large teaching hospital in China: A 20-year surveillance study (1998\u20132017)","volume":"8","author":"Tian","year":"2019","journal-title":"Antimicrob. Resist. Infect. Control."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Bereanu, A.S., Bereanu, R., Mohor, C., Vintil\u0103, B.I., Codru, I.R., Olteanu, C., and Sava, M. (2024). Prevalence of Infections and Antimicrobial Resistance of ESKAPE Group Bacteria Isolated from Patients Admitted to the Intensive Care Unit of a County Emergency Hospital in Romania. Antibiotics, 13.","DOI":"10.3390\/antibiotics13050400"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1247627","DOI":"10.3389\/fpubh.2023.1247627","article-title":"Surveillance of antimicrobial resistance in the United Arab Emirates: The early implementation phase","volume":"11","author":"Thomsen","year":"2023","journal-title":"Front. Public Health"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Banawas, S.S., Alobaidi, A.S., Dawoud, T.M., AlDehaimi, A., Alsubaie, F.M., Abdel-Hadi, A., and Manikandan, P. (2023). Prevalence of Multidrug-Resistant Bacteria in Healthcare-Associated Bloodstream Infections at Hospitals in Riyadh, Saudi Arabia. Pathogens, 12.","DOI":"10.3390\/pathogens12091075"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e02260-23","DOI":"10.1128\/mbio.02260-23","article-title":"A global view on carbapenem-resistant Acinetobacter baumannii","volume":"14","author":"Reuter","year":"2023","journal-title":"mBio"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Haque, S., Ahmed, A., Islam, N., and Haque, F.K.M. (2024). High Prevalence of Multidrug-Resistant Bacteria in the Trachea of Intensive Care Units Admitted Patients: Evidence from a Bangladeshi Hospital. Antibiotics, 13.","DOI":"10.3390\/antibiotics13010062"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1128\/JCM.02784-14","article-title":"Molecular Epidemiology of Carbapenem-Resistant Acinetobacter baumannii Isolates in the Gulf Cooperation Council States: Dominance of OXA-23-Type Producers","volume":"53","author":"Zowawi","year":"2015","journal-title":"J. Clin. Microbiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.jgar.2020.11.016","article-title":"Detection of OXA-23, GES-11 and NDM-1 among carbapenem-resistant Acinetobacter baumannii in Dubai: A preliminary study","volume":"24","author":"Nabi","year":"2021","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1016\/j.jointm.2022.10.001","article-title":"Antimicrobial stewardship in the intensive care unit","volume":"3","author":"Ture","year":"2023","journal-title":"J. Intensive Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"47","DOI":"10.31729\/jnma.8862","article-title":"Carbapenem-Resistant Gram-Negative Bacterial Infections at a Tertiary Health Care Center in Nepal: An Observational Study","volume":"63","author":"Konwar","year":"2025","journal-title":"JNMA J. Nepal. Med. Assoc."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"109","DOI":"10.2478\/jccm-2025-0020","article-title":"The challenge of antimicrobial resistance in intensive care setting","volume":"11","author":"Piscitelli","year":"2025","journal-title":"J. Crit. Care Med."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Chakraborty, M., Sardar, S., De, R., Biswas, M., Mascellino, M.T., Miele, M.C., Biswas, S., and Mitra, A.N. (2023). Current Trends in Antimicrobial Resistance Patterns in Bacterial Pathogens among Adult and Pediatric Patients in the Intensive Care Unit in a Tertiary Care Hospital in Kolkata, India. Antibiotics, 12.","DOI":"10.3390\/antibiotics12030459"},{"key":"ref_28","first-page":"504","article-title":"Prevalence of fluoroquinolone resistance in Escherichia coli in an Indian teaching hospital and adjoining communities","volume":"10","author":"Rath","year":"2015","journal-title":"J. Taibah Univ. Med. Sci."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Munro, C., Zilberberg, M.D., and Shorr, A.F. (2024). Bloodstream Infection in the Intensive Care Unit: Evolving Epidemiology and Microbiology. Antibiotics, 13.","DOI":"10.3390\/antibiotics13020123"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Huang, J., Lv, C., Li, M., Rahman, T., Chang, Y.