{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T17:13:29Z","timestamp":1791047609783,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"vor","delay-in-days":331,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100007613","name":"Majmaah University","doi-asserted-by":"publisher","award":["R-2025-2090"],"award-info":[{"award-number":["R-2025-2090"]}],"id":[{"id":"10.13039\/501100007613","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BioMed Research International"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hospital\u2010acquired pneumonia (HAP), including ventilator\u2010associated pneumonia (VAP), is a leading cause of morbidity and mortality in intensive care units (ICUs). Local, organism\u2010specific antimicrobial resistance data are critical to guide empiric therapy and strengthen antimicrobial stewardship efforts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of this study is to describe the spectrum of Gram\u2010negative bacilli (GNB) responsible for ICU\u2010acquired lower respiratory tract infections (LRTIs) in a Saudi general hospital and to characterize their antimicrobial resistance profiles, including multidrug\u2010resistant (MDR), extensively drug\u2010resistant (XDR), and pandrug\u2010resistant (PDR) patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 271 nonduplicate GNB isolates recovered from ICU respiratory specimens (sputum, tracheal aspirates, and throat swabs) collected between 2020 and 2022. Demographic characteristics, specimen distribution, bacterial species, and antimicrobial susceptibility patterns were summarized. MDR, XDR, and PDR classifications were determined according to standard phenotypic criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 271 specimens, 126 (46%) were sputum, 108 (40%) were tracheal aspirates, and 37 (14%) were throat swabs. Patients were 52% male (141\/271) and 48% female (130\/271), with 56% aged &gt;\u200965 years. Twenty\u2010three GNB species were identified; the predominant pathogens were\n                      <jats:italic>Klebsiella<\/jats:italic>\n                      spp. (92\/271, 34.0%),\n                      <jats:italic>Pseudomonas<\/jats:italic>\n                      spp. (73\/271, 27.0%), and\n                      <jats:italic>Acinetobacter<\/jats:italic>\n                      spp. (32\/271, 12%). Enterobacteriaceae accounted for 130 isolates (48.0%), while non\u2010Enterobacteriaceae comprised 141 (52.0%). There were statistically significant (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.016) differences between the three most common organisms (\n                      <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                      ,\n                      <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                      , and\n                      <jats:italic>Acinetobacter baumannii<\/jats:italic>\n                      complex). Antimicrobial susceptibility testing revealed extensive resistance patterns across the major isolates.\n                      <jats:italic>Pseudomonas<\/jats:italic>\n                      spp. demonstrated very high resistance to cephalosporins (&gt;\u200995%), with lower resistance observed to amikacin (43%).\n                      <jats:italic>Acinetobacter<\/jats:italic>\n                      spp. showed the most alarming profile, with nearly universal resistance to\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2010lactams and carbapenems (&gt;\u200990%), although colistin retained complete activity (0% resistance). In contrast,\n                      <jats:italic>Klebsiella<\/jats:italic>\n                      spp. exhibited high resistance to third\u2010generation cephalosporins (86%\u201393%) and carbapenems (70%\u201377%) while maintaining moderate susceptibility to amikacin (45%) and tigecycline (36%). These findings demonstrate a substantial burden of MDR among ICU GNB isolates, with colistin emerging as the only consistently effective therapeutic option.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      ICU cohort is dominated by a limited number of highly resistant GNB led by\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      ,\n                      <jats:italic>P. aeruginosa<\/jats:italic>\n                      , and\n                      <jats:italic>A. baumannii<\/jats:italic>\n                      . The cohort predominantly affects older adults (&gt;\u200960 years), and the breadth of MDR\/XDR\/PDR underscores the urgency of rigorous antimicrobial stewardship, infection prevention, and rapid diagnostics to optimize empiric therapy.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/bmri\/5283526","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T16:15:34Z","timestamp":1764346534000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Incidence and Antibiotic Susceptibility of Gram\u2010Negative Bacteria Associated With Chest Infections in Intensive Care Unit Patients From a Selected Hospital in the Kingdom of Saudi Arabia"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-4231-163X","authenticated-orcid":false,"given":"Afrah","family":"Almouwlid","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6446-5522","authenticated-orcid":false,"given":"Kamal","family":"Albenasy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2574-7800","authenticated-orcid":false,"given":"Yasser","family":"Kamel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8092-6086","authenticated-orcid":false,"given":"Abdelrahman","family":"Abdelmoktader","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6161-3834","authenticated-orcid":false,"given":"Mohammed","family":"Alaidarous","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9603-6478","authenticated-orcid":false,"given":"Ahmed","family":"Abdel-Hadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,28]]},"reference":[{"key":"e_1_2_13_1_2","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms12010213"},{"key":"e_1_2_13_2_2","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics13040375"},{"key":"e_1_2_13_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-020-05980-0"},{"key":"e_1_2_13_4_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1376513"},{"key":"e_1_2_13_5_2","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics14070700"},{"key":"e_1_2_13_6_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2024.1381511"},{"key":"e_1_2_13_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2011.03570.x"},{"key":"e_1_2_13_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.isci.2024.111367"},{"key":"e_1_2_13_9_2","doi-asserted-by":"publisher","DOI":"10.15537\/smj.2018.10.22944"},{"key":"e_1_2_13_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s43168-025-00435-w"},{"key":"e_1_2_13_11_2","volume-title":"MicroScan 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