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Review
. 2025 Jun 3:20:101099.
doi: 10.1016/j.onehlt.2025.101099. eCollection 2025 Jun.

Gram-positive ESKAPE pathogens in Germany: A comprehensive analysis of occurrence and resistance development in animal, food, and environmental sources

Marwa Bassiouny  1   2 , Heinrich Neubauer  1 , Lisa D Sprague  1
Affiliations
Review

Gram-positive ESKAPE pathogens in Germany: A comprehensive analysis of occurrence and resistance development in animal, food, and environmental sources

Marwa Bassiouny et al. One Health. .

Abstract

Antimicrobial resistance (AMR) is a global problem affecting both humans and animals. Multidrug resistance (MDR) infections are predominantly caused by a group of bacteria known as ESKAPE pathogens, namely Enterococcus (E.) faecium, Staphylococcus (S.) aureus, Klebsiella (K.) pneumoniae, Acinetobacter (A.) baumannii, Pseudomonas (P.) aeruginosa, and Enterobacter species. They are among the top threats to public health worldwide as their acquisition of AMR genes has significantly diminished available treatment alternatives for severe infections, increased disease burden, and elevated mortality rates due to treatment failures. The current review aimed to investigate the occurrence and resistance development of the Gram-positive ESKAPE pathogens, E. faecium and S. aureus, in animals, food, and environmental sources in Germany. S. aureus has been extensively investigated in human medicine, and there is a decent knowledge regarding their presence in animals, food, and the environmental health sectors. However, limited published work exists on E. faecium in non-human samples. MDR isolates of both bacteria, harbouring resistance genes conferring resistance to several antimicrobial classes, have been detected in various companion animals and livestock species, as well as food and environmental samples across different regions of Germany. Notably, isolates with identical genotypes have been found in both animals and farm employees, underscoring the potential for cross-infection between animals and humans. This review highlights the impact of E. faecium and S. aureus in non-human sources in Germany and emphasizes the importance of addressing MDR from a One-Health perspective.

Keywords: E. faecium; ESKAPE pathogens; Germany; MRSA; One-health; Resistance development.

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Conflict of interest statement

None.

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