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Objective <p>ESKAPE pathogens (<i>Enterococcus faecium</i>,<i> Staphylococcus aureus</i>,<i> Klebsiella pneumoniae</i>,<i> Acinetobacter baumannii</i>,<i> Pseudomonas aeruginosa</i>, and <i>Enterobacter</i> spp.) are major causes of healthcare-associated infections and pose a serious public health threat because of their high antimicrobial resistance potential. This study evaluated the distribution, resistance profiles, and associated factors of ESKAPE pathogens isolated in Somalia.</p> Methods <p>This retrospective single-center laboratory-based study was conducted at Mogadishu Somalia Türkiye Recep Tayyip Erdoğan Training and Research Hospital, a tertiary care center in Mogadishu, Somalia. Only culture-positive clinical specimens yielding ESKAPE pathogens between January 2024 and December 2025 were included. A total of 2,486 ESKAPE isolates were analyzed. Antimicrobial susceptibility testing was performed using the Kirby–Bauer disk diffusion method according to CLSI criteria. Demographic and clinical data were analyzed using SPSS and R software. Associations between selected demographic and clinical factors and specific pathogens were evaluated using univariate binary logistic regression analysis.</p> Results <p>Of the isolates, 1,442/2,486 (58.0%) were obtained from male patients, and the most common age group was 18–40 years [952/2,486 (38.3%)]. The most prevalent pathogens were <i>K. pneumoniae</i> [1,033/2,486 (41.6%)] and <i>S. aureus</i> [629/2,486 (25.3%)]. Overall, MDR and XDR phenotypes were detected in 1,633/2,486 (65.7%) and 687/2,486 (27.6%) isolates, respectively. The highest MDR and XDR rates were observed in <i>A. baumannii</i> [135/138 (97.8%) and 97/138 (70.3%)]. High resistance to ceftazidime [128/138 (92.8%)], cefepime [116/138 (84.1%)], ciprofloxacin [115/138 (83.3%)], trimethoprim-sulfamethoxazole [121/138 (87.7%)], and carbapenems [99/138 (71.7%)] was detected in <i>A. baumannii</i>. Susceptibility to vancomycin and linezolid remained largely preserved among Gram-positive pathogens. <i>A. baumannii</i> and <i>Enterobacter</i> spp. were significantly associated with ICU admission, while gender-related differences were observed for <i>P. aeruginosa</i> and <i>S. aureus</i>.</p> Conclusion <p>A high burden of antimicrobial resistance was observed among ESKAPE pathogens, particularly Gram-negative bacteria, with <i>A. baumannii</i> playing a central role. These findings provide important local surveillance data that may support empirical antibiotic selection, antimicrobial stewardship, and infection control strategies in Somalia.</p>

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Antimicrobial resistance profiles of ESKAPE pathogens isolated in a microbiology laboratory in Somalia: a two-year retrospective study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月6日

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  • Zerife Orhan,
  • Serpil Doğan,
  • Said Mohamed Mohamud,
  • Rahma Yusuf Haji Mohamud,
  • Liban Abdi Nor,
  • Ahmet Doğan,
  • Iftin Mohamed Osman,
  • Arzu Kayış

摘要

Objective

ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.) are major causes of healthcare-associated infections and pose a serious public health threat because of their high antimicrobial resistance potential. This study evaluated the distribution, resistance profiles, and associated factors of ESKAPE pathogens isolated in Somalia.

Methods

This retrospective single-center laboratory-based study was conducted at Mogadishu Somalia Türkiye Recep Tayyip Erdoğan Training and Research Hospital, a tertiary care center in Mogadishu, Somalia. Only culture-positive clinical specimens yielding ESKAPE pathogens between January 2024 and December 2025 were included. A total of 2,486 ESKAPE isolates were analyzed. Antimicrobial susceptibility testing was performed using the Kirby–Bauer disk diffusion method according to CLSI criteria. Demographic and clinical data were analyzed using SPSS and R software. Associations between selected demographic and clinical factors and specific pathogens were evaluated using univariate binary logistic regression analysis.

Results

Of the isolates, 1,442/2,486 (58.0%) were obtained from male patients, and the most common age group was 18–40 years [952/2,486 (38.3%)]. The most prevalent pathogens were K. pneumoniae [1,033/2,486 (41.6%)] and S. aureus [629/2,486 (25.3%)]. Overall, MDR and XDR phenotypes were detected in 1,633/2,486 (65.7%) and 687/2,486 (27.6%) isolates, respectively. The highest MDR and XDR rates were observed in A. baumannii [135/138 (97.8%) and 97/138 (70.3%)]. High resistance to ceftazidime [128/138 (92.8%)], cefepime [116/138 (84.1%)], ciprofloxacin [115/138 (83.3%)], trimethoprim-sulfamethoxazole [121/138 (87.7%)], and carbapenems [99/138 (71.7%)] was detected in A. baumannii. Susceptibility to vancomycin and linezolid remained largely preserved among Gram-positive pathogens. A. baumannii and Enterobacter spp. were significantly associated with ICU admission, while gender-related differences were observed for P. aeruginosa and S. aureus.

Conclusion

A high burden of antimicrobial resistance was observed among ESKAPE pathogens, particularly Gram-negative bacteria, with A. baumannii playing a central role. These findings provide important local surveillance data that may support empirical antibiotic selection, antimicrobial stewardship, and infection control strategies in Somalia.