Impact of ESKAPE pathogens on the One Health framework considering epidemiology and environmental occurrence

SUMMARY

The ESKAPE group of pathogens represents one of the most critical threats to global health due to their capacity to evade antimicrobial treatments. This review provides a structured synthesis of the literature addressing antimicrobial resistance mechanisms, epidemiological relevance, clinical impact, and emerging strategies for containment within a One Health framework. Relevant studies and surveillance reports were analyzed to characterize the global distribution and burden of these organisms across human, animal, and environmental settings. The evidence indicates that ESKAPE pathogens remain leading causes of healthcare-associated infections while increasingly being identified in non-clinical reservoirs, highlighting the interconnected nature of antimicrobial resistance. Recent findings point to sustained high morbidity and mortality associated with these pathogens, driven by the expansion of multidrug-resistant lineages, and the limited effectiveness of current therapeutic options. Key challenges identified include gaps in surveillance integration, the spread of resistance determinants across sectors, and variability in infection control practices. Addressing these issues requires coordinated strategies that integrate surveillance, antimicrobial stewardship, infection prevention, and the development of novel therapeutics within a comprehensive One Health approach.