{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:38:10Z","timestamp":1790789890386,"version":"4.1.0"},"reference-count":50,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Pneumonia is an inflammatory condition of the lower respiratory tract, commonly caused by infection and associated with substantial morbidity and healthcare utilization. The burden of pneumonia on healthcare is exacerbated by limited data on pathogenic causes and associated antimicrobial resistance (AMR). Here, we conducted a literature review and synthesized data on the microbial causes and AMR in hospitalized pneumonia patients from Kazakhstan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched PubMed, Medline, Embase, Web of Science, the Cochrane Central Register of Controlled Trials, eLIBRARY, and CyberLeninka for observational studies of hospitalized pneumonia patients reporting microbiologically confirmed pathogen and antimicrobial resistance data from Kazakhstan. Exclusion criteria were unclear pneumonia definitions or absence of pathogen\u2010specific AMR data. We assessed study quality using the Joanna Briggs Institute checklist and extracted data on microbial prevalence and resistance rates by pathogen\u2010antibiotic combinations. We synthesized microbial etiology and AMR patterns and performed random\u2010effects meta\u2010analysis of prevalence data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Nine studies represented 1534 isolates from 1474 inpatients (2008\u20132022). The most prevalent pathogens were\n                      <jats:italic>Streptococcus pneumoniae<\/jats:italic>\n                      (17.8%),\n                      <jats:italic>Streptococcus<\/jats:italic>\n                      spp. (17.3%),\n                      <jats:italic>Haemophilus influenzae<\/jats:italic>\n                      (12.6%), and\n                      <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                      (10.7%). Hospital\u2010acquired pathogens comprised 48% of isolates.\n                      <jats:italic>Acinetobacter baumannii<\/jats:italic>\n                      had the highest resistance, exceeding 70% across major antibiotic classes.\n                      <jats:italic>Escherichia coli<\/jats:italic>\n                      had high resistance to \u03b2\u2010lactams (&gt;\u200966%) and fluoroquinolones (63%).\n                      <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                      had 60% fluoroquinolone and 27% carbapenem resistance. Fluoroquinolone resistance was widespread across multiple pathogens.\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      had relatively lower resistance rates. Pathogen distribution varied by clinical setting and patient population.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Data on the etiologic causes and AMR in pneumonia are sparse in Kazakhstan and methodologically heterogeneous. Hospital\u2010acquired pneumonia pathogens were highly prevalent and associated with high AMR rates. These findings underscore the need for improved pathogen surveillance and antimicrobial stewardship in Kazakhstan to address the high burden of antibiotic\u2010resistant and hospital\u2010acquired pneumonia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.72236","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T11:42:01Z","timestamp":1774870921000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Microbial Etiology and Antimicrobial Resistance in Pneumonia Among Hospitalized Patients in Kazakhstan: A Systematic Review and Single\u2010Arm Meta\u2010Analysis of Prevalence Data"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9086-9396","authenticated-orcid":false,"given":"Radmir","family":"Sarsenov","sequence":"first","affiliation":[{"name":"Department of Biology, School of Sciences and Humanities Nazarbayev University Astana Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxim","family":"Solomadin","sequence":"additional","affiliation":[{"name":"International Center for Vaccinology Kazakh National Agrarian Research University (KazNARU) Almaty Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyona","family":"Lavrinenko","sequence":"additional","affiliation":[{"name":"Research Laboratory Karaganda Medical University Karaganda Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vyacheslav","family":"Beloussov","sequence":"additional","affiliation":[{"name":"Kazakhstan\u2010Japan Innovation Centre Kazakh National Agrarian Research University (KazNARU) Almaty Kazakhstan"},{"name":"TreeGene Molecular Genetics Laboratory Almaty Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vitaliy","family":"Strochkov","sequence":"additional","affiliation":[{"name":"Kazakhstan\u2010Japan Innovation Centre Kazakh National Agrarian Research University (KazNARU) Almaty Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shynggys","family":"Orkara","sequence":"additional","affiliation":[{"name":"Kazakhstan\u2010Japan Innovation Centre Kazakh National Agrarian Research University (KazNARU) Almaty Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1814-2798","authenticated-orcid":false,"given":"Nurlan","family":"Sandybayev","sequence":"additional","affiliation":[{"name":"Kazakhstan\u2010Japan Innovation Centre Kazakh National Agrarian Research University (KazNARU) Almaty Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7136-7921","authenticated-orcid":false,"given":"Sergey","family":"Yegorov","sequence":"additional","affiliation":[{"name":"Department of Biology, School of Sciences and Humanities Nazarbayev University Astana Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,30]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-021-00259-0"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00630-9"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)02724-0"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1500245"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-022-07263-z"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41479-020-00074-3"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics13121123"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-91216-4"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkac218"},{"key":"e_1_2_12_11_1","unstructured":"GLASS Country Participation accessed September 6 2025 https:\/\/www.who.int\/initiatives\/glass\/country-participation."},{"key":"e_1_2_12_12_1","unstructured":"JBI Critical Appraisal Tools|JBI accessed October 8 2024 https:\/\/jbi.global\/critical-appraisal-tools."},{"key":"e_1_2_12_13_1","unstructured":"Covidence Better Systematic Review Management. 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