ESKAPE pathogens and antimicrobial resistance: emerging trends and therapeutic challenges

Antimicrobial resistance (AMR) has emerged as one of the most-pressing global health threats of the 21st century, compromising the efficacy of existing antibiotics and threatening modern medical practices. Among the most-concerning multidrug-resistant (MDR) pathogens are the ESKAPE organisms (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.), which the World Health Organization (WHO) has designated as a high-priority group due to their capacity to evade conventional antibiotics and cause severe hospital-acquired infections (HAIs). Infections caused by ESKAPE pathogens are notoriously difficult to treat, frequently associated with poor clinical outcomes, high morbidity, and significant mortality, particularly in immunocompromised individuals. This review provides a comprehensive overview of ESKAPE pathogens, focusing on their clinical relevance, virulence determinants, diverse antibiotic resistance mechanisms and potential future therapeutic approaches. Furthermore, it highlights the recent global prevalence data from 2021 to 2025, demonstrating the escalating burden of MDR ESKAPE infections. Collectively, these insights reinforce the urgent need for enhanced surveillance, stringent infection control measures, and the development of innovative therapeutic strategies to address the growing threat of ESKAPE-driven AMR.