{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:00:22Z","timestamp":1793318422281,"version":"4.5.0"},"reference-count":30,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Own funds of the Military Institute of Medicine - National Research Institute, Warsaw, Poland","award":["n\/a"],"award-info":[{"award-number":["n\/a"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Modern healthcare faces a growing burden of antimicrobial resistance, prominently driven by ESKAPE pathogens. These organisms\u2014Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.\u2014are the leading causes of healthcare-associated infections, associated with limited therapeutic options and increased morbidity. Continuous surveillance is crucial for informing empirical therapy and guiding stewardship. Methods: We perform a single-center, seven-year retrospective study (2018\u20132024) at a 1000-bed tertiary hospital in Warsaw, Poland. Bloodstream isolates of ESKAPE pathogens were identified according to the EUCAST guidelines. Data were analyzed by pathogen, ward, and year of isolation. Results: From 2483 positive blood cultures, 3724 ESKAPE pathogens were recovered. S. aureus and K. pneumoniae predominated, particularly in the Intensive Care Unit and Hematology ward. Resistance analysis revealed persistently high vancomycin resistance in E. faecium, variable but notable methicillin resistance in S. aureus, and frequent ESBL production in K. pneumoniae with an alarming rise in carbapenemase-producing strains, including dual NDM + OXA-48 co-producers. A. baumannii exhibited near-universal multidrug resistance. P. aeruginosa demonstrated lower resistance rates with preserved colistin susceptibility, while Enterobacter spp. remained fully carbapenem-susceptible. Linezolid retained activity against E. faecium, while colistin remained effective against A. baumannii and P. aeruginosa. Modern \u03b2-lactam\/\u03b2-lactamase inhibitor combinations were active against K. pneumoniae. Conclusions: Our findings underscore the critical role of ESKAPE pathogens in bloodstream infections and highlight divergent resistance patterns across species. The emergence of carbapenemase-producing K. pneumoniae and the persistence of multidrug-resistant A. baumannii are of particular concern. Sustained surveillance, robust antimicrobial stewardship, and tailored infection control strategies remained essential to curb the evolving resistance threat in tertiary care settings.<\/jats:p>","DOI":"10.3390\/jcm14196932","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T10:54:48Z","timestamp":1759229688000},"page":"6932","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["ESKAPE Pathogens in Bloodstream Infections: Dynamics of Antimicrobial Resistance from 2018 to 2024\u2014A Single-Center Observational Study in Poland"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6394-8451","authenticated-orcid":false,"given":"Aneta","family":"Guzek","sequence":"first","affiliation":[{"name":"Department of Laboratory Diagnostics, Section of Microbiology, Military Institute of Medicine\u2014National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6589-1460","authenticated-orcid":false,"given":"Dariusz","family":"Tomaszewski","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Therapy, Military Institute of Aviation Medicine, 01-755 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8355-0696","authenticated-orcid":false,"given":"Zbigniew","family":"Rybicki","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Therapy, Military Institute of Medicine\u2014National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0514-2281","authenticated-orcid":false,"given":"Wies\u0142aw","family":"Piechota","sequence":"additional","affiliation":[{"name":"Department of Laboratory Diagnostics, Military Institute of Medicine\u2014National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2101-5053","authenticated-orcid":false,"given":"Katarzyna","family":"Mackiewicz","sequence":"additional","affiliation":[{"name":"Department of Laboratory Diagnostics, Section of Microbiology, Military Institute of Medicine\u2014National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Konior","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Tropical Medicine, Military Institute of Medicine\u2014National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2394-535X","authenticated-orcid":false,"given":"Anna","family":"Olczak-Pie\u0144kowska","sequence":"additional","affiliation":[{"name":"Department of Public Health, Epidemiology and Vaccinology, Military Institute of Medicine\u2014National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e20561","DOI":"10.1016\/j.heliyon.2023.e20561","article-title":"The Burden of Hospital Acquired Infections and Antimicrobial Resistance","volume":"9","author":"Abban","year":"2023","journal-title":"Heliyon"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e70168","DOI":"10.1002\/hsr2.70168","article-title":"The Extra Length of Stay, Costs, and Mortality Associated with Healthcare-Associated Infections: A Case-control Study","volume":"7","author":"Moradi","year":"2024","journal-title":"Health Sci. Rep."