ESKAPEE: Mechanisms, Spread, and Evolution of Antimicrobial Resistance

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Mechanism and Evolution of Antibiotic Resistance".

Deadline for manuscript submissions: 31 December 2025 | Viewed by 810

Special Issue Editors


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Guest Editor
School of Medicine, Zhejiang University, Hangzhou, China
Interests: antimicrobial resistance; genomic epidemiology of infectious agents; One Health; drug discovery

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Guest Editor
State Key Laboratory of Pathogen and Biosecurity, Academy of Military Medical Sciences, Beijing, China
Interests: population genomics of bacteria; bacterial evolution

Special Issue Information

Dear Colleagues,

ESKAPE consists of six bacterial pathogens that contribute to a considerable amount of antibiotic-resistant infections identified in clinical medicine, including Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. These highly virulent and antibiotic-resistant ESKAPE pathogens are the leading cause of nosocomial infection around the globe, particularly among critically ill and immunocompromised individuals. Their capacity to harbor intrinsic or acquired resistance determinants under both natural and anthropogenic selective pressures has led to the widespread emergence of multidrug-resistant strains, enabling these bacteria to evade or withstand conventional antibiotic therapies. Consequently, infections caused by ESKAPE pathogens are frequently associated with limited treatment options, higher risks of therapeutic failure, and increased morbidity and mortality. The growing burden of these infections imposes significant challenges on healthcare systems, necessitating urgent efforts to develop more effective strategies for prevention, diagnosis, and treatment.

This Special Issue aims to provide an in-depth discussion of the mechanisms of resistance among ESKAPE pathogens and the spread and evolution of such pathogens, integrating insights from molecular microbiology, evolutionary biology, and epidemiology. It critically examines the genetic determinants, biochemical pathways, and adaptive strategies that underpin the emergence and dissemination of antimicrobial resistance. Through rigorous scientific analysis, this collection of articles hopes to enhance the understanding of the epidemiological dynamics of ESKAPE pathogens and to inform effective clinical practices and public health policies.

Dr. Ning Dong
Dr. Yarong Wu
Guest Editors

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Keywords

  • ESKAPE pathogens
  • antimicrobial resistance
  • genomic epidemiology

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Published Papers (1 paper)

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Research

14 pages, 2680 KB  
Article
Molecular Epidemiology of tet(A)-v1-Positive Carbapenem-Resistant Klebsiella pneumoniae in Pediatric Patients in a Chinese Hospital
by Chen Xu, Chunli Li, Yuanyuan Li, Xiangkun Zeng, Yi Yang, Mi Zhou, Jiani Jiang, Yunbing Li, Guangfen Zhang, Xiaofan Li, Jiayi You, Yi Liu, Lili Huang, Sheng Chen and Ning Dong
Antibiotics 2025, 14(9), 852; https://doi.org/10.3390/antibiotics14090852 - 22 Aug 2025
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Abstract
Background: The emergence and spread of the tigecycline resistance gene tet(A)-v1 in carbapenem-resistant Klebsiella pneumoniae (CRKP) poses significant public health challenges. However, the prevalence of tet(A)-v1-positive CRKP, especially in pediatric patients, remains poorly understood. This study aims to address the gap [...] Read more.
Background: The emergence and spread of the tigecycline resistance gene tet(A)-v1 in carbapenem-resistant Klebsiella pneumoniae (CRKP) poses significant public health challenges. However, the prevalence of tet(A)-v1-positive CRKP, especially in pediatric patients, remains poorly understood. This study aims to address the gap by performing an in-depth analysis of isolates collected from a children’s hospital in China. Methods: A 4-year retrospective study was conducted in the children’s hospital in Suzhou, China. Non-duplicated specimens were obtained from pediatric patients, and antimicrobial susceptibility profiles were assessed. Whole-genome sequencing and bioinformatics analyses were conducted to characterize the genetic background, antimicrobial resistance determinants, hypervirulence-associated genes, diversity of tet(A)-v1-carrying plasmids, the genetic environment of tet(A)-v1, and the potential for clonal transmission. Conjugative transferability of tet(A)-v1-carrying plasmids was also evaluated via conjugation assays. Results: Of the 73 tet(A)-v1-positive CRKP isolates from pediatric patients, 10.96% were non-susceptible to tigecycline. These isolates exhibited high genetic diversity, spanning across 13 STs (sequence types), with ST17 being predominant. Three carbapenemases were identified, with IMP being the most common. Isolates from diverse backgrounds, such as ST17, ST20, ST323, ST792, and ST3157, demonstrated evidence of clonal transmission. The tet(A)-v1 gene was located on 14 distinct plasmids across seven replicon types, with IncFIA/IncHI1 and IncFII being most commonly detected. All tet(A)-v1-carrying plasmids were multidrug-resistant, and 68.49% were conjugatively transferable, indicating a high potential for horizontal transfer. Four genetic contexts bordering tet(A)-v1 were identified, which points to active clonal dissemination. Conclusions: Although limited to a single hospital, this study represents one of the first in-depth investigations of tet(A)-v1-positive CRKP in pediatric patients, providing valuable insights into the prevalence and spread of tet(A)-v1 in this vulnerable group. These findings emphasize the urgent need for enhanced surveillance and infection control measures to curb the spread of tet(A)-v1-positive CRKP in pediatric healthcare environments, offering critical insights to mitigate its public health impact. Full article
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