{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:36:49Z","timestamp":1792093009638,"version":"4.4.0"},"reference-count":46,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>\n                    Hospital-acquired pneumonia is typically polymicrobial; nevertheless,\n                    <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                    is a principal causative pathogen, attributable to its link with poor clinical prognoses and extensive antimicrobial resistance. Our study aims to assess the prevalence, microbiological profiles and determinants of hospital-acquired pneumonia with a focus on antibiotic-resistant\n                    <jats:italic>P. aeruginosa<\/jats:italic>\n                    across three hospitals in Addis Ababa. A cross-sectional study was conducted in which 1,800 patients were screened, and 298 cases of hospital-acquired pneumonia were identified between September 2022 and April 2024. Patient interviews and microbiological analysis of lower respiratory tract samples were performed. We detected a 17% prevalence of hospital-acquired pneumonia and 19% prevalence of ventilator-associated pneumonia across the study hospitals. Our patient profiles indicated a predominance of males (59%), with the largest proportion aged 30\u201339 years (28%), most were married (71%) and had attained secondary-level education (33%). Over half of the patients were admitted to the adult ICU (55%), 60% had a history of prior hospitalization and respiratory disease was the leading cause of admission (30%).\n                    <jats:italic>Acinetobacter baumannii<\/jats:italic>\n                    (n\u2009=\u200924) was the most frequently isolated pathogen, followed by\n                    <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                    (n\u2009=\u200921) and\n                    <jats:italic>Staphylococcus aureus<\/jats:italic>\n                    (n\u2009=\u200913). Compounding these challenges, the\n                    <jats:italic>P. aeruginosa<\/jats:italic>\n                    isolates (7%) exhibited high resistance to ceftazidime and cefepime (89% resistance), while retaining relatively high susceptibility to amikacin (90%); notably, 67% of the isolates were multidrug resistant. We tested several patient-level vulnerabilities, only aspiration remained independently associated with presence of pneumonia-associated pathogen in patient samples (AOR\u2009=\u20094.43, 95% CI: 1.74\u201311.24, p\u2009=\u20090.002). This study demonstrates a substantial burden of multidrug resistance hospital-acquired pneumonia by ESKAPE pathogens that indicate deficiencies in hospital defences against hospital-acquired pathogens and risk of adverse patient outcomes. There is an urgent need to shift infection prevention strategies, emphasizing aspiration prevention measures and strengthened diagnostic stewardship.\n                  <\/jats:p>","DOI":"10.1371\/journal.pone.0340680","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T18:24:57Z","timestamp":1768933497000},"page":"e0340680","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Prevalence, microbiological profiles, and determinants of hospital-acquired pneumonia in Addis Ababa: A focus on Pseudomonas aeruginosa and its antimicrobial resistance patterns in three hospitals"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6740-4362","authenticated-orcid":true,"given":"Etsub Brhanesilassie","family":"Hailemichael","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6431-7363","authenticated-orcid":true,"given":"Adey Feleke","family":"Desta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Girma","family":"Taye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sirak Robele","family":"Gari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etsehiwot","family":"Adamu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeleke","family":"Ayenew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wondwossen","family":"Amogne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"issue":"18","key":"pone.0340680.ref001","doi-asserted-by":"crossref","first-page":"2117","DOI":"10.1007\/s40265-021-01635-6","article-title":"The Epidemiology and Pathogenesis and Treatment of Pseudomonas aeruginosa Infections: An Update","volume":"81","author":"D Reynolds","year":"2021","journal-title":"Drugs"},{"issue":"1","key":"pone.0340680.ref002","article-title":"Investigating patient outcomes and 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