ESKAPE in China: epidemiology and characteristics of antibiotic resistance

Emerg Microbes Infect. 2024 Dec;13(1):2317915. doi: 10.1080/22221751.2024.2317915. Epub 2024 Feb 23.


The escalation of antibiotic resistance and the diminishing antimicrobial pipeline have emerged as significant threats to public health. The ESKAPE pathogens - Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. - were initially identified as critical multidrug-resistant bacteria, demanding urgently effective therapies. Despite the introduction of various new antibiotics and antibiotic adjuvants, such as innovative β-lactamase inhibitors, these organisms continue to pose substantial therapeutic challenges. People's Republic of China, as a country facing a severe bacterial resistance situation, has undergone a series of changes and findings in recent years in terms of the prevalence, transmission characteristics and resistance mechanisms of antibiotic resistant bacteria. The increasing levels of population mobility have not only shaped the unique characteristics of antibiotic resistance prevalence and transmission within People's Republic of China but have also indirectly reflected global patterns of antibiotic-resistant dissemination. What's more, as a vast nation, People's Republic of China exhibits significant variations in the levels of antibiotic resistance and the prevalence characteristics of antibiotic resistant bacteria across different provinces and regions. In this review, we examine the current epidemiology and characteristics of this important group of bacterial pathogens, delving into relevant mechanisms of resistance to recently introduced antibiotics that impact their clinical utility in China.

Keywords: China; ESKAPE; antimicrobial resistance; epidemiology.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Infections* / drug therapy
  • Bacterial Infections* / epidemiology
  • Bacterial Infections* / microbiology
  • Drug Resistance, Multiple, Bacterial
  • Enterococcus faecium*
  • Humans
  • Klebsiella pneumoniae


  • Anti-Bacterial Agents

Grants and funding

This work was supported by The National Key Research and Development Program of China (2021YFC2300300). This work was partially supported by grants from the Key Research and Development program of Zhejiang province (No. 2021C03068), the Natural Science Foundation of Zhejiang Province, China (No. LY24H190002), the National Natural Science Foundation of China (No. 81971984).