Antimicrobial Resistance, Epidemiology, Clinical Impact and Molecular Characterization of Multidrug-Resistant ESKAPEE Pathogens

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotic Therapy in Infectious Diseases".

Deadline for manuscript submissions: 30 April 2026 | Viewed by 341

Special Issue Editors


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Istituto Zooprofilattico Sperimentale of Puglia and Basilicata, Anthrax Reference Institute of Italy, 71121 Foggia, Italy
Interests: microbiology, SARS-CoV-2, molecular diagnostics; molecular typing; vaccines; immunology; mass spectrometry MALDI-TOF
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Guest Editor
Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
Interests: microbiology; Bacillus anthracis; anthrax; molecular diagnostics; mass spectrometry MALDI-TOF
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The acronym ESKAPEE identifies bacteria (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp. and Escherichia coli) that are able to escape the biocidal action of antimicrobials, presenting high rates of multi-resistance. Indeed, commonly available treatment options, including broad-spectrum beta-lactams, carbapenems, glycopeptides, fluoroquinolones, and aminoglycosides, are currently increasingly ineffective against ESKAPEE pathogens; this is predisposing us to a future in which antibiotics are ineffective.

For this reason, ESKAPEE pathogens are responsible for serious nosocomial infections, difficult to fight, worldwide.

In the food sector, ESKAPEE pathogens can contaminate multiple compartments of the food production chain and pose a significant threat to public health. In addition, the overuse or misuse of antibiotics in animal husbandry could increase resistance in these bacteria, thus promoting their spread throughout food production and consumption.

Given the current importance and concern around this topic, this Special Issue is seeking manuscripts that advance our understanding of antimicrobial resistance, virulence, and epidemiology of ESKAPEE pathogens.

Specifically, we are seeking manuscripts in the following areas:

  • Mechanisms of antimicrobial resistance ;
  • Phenotypic and genotypic assessment of antibiotic resistance;
  • Molecular characterization of multidrug-resistant ESKAPEE pathogens;
  • Nosocomial outbreaks caused by ESKAPEE pathogens;
  • Identification of ESKAPEE pathogens in food and environmental samples;
  • Novel drug combinations designed to combat infections caused by ESKAPEE pathogens.

Dr. Lorenzo Pace
Dr. Viviana Manzulli
Guest Editors

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Keywords

  • ESKAPEE
  • antimicrobial resistance
  • antibiotic resistance
  • multidrug-resistant pathogens
  • nosocomial infection
  • molecular mechanism

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Published Papers (1 paper)

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Review

25 pages, 1739 KB  
Review
Beyond the Spotlight: Enterobacter spp. as Overlooked Carbapenemase Producers in Europe
by Ivana Cirkovic and Snezana Brkic
Antibiotics 2025, 14(10), 1045; https://doi.org/10.3390/antibiotics14101045 - 18 Oct 2025
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Abstract
Antimicrobial resistance (AMR) poses a critical global health challenge, with carbapenemase-producing Enterobacterales (CPE) representing one of the most urgent threats. While Klebsiella pneumoniae and Escherichia coli have been the focus of most surveillance programs, Enterobacter spp., members of the Enterococcus faecium, Staphylococcus [...] Read more.
Antimicrobial resistance (AMR) poses a critical global health challenge, with carbapenemase-producing Enterobacterales (CPE) representing one of the most urgent threats. While Klebsiella pneumoniae and Escherichia coli have been the focus of most surveillance programs, Enterobacter spp., members of the Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp., and Escherichia coli (ESKAPEE) group, remain an underrecognized but increasingly important reservoir of carbapenemase genes in Europe. Despite being categorized by the World Health Organization (WHO) as “critical-priority” pathogens, Enterobacter spp. are largely excluded from major AMR surveillance frameworks, creating blind spots in detection and control. This review summarizes the taxonomy, intrinsic resistance mechanisms, and clinical relevance of Enterobacter spp., with a particular focus on carbapenemase epidemiology across Europe. We highlight the distribution and genetic context of major carbapenemases, including VIM, OXA-48-like, KPC, and NDM, and discuss emerging or minor enzymes such as IMI, FRI, GES, and IMP. Epidemiological data reveal shifting dominance patterns over time, with VIM enzymes consolidating their prevalence after 2015, while OXA-48-like and KPC declined, and NDM gained ground. The genetic diversity of Enterobacter spp., coupled with their ability to act as both nosocomial pathogens and silent intestinal or environmental reservoirs, facilitates the dissemination of carbapenemase genes via epidemic plasmids and clonal expansion. Addressing the growing impact of carbapenemase-producing Enterobacter spp. requires their systematic inclusion in national and international monitoring programs, expanded use of genomic epidemiology in clinical microbiology, and better alignment between research, clinical practice, and policy. A One Health approach is essential to curb the spread of carbapenemases across human, environmental, and animal reservoirs, and to safeguard the remaining therapeutic options. Full article
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