Análise crítica das bactérias do grupo ESKAPE: resistência aos antibióticos, riscos epidemiológicos e implicações clínicas

Abstract

This study aims to critically analyze Healthcare-Associated Infections (HAIs), with an emphasis on epidemiological aspects, the main etiological agents involved, and the mechanisms of antimicrobial resistance, especially those associated with the ESKAPE group (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp.). The conceptual evolution of HAIs from the 1990s to the present day is presented, highlighting their relevance as a public health problem due to their high incidence, impact on morbidity and mortality indicators, and economic burden on healthcare systems. The methodology is based on a systematic literature review, guided by critical analysis of national and international scientific literature, supplemented by technical documents issued by regulatory bodies and health reference institutions. The discussion covers the distinction between preventable and non-preventable infections, predisposing host factors such as immunosuppression, malnutrition, age extremes, and comorbidities, and the risks associated with invasive interventions. The role of ESKAPE microorganisms is analyzed, recognized for their high pathogenic potential and ability to develop multiple antimicrobial resistance mechanisms, such as target modification, production of inactivating enzymes, biofilm formation, and reduced membrane permeability. The results highlight the need for integrated strategies for surveillance, prevention, and control of HAIs, focusing on rational antimicrobial use, adherence to biosafety protocols, and strengthening public policies to combat bacterial resistance. It is concluded that the complexity of HAIs, especially those caused by multidrug-resistant bacteria, demands multidisciplinary approaches and continuous investment in research, innovation, and ongoing health professional education.