-F., Guo, X., Song, Z., Zhao, Y., Li, Q., and Ni, P. (2024). Carbapenem-resistant Escherichia coli exhibit diverse spatiotemporal epidemiological characteristics across the globe. Commun. Biol., 7.","DOI":"10.1038\/s42003-023-05745-7"},{"key":"ref_31","unstructured":"World Health Organization (2022). Global Antimicrobial Resistance and Use Surveillance System (GLASS) Report: 2022, World Health Organization."},{"key":"ref_32","first-page":"04793","article-title":"First Report of bla(CTX-M-28) in Enterobacteriaceae Isolates in the United Arab Emirates","volume":"13","author":"Alfaresi","year":"2018","journal-title":"J. Pathog."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"717","DOI":"10.3201\/eid2804.211975","article-title":"Increasing Antimicrobial Resistance in World Health Organization Eastern Mediterranean Region, 2017\u20132019","volume":"28","author":"Talaat","year":"2022","journal-title":"Emerg. Infect. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1007\/s00134-022-06944-2","article-title":"Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: The EUROBACT-2 international cohort study","volume":"49","author":"Tabah","year":"2023","journal-title":"Intensive Care Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"7641","DOI":"10.2147\/IDR.S428103","article-title":"Methicillin Resistant Staphylococcus aureus: Molecular Mechanisms Underlying Drug Resistance Development and Novel Strategies to Combat","volume":"16","author":"Abebe","year":"2023","journal-title":"Infect. Drug Resist."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Thomsen, J., Abdulrazzak, N.M., AlRand, H., The UAE AMR Surveillance Consortium, Menezes, G.A., Moubareck, C.A., Everett, D.B., Senok, A., and Podbielski, A. (2023). Epidemiology of vancomycin-resistant enterococci in the United Arab Emirates: A retrospective analysis of 12 years of national AMR surveillance data. Front. Public Health, 11.","DOI":"10.3389\/fpubh.2023.1275778"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/s42506-023-00133-9","article-title":"Prevalence of Vancomycin-resistant enterococci (VRE) in Egypt (2010\u20132022): A systematic review and meta-analysis","volume":"98","author":"Azzam","year":"2023","journal-title":"J. Egypt. Public Health Assoc."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"O\u2019Toole, R.F., Leong, K.W.C., Cumming, V., and Van Hal, S.J. (2023). Vancomycin-resistant Enterococcus faecium and the emergence of new sequence types associated with hospital infection. Res. Microbiol., 174.","DOI":"10.1016\/j.resmic.2023.104046"},{"key":"ref_39","unstructured":"European Centre for Disease Prevention and Control (2021). Surveillance Atlas of Infectious Diseases, European Centre for Disease Prevention and Control."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e64139","DOI":"10.7554\/eLife.64139","article-title":"Antimicrobial resistance and COVID-19: Intersections and implications","volume":"10","author":"Knight","year":"2021","journal-title":"Elife"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Bolikas, E., Astrinaki, E., Panagiotaki, E., Vitsaxaki, E., Saplamidou, S., Drositis, I., Stafylaki, D., Chamilos, G., Gikas, A., and Kofteridis, D.P. (2023). Impact of SARS-CoV-2 Preventive Measures against Healthcare-Associated Infections from Antibiotic-Resistant ESKAPEE Pathogens: A Two-Center, Natural Quasi-Experimental Study in Greece. Antibiotics, 12.","DOI":"10.3390\/antibiotics12071088"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/j.jclinepi.2007.11.008","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies","volume":"61","author":"Altman","year":"2008","journal-title":"J. Clin. Epidemiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.ijid.2019.11.028","article-title":"The Impact of Integrating Rapid PCR-Based Blood Culture Identification Panel to an Established Antimicrobial Stewardship Program in the United Arab Emirates","volume":"91","author":"Nasef","year":"2020","journal-title":"Int. J. Infect. Dis."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/14\/11\/1142\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T11:22:39Z","timestamp":1762860159000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/14\/11\/1142"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,11]]},"references-count":43,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["antibiotics14111142"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics14111142","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,11]]}}}