{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T04:20:12Z","timestamp":1787804412412,"version":"build-2784847793"},"reference-count":55,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003825","name":"Hungarian Academy of Sciences","doi-asserted-by":"crossref","award":["LP2025-8\/2025"],"award-info":[{"award-number":["LP2025-8\/2025"]}],"id":[{"id":"10.13039\/501100003825","id-type":"DOI","asserted-by":"crossref"}]},{"award":["LP2025-8\/2025"],"award-info":[{"award-number":["LP2025-8\/2025"]}],"id":[{"id":"https:\/\/ror.org\/02ks8qq67","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background\/Objectives: Surveillance of local antibiotic resistance plays a critical role in guiding empirical antibiotic therapies in emergency departments (EDs). This study aimed to collect and analyze a five-year period of prevalence and AMR rates among \u201cESKAPE\u201d pathogens in a tertiary-care ED setting. Methods: This retrospective observational study included a complete census of microbiological specimens collected from patients presenting to the emergency department between 1 January 2019 and 31 December 2023. Data was retrieved from the MedBakter laboratory information system. Non relevant isolated and duplications were excluded. Only the first isolates per patient per phenotype were included in the final dataset. Results: The final dataset contained 6510 isolates. The most frequent isolates were E. coli (2717, 41.7%), K. pneumoniae (715, 11.0%), and P. mirabilis (696, 10.7%) followed by E. faecalis (662, 10.2%). Prevalence of multi-drug resistance (MDR) was 23.26% among \u201cESKAPE\u201d pathogens, with highest prevalence in M. morganii (79.6%), P. stuartii (78.5%) and S. marcescens (77.1%). Difficult-to-treat resistance (DTR) was found in 32 isolates, while extensive drug resistance (XDR) was found in 5 isolates. The prevalence of other high-priority MDR bacteria was 12.4% for MRSA and 4.7% for VRE, while among Gram-negative bacteria the prevalence of carbapenem-resistant Enterobacterales was 0.52%. The prevalence of cephalosporin-resistant Enterobacterales varied greatly between 0 and 33%. Conclusions: Despite these important AMR trends, the cumulative antibiogram, according to the World Health Organization (WHO)-issued Access, Watch and Reserve (AWaRe) classification, revealed room for empirical antibiotic choices that spare Watch and Reserve agents. The results will aid the revision of the local antibiotic guidelines.<\/jats:p>","DOI":"10.3390\/antibiotics15090827","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T15:01:07Z","timestamp":1787670067000},"page":"827","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["ESKAPE Pathogens in a Hungarian Emergency Department: A 5-Year Retrospective Observational Study of Prevalence and Resistance Patterns Utilizing the AWaRe Framework"],"prefix":"10.3390","volume":"15","author":[{"given":"Peter","family":"Erdelyi","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Albert Szent-Gy\u00f6rgyi Health Center, University of Szeged, 6725 Szeged, Hungary"},{"name":"Doctoral School of Experimental and Preventive Medicine (KIMODI), Albert Szent-Gy\u00f6rgyi Health Center, University of Szeged, 6720 Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8009-8962","authenticated-orcid":false,"given":"Ria","family":"Benko","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Albert Szent-Gy\u00f6rgyi Health Center, University of Szeged, 6725 Szeged, Hungary"},{"name":"Institute of Clinical Pharmacy, Faculty of Pharmacy, University of Szeged, 6725 Szeged, Hungary"},{"name":"Institute of Clinical Pharmacy, Albert Szent-Gy\u00f6rgyi Health Center, University of Szeged, 6725 Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7038-5215","authenticated-orcid":false,"given":"Laszlo","family":"Papp","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Albert Szent-Gy\u00f6rgyi Health Center, University of Szeged, 6725 Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1270-0365","authenticated-orcid":false,"given":"Mario","family":"Gajdacs","sequence":"additional","affiliation":[{"name":"Department of Public Health, Albert Szent-Gy\u00f6rgyi Medical School, University of Szeged, 6720 Szeged, Hungary"},{"name":"MTA-SZTE Lend\u00fclet \u201cMomentum\u201d Anthropogenic Stress and Plant Resilience Research Group, K\u00f6z\u00e9p fasor 52, 6726 Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7877-2399","authenticated-orcid":false,"given":"Maria","family":"Matuz","sequence":"additional","affiliation":[{"name":"Institute of Clinical Pharmacy, Faculty of Pharmacy, University of Szeged, 6725 Szeged, Hungary"},{"name":"Institute of Clinical Pharmacy, Albert Szent-Gy\u00f6rgyi Health Center, University of Szeged, 6725 Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorottya","family":"Gyarfas","sequence":"additional","affiliation":[{"name":"Albert Szent-Gy\u00f6rgyi Faculty of Medicine, University of Szeged, 6720 Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2309-3532","authenticated-orcid":false,"given":"Edit","family":"Hajdu","sequence":"additional","affiliation":[{"name":"Infectious Disease Ward, Department of Internal Medicine, University of Szeged, 6720 Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5268-6134","authenticated-orcid":false,"given":"Laszlo","family":"Orosz","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Albert Szent-Gy\u00f6rgyi Health Center and Faculty of Medicine, University of Szeged, 6725 Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Visnyovszki","sequence":"additional","affiliation":[{"name":"Central Hospital of Southern Pest\u2014National Institute of Hematology and Infectious Diseases, 1097 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9907-0321","authenticated-orcid":false,"given":"Zoltan","family":"Peto","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Albert Szent-Gy\u00f6rgyi Health Center, University of Szeged, 6725 Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"5419","DOI":"10.2147\/IDR.S530557","article-title":"Antimicrobial Resistance: A Rising Global Threat to Public Health","volume":"23","author":"Patra","year":"2025","journal-title":"Infect. 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