{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T15:03:57Z","timestamp":1784127837196,"version":"3.55.0"},"reference-count":63,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      Ventilator-associated pneumonia (VAP) caused by\n                      <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                      poses a major therapeutic challenge for critically ill infants and young children.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this study, we assessed the antimicrobial susceptibility profiles of 42\n                      <jats:italic>P. aeruginosa<\/jats:italic>\n                      isolates recovered from neonatal and paediatric intensive care unit (NICUs and PICU) patients with VAP between March and September 2021. Five isolates (11.9%) exhibited an extensively drug-resistant (XDR) phenotype and were resistant to both ceftazidime\u2013avibactam and ceftolozane\u2013tazobactam. These five isolates were subjected to whole-genome sequencing (WGS) and comparative genomic analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All five isolates belonged to serogroup O11 and sequence type ST773. Nevertheless, WGS-based phylogenetic analyses, such as core genome MLST and SNP-based phylogeny, showed that the isolates were non-clonal and had a closer genetic relationship to previously identified ST773 strains from Egypt and Germany. Several multidrug efflux systems and a broad range of acquired antimicrobial resistance genes, such as\n                      <jats:italic>bla<\/jats:italic>\n                      NDM-1,\n                      <jats:italic>rmtB4, tet(G)<\/jats:italic>\n                      , and\n                      <jats:italic>flor2<\/jats:italic>\n                      , carried on a conserved integrative conjugative element previously reported in ST773, were found by genomic analysis. Furthermore, on a genomic island inserted downstream of the\n                      <jats:italic>glmS<\/jats:italic>\n                      gene, a class 1 integron containing\n                      <jats:italic>qnrVC1, aadA11, qacE\u03941<\/jats:italic>\n                      , and\n                      <jats:italic>sul1<\/jats:italic>\n                      was found. All strains possessed the same quinolone resistance-determining region alterations (\n                      <jats:italic>gyrA<\/jats:italic>\n                      T83I and\n                      <jats:italic>parC<\/jats:italic>\n                      S87L) and the same array of virulence-associated genes linked to motility, secretion systems, iron acquisition, quorum sensing, and toxin production.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>\n                      This study reports the identification of non-clonal, XDR\n                      <jats:italic>P. aeruginosa<\/jats:italic>\n                      ST773 isolates associated with VAP in critically ill infants and young children. Despite their non-clonal nature, the isolates shared key features, including mobile genetic elements carrying important resistance genes and a consistent virulence gene profile. These findings highlight the clinical significance of this sequence type and raise concerns about its potential impact in the NICU and PICU settings. Continuous genomic surveillance, along with improved antimicrobial stewardship and stricter infection control practices, remains essential to limit its spread.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1870600","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T04:25:35Z","timestamp":1783657535000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Whole genome sequencing of ceftolozane\/tazobactam-resistant, XDR Pseudomonas aeruginosa ST773 in hospitalized critically ill infants and young children with ventilator-associated pneumonia"