{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T12:47:11Z","timestamp":1785847631712,"version":"3.56.0"},"reference-count":31,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"unspecified","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"General Guidance Project of Hospital Management Innovation Research of Jiangsu Provincial Hospital Association","award":["JSYGY-3-2023-103"],"award-info":[{"award-number":["JSYGY-3-2023-103"]}]},{"name":"General Guidance Project of Hospital Management Innovation Research of Jiangsu Provincial Hospital Association","award":["JSYGY-3-2023-114"],"award-info":[{"award-number":["JSYGY-3-2023-114"]}]},{"name":"Key Project of Infection Management of Suzhou Hospital Association","award":["SZSYYXH-2023-ZD1"],"award-info":[{"award-number":["SZSYYXH-2023-ZD1"]}]},{"name":"Key Project of Hospital Management Innovation Research of Jiangsu Provincial Hospital Association","award":["JSYGY-2-2024-256"],"award-info":[{"award-number":["JSYGY-2-2024-256"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,7,16]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"\n Objective<\/jats:title>\n To investigate the differences in pathogenic bacterial profiles between ventilator-associated pneumonia (VAP) and non-ventilator-associated hospital-acquired pneumonia (NV-HAP) and to provide data to support clinical infection prevention and control.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n A retrospective observational study using surveillance data, accompanied by a statistical analysis of pathogen-related variables between the two study cohorts.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Sixty-one secondary and tertiary healthcare institutions in a single city. Data were extracted from the city\u2019s regional healthcare-associated infection surveillance platforms.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n Inpatients (\u226518 years old) diagnosed with confirmed hospital-acquired pneumonia (HAP), including VAP and NV-HAP, at the aforementioned 61 healthcare institutions during the study period. Patients with community-acquired pneumonia (CAP) were excluded.<\/jats:p>\n <\/jats:sec>\n \n Outcome measures<\/jats:title>\n (1) Pathogen distribution in patients with VAP and NV-HAP; (2) temporal trends in pathogen isolation rates (January 2020\u2013December 2024) in both groups; (3) antimicrobial resistance<\/jats:p>\n \n characteristics of major pathogens, including detection\/composition ratios of key multidrug-resistant organisms (MDROs): carbapenem-resistant\n Acinetobacter baumannii<\/jats:italic>\n (CRAB), methicillin-resistant\n Staphylococcus aureus<\/jats:italic>\n (MRSA), carbapenem-resistant\n Escherichia coli<\/jats:italic>\n (CREC), carbapenem-resistant\n Klebsiella pneumoniae<\/jats:italic>\n (CRKP) and carbapenem-resistant\n Pseudomonas aeruginosa<\/jats:italic>\n (CRPA); (4) susceptibility of major pathogens to antimicrobials.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Pathogen distribution differed between the two groups, with Gram-negative bacteria being predominant in both groups (73.72% vs 80.98%). Among patients with NV-HAP, the isolation rates of\n K.\u202fpneumoniae<\/jats:italic>\n ,\n Burkholderia cepacia<\/jats:italic>\n and\n Candida albicans<\/jats:italic>\n showed a decreasing trend, whereas\n A.\u202fbaumannii<\/jats:italic>\n exhibited a slow increase. In patients with VAP, the isolation rates of\n K.\u202fpneumoniae<\/jats:italic>\n and\n B.\u202fcepacia<\/jats:italic>\n decreased, whereas\n Stenotrophomonas maltophilia<\/jats:italic>\n increased. The proportion of drug-resistant bacteria was higher in patients with VAP than in those with NV-HAP (28.12% vs 19.74%). CRAB showed higher detection and composition ratios in the former group (77.37% and 48.05%, respectively). The MRSA detection rates were approximately 50% in both groups, whereas the CREC detection rate was below 6%. CRPA detection increased in patients with VAP, whereas CRKP and CRPA detection rates decreased in patients with NV-HAP. The antimicrobial resistance profiles of major pathogens were similar between the two groups.\n K.\u202fpneumoniae<\/jats:italic>\n and\n E.\u202fcoli<\/jats:italic>\n remained susceptible to most antimicrobials, whereas CRKP and CREC were susceptible to only a few agents, such as tigecycline and polymyxin B.\n A.\u202fbaumannii<\/jats:italic>\n exhibited high resistance rates, with both\n A.\u202fbaumannii<\/jats:italic>\n and CRAB being susceptible only to tigecycline, minocycline and polymyxin B.\n P.\u202faeruginosa<\/jats:italic>\n and CRPA were largely susceptible to most antimicrobials.\n S.\u202fmaltophilia<\/jats:italic>\n exhibited a ceftazidime resistance rate exceeding 36%, and\n B.\u202fcepacia<\/jats:italic>\n exhibited ticarcillin\/clavulanate and cefoperazone\/sulbactam resistance rates exceeding 67%. The resistance rates of\n S.\u202faureus<\/jats:italic>\n and MRSA to penicillin, erythromycin and clindamycin ranged from 41.83% to 98.72%. The resistance rates of\n C.\u202falbicans<\/jats:italic>\n to commonly used antifungal agents were below 8%.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The two groups differed in the distribution and antimicrobial resistance of the pathogens and MDROs, and these profiles fluctuated over time. Patients with VAP have a higher percentage of drug-resistant bacteria, requiring special attention to CRAB and CRPA. Local microbiological epidemiological surveillance should be strengthened to improve infection prevention, control strategies and guide empirical antibiotic therapy.<\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-116593","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T11:56:28Z","timestamp":1785844588000},"page":"e116593","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Differences and trends in pathogens between ventilator-associated pneumonia and non-ventilator-associated pneumonia: data from 61 hospitals in Suzhou, China, 2020\u20132024"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3869-4653","authenticated-orcid":false,"given":"Jiajia","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Infection Management, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaochao","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Infection Management, The First Affiliated Hospital of Soochow University, Suzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Infection Management, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinling","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Infection Management, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, 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