{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T03:18:18Z","timestamp":1783653498054,"version":"3.55.0"},"reference-count":37,"publisher":"Akademiai Kiado Zrt.","issue":"4","content-domain":{"domain":["akjournals.com"],"crossmark-restriction":true},"short-container-title":["AMicr"],"published-print":{"date-parts":[[2025,11,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    The distribution of antimicrobial resistance in major pathogens was analyzed in a tertiary care hospital of Lodhran, Pakistan. Altogether, 1910 patients diagnosed and treated at Shahida Islam Medical Complex Hospital from December 2023 to August 2025 were selected. The antimicrobial resistance of major bacterial and fungal pathogens was quantified, and logistic regression analysis was used to identify the risk factors for infection. Methicillin-resistant\n                    <jats:italic>Staphylococcus aureus<\/jats:italic>\n                    (MRSA) isolates retained susceptibility to\u00a0vancomycin (58.3%), while ceftazidime\/avibactam showed activity against\n                    <jats:italic>Escherichia coli<\/jats:italic>\n                    (80%),\n                    <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    (82%), and\n                    <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                    (78%). Vancomycin-resistant Enterococcus (VRE) demonstrated resistance to nearly all antibiotics. PCR confirmed TEM and SHV in 23\/51 (45%) of\n                    <jats:italic>E. coli<\/jats:italic>\n                    isolates, while in\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    TEM and SHV were each detected in 20\/35 (56%). Among\n                    <jats:italic>P.\u00a0aeruginosa<\/jats:italic>\n                    isolates, VIM, NDM, and OXA-48 were each present in 14\/37 (37%). The\n                    <jats:italic>mecA<\/jats:italic>\n                    was found in 47\/49 (95%) of\n                    <jats:italic>S. aureus<\/jats:italic>\n                    isolates (MRSA),\n                    <jats:italic>vanA<\/jats:italic>\n                    in 34\/49 (70%) of\n                    <jats:italic>S. aureus<\/jats:italic>\n                    (VRSA), and\n                    <jats:italic>vanA<\/jats:italic>\n                    in 34\/43 (80%) of\n                    <jats:italic>Enterococcus<\/jats:italic>\n                    isolates (VRE). MLST analysis of representative multidrug-resistant isolates identified ST131 (1\/3, 33%) among\n                    <jats:italic>E. coli<\/jats:italic>\n                    , ST11 (1\/3, 33%) and ST258 (1\/3, 33%) among\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    , ST175 (1\/3, 33%) and ST233 (1\/3, 33%) among\n                    <jats:italic>P. aeruginosa<\/jats:italic>\n                    , ST5 (1\/3, 33%) and ST22 (1\/3, 33%) among\n                    <jats:italic>S. aureus<\/jats:italic>\n                    , and ST17 (1\/3, 33%) among\n                    <jats:italic>Enterococcus<\/jats:italic>\n                    spp. PCA revealed distinct clustering of species, with Gram-negatives overlapping, Gram-positives forming separate groups, and fungi clustering independently. Logistic regression identified age \u226565, ICU admission, comorbidities, prior antibiotic exposure, invasive procedures, and immunosuppressive therapy as significant AMR risk factors, while infection control and stewardship reduced risk (\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.05). This study demonstrates a high burden of antimicrobial resistance, primarily mediated by TEM and SHV \u03b2-lactamases in\n                    <jats:italic>E. coli<\/jats:italic>\n                    and\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    , and by VIM, NDM, and OXA-48 carbapenemases in\n                    <jats:italic>P. aeruginosa<\/jats:italic>\n                    . Additionally, MRSA, VRSA, and VRE showed multidrug resistance. Effective infection control and antibiotic stewardship remain critical to limit the spread of resistant pathogens and to reduce hospital-acquired AMR risk.\n                  <\/jats:p>","DOI":"10.1556\/030.2025.02715","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T08:23:51Z","timestamp":1761207831000},"page":"350-360","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":1,"title":["Antimicrobial resistance in major bacterial and fungal pathogens in hospital-acquired infections from a tertiary care hospital in Lodhran, Pakistan"],"prefix":"10.1556","volume":"72","author":[{"given":"Aabid","family":"Nehvi","sequence":"first","affiliation":[{"name":"East and North Hertfordshire NHS TRUST, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0430-961X","authenticated-orcid":true,"given":"Sampana","family":"Fatima","sequence":"additional","affiliation":[{"name":"Shahida Islam Medical and Dental College, Lodhran, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7669-4802","authenticated-orcid":true,"given":"Abdullah","family":"Subhani","sequence":"additional","affiliation":[{"name":"Jinnah Hospital, Gujranwala, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohsin","family":"Iqbal","sequence":"additional","affiliation":[{"name":"East and North Hertfordshire NHS TRUST, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul Ghani","family":"Rahimoon","sequence":"additional","affiliation":[{"name":"Liaqat University of Medical and Health Sciences, Jamshoro, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Salman","sequence":"additional","affiliation":[{"name":"Guangdong Ocean University, Zhanjiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdelrhman H.","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Luxor University, Luxor, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"425","reference":[{"issue":"7","key":"B1","series-title":"Disease-a-Month","first-page":"422","article-title":"Nosocomial or hospital-acquired infections: an overview","volume":"55","author":"McFee RB","year":"2009 Jul","unstructured":"McFee RB. 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