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"ofad500.2056","DOI":"10.1093\/ofid\/ofad500.2056","article-title":"The Impact of Healthcare Associated Infections on Costs and Lengths of Stay 2019\u20132023","volume":"10","author":"Sentiff","year":"2023","journal-title":"Open Forum Infect. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"90","DOI":"10.21101\/cejph.a7631","article-title":"Analysis of Impact of Nosocomial Infections on Cost of Patient Hospitalisation","volume":"31","author":"Blatnik","year":"2023","journal-title":"Cent. Eur. J. Public Health"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Pipit\u00f2, L., Rubino, R., D\u2019Agati, G., Bono, E., Mazzola, C.V., Urso, S., Zinna, G., Distefano, S.A., Firenze, A., and Bonura, C. (2025). Antimicrobial Resistance in ESKAPE Pathogens: A Retrospective Epidemiological Study at the University Hospital of Palermo, Italy. Antibiotics, 14.","DOI":"10.3390\/antibiotics14020186"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Seid, M., Bayou, B., Aklilu, A., Tadesse, D., Manilal, A., Zakir, A., Kulyta, K., Kebede, T., Alodaini, H.A., and Idhayadhulla, A. (2025). Antimicrobial Resistance Patterns of WHO Priority Pathogens at General Hospital in Southern Ethiopia During the COVID-19 Pandemic, with Particular Reference to ESKAPE-Group Isolates of Surgical Site Infections. BMC Microbiol., 25.","DOI":"10.1186\/s12866-025-03783-1"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1128\/JCM.02130-10","article-title":"Comparison of Nine Phenotypic Methods for Detection of Extended-Spectrum Beta-Lactamase Production by Enterobacteriaceae","volume":"49","author":"Garrec","year":"2011","journal-title":"J. Clin. Microbiol."},{"key":"ref_8","unstructured":"The European Committee on Antimicrobial Susceptibility Testing (EUCAST) (2025, March 15). Breakpoint Tables for Interpretation of MICs and Zone Diameters, versions 8.0\u201314.0, 2018\u20132024. Available online: https:\/\/www.eucast.org?clinical_breakpoints."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Ma, J., Song, X., Li, M., Yu, Z., Cheng, W., Yu, Z., Zhang, W., Zhang, Y., Shen, A., and Sun, H. (2023). Global Spread of Carbapenem-Resistant Enterobacteriaceae: Epidemiological Features, Resistance Mechanisms, Detection and Therapy. Microbiol. Res., 266.","DOI":"10.1016\/j.micres.2022.127249"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1136\/ebnurs-2022-103540","article-title":"Antimicrobial Resistance Collaborators (2022). Global Burden of Bacterial Antimicrobial Resistance in 2019: A Systematic Analysis","volume":"27","author":"Ranjbar","year":"2024","journal-title":"Evid. Based Nurs."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"ofz503","DOI":"10.1093\/ofid\/ofz503","article-title":"ESKAPE Pathogens in Bloodstream Infections Are Associated With Higher Cost and Mortality but Can Be Predicted Using Diagnoses Upon Admission","volume":"6","author":"Marturano","year":"2019","journal-title":"Open Forum Infect. Dis."},{"key":"ref_12","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_13","doi-asserted-by":"crossref","unstructured":"De Prisco, M., Manente, R., Santella, B., Serretiello, E., Dell\u2019Annunziata, F., Santoro, E., Bernardi, F.F., D\u2019Amore, C., Perrella, A., and Pagliano, P. (2024). Impact of ESKAPE Pathogens on Bacteremia: A Three-Year Surveillance Study at a Major Hospital in Southern Italy. Antibiotics, 13.","DOI":"10.3390\/antibiotics13090901"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e70897","DOI":"10.1002\/hsr2.70897","article-title":"Multidrug-Resistant ESKAPEEc Pathogens From Bloodstream Infections in South Africa: A Cross-Sectional Study Assessing Resistance to WHO AWaRe Antibiotics","volume":"8","author":"Hetsa","year":"2025","journal-title":"Health Sci. Rep."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1416","DOI":"10.1017\/ice.2021.391","article-title":"Increased Rates of Secondary Bacterial Infections, Including Enterococcus Bacteremia, in Patients Hospitalized with Coronavirus Disease 2019 (COVID-19)","volume":"43","author":"DeVoe","year":"2022","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Golli, A.L., Popa, S.G., Ghenea, A.E., and Turcu, F.L. (2025). The Impact of the COVID-19 Pandemic on the Antibiotic Resistance of Gram-Negative Pathogens Causing Bloodstream Infections in an Intensive Care Unit. Biomedicines, 13.","DOI":"10.3390\/biomedicines13020379"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Mendes, G., Ramalho, J.F., Duarte, A., Pedrosa, A., Silva, A.C., M\u00e9ndez, L., and Caneiras, C. (2022). First Outbreak of NDM-1-Producing Klebsiella Pneumoniae ST11 in a Portuguese Hospital Centre during the COVID-19 Pandemic. Microorganisms, 10.","DOI":"10.3390\/microorganisms10020251"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Ficik, J., Andrez\u00e1l, M., Drahovsk\u00e1, H., B\u00f6hmer, M., Szemes, T., Lipt\u00e1kov\u00e1, A., and Slobodn\u00edkov\u00e1, L. (2023). Carbapenem-Resistant Klebsiella Pneumoniae in COVID-19 Era\u2014Challenges and Solutions. Antibiotics, 12.","DOI":"10.3390\/antibiotics12081285"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"796","DOI":"10.7326\/ANNALS-24-03078","article-title":"Impact of the COVID-19 Pandemic on Antibiotic Resistant Infection Burden in U.S. Hospitals: Retrospective Cohort Study of Trends and Risk Factors","volume":"178","author":"Yek","year":"2025","journal-title":"Ann. Intern Med."