Annual prevalence and antimicrobial resistance in bloodstream infections caused by the ESKAPE group in Neonatal Intensive Care Units in Mexico, a multicenter study, 2020–2024
Published 2026-03-24
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Copyright (c) 2026 José Castillo Bejarano, Daniela Padilla Alanis, Erika Larragoity González, Mónica Abud González, Luis Ortiz Padilla, Raúl Romero Feregrino, Daniel Pacheco Rosas, Mariana Chávez Rodríguez, Susana Cantú González, Maribel Baquera Arteaga, Martín Cisneros Castolo, Jorge Vera Delgado, Dzoara Lugo Ondarza, Abiel Mascareñas De los Santos, Néstor Casilla Vegas, Héctor Sánchez Rodríguez, Omar Rangel Selvera, Cynthia Peña López, Sara Rosales González

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Abstract
Introduction: Bloodstream infections (BSIs) are a significant cause of mortality in neonatal intensive care units (NICUs). ESKAPE pathogens have been identified as a serious threat to public health, particularly among the neonatal population. Objective: To estimate the annual prevalence and antimicrobial resistance in BSIs caused by ESKAPE pathogens in NICUs. Methods: Multicenter study conducted in eight NICUs in Mexico between 2020 and 2024. All blood cultures positive for Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. were included. Standardized antimicrobial susceptibility tests were performed. The statistical analysis was performed using SPSS v. 24. Results: 1,355 BSI cases were identified. Staphylococcus aureus showed 42.8% resistance to methicillin, and Enterococcus faecium showed 60% resistance to vancomycin. Resistance to meropenem was noted in 26.7% of A. baumannii isolates and 16.8% of P. aeruginosa isolates. Third-generation cephalosporin resistance was detected in 60.6% of K. pneumoniae isolates and 21% of those belonging to the Enterobacter cloacae complex. Conclusion: ESKAPE pathogens showed high and sustained levels of antimicrobial resistance in newborns. These findings highlight the need for implementing antimicrobial optimization programs in Mexico.