},{"key":"ref_20","first-page":"1","article-title":"An Outbreak of Double Carbapenemase-Producing Klebsiella Pneumoniae, Harbouring NDM-5 and OXA-48 Genes, at a Tertiary Hospital in Canberra, Australia","volume":"48","author":"Mhango","year":"2024","journal-title":"Commun. Dis. Intell."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Lazar, D.S., Nica, M., Dascalu, A., Oprisan, C., Albu, O., Codreanu, D.R., Kosa, A.G., Popescu, C.P., and Florescu, S.A. (2024). Carbapenem-Resistant NDM and OXA-48-like Producing K. Pneumoniae: From Menacing Superbug to a Mundane Bacteria; A Retrospective Study in a Romanian Tertiary Hospital. Antibiotics, 13.","DOI":"10.3390\/antibiotics13050435"},{"key":"ref_22","first-page":"5","article-title":"The Empiric Antimicrobial Therapy: The Comparison of Initial Choice with the Results of Microbiological Investigations. An Observational Study","volume":"29","author":"Tomaszewski","year":"2023","journal-title":"Pol. J. Aviat. Med."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Huang, C., Moradi, S., Sholeh, M., Tabaei, F.M., Lai, T., Tan, B., Meng, J., and Azizian, K. (2025). Global Trends in Antimicrobial Resistance of Enterococcus Faecium: A Systematic Review and Meta-Analysis of Clinical Isolates. Front. Pharmacol., 16.","DOI":"10.3389\/fphar.2025.1505674"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1186\/s13756-020-00829-z","article-title":"Global Trends of Antimicrobial Susceptibility to Ceftaroline and Ceftazidime\u2013Avibactam: A Surveillance Study from the ATLAS Program (2012\u20132016)","volume":"9","author":"Zhang","year":"2020","journal-title":"Antimicrob. Resist. Infect. Control"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Zhang, X., Paganelli, F.L., Bierschenk, D., Kuipers, A., Bonten, M.J.M., Willems, R.J.L., and van Schaik, W. (2012). Genome-Wide Identification of Ampicillin Resistance Determinants in Enterococcus Faecium. PLoS Genet., 8.","DOI":"10.1371\/journal.pgen.1002804"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Sader, H.S., Mendes, R.E., Duncan, L., Kimbrough, J.H., Carvalhaes, C.G., and Castanheira, M. (2023). Ceftazidime-Avibactam, Meropenem-Vaborbactam, and Imipenem-Relebactam Activities Against Multidrug-Resistant Enterobacterales from United States Medical Centers (2018\u20132022). Diagn. Microbiol. Infect. Dis., 106.","DOI":"10.1016\/j.diagmicrobio.2023.115945"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/s13756-024-01376-7","article-title":"Prevalence of Colistin Resistance in Clinical Isolates of Acinetobacter baumannii: A Systematic Review and Meta-Analysis","volume":"13","author":"Bostanghadiri","year":"2024","journal-title":"Antimicrob. Resist. Infect. Control"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Ramatla, T., Nkhebenyane, J., Lekota, K.E., Thekisoe, O., Monyama, M., Achilonu, C.C., and Khasapane, G. (2025). Global Prevalence and Antibiotic Resistance Profiles of Carbapenem-Resistant Pseudomonas Aeruginosa Reported from 2014 to 2024: A Systematic Review and Meta-Analysis. Front. Microbiol., 16.","DOI":"10.3389\/fmicb.2025.1599070"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.diagmicrobio.2005.12.009","article-title":"Antimicrobial Susceptibility Pattern Comparisons Among Intensive Care Unit and General Ward Gram-Negative Isolates from the Meropenem Yearly Susceptibility Test Information Collection Program (USA)","volume":"56","author":"Rhomberg","year":"2006","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s44280-024-00044-0","article-title":"Changing Antimicrobial Resistance Profile of Enterobacter spp. Isolates in Hospitals across China: A Seven-Year Analysis from the CHINET Antimicrobial Resistance Surveillance Program (2015\u20132021)","volume":"2","author":"Yan","year":"2024","journal-title":"One Health Adv."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/19\/6932\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:00:53Z","timestamp":1760104853000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/19\/6932"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,30]]},"references-count":30,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["jcm14196932"],"URL":"https:\/\/doi.org\/10.3390\/jcm14196932","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,30]]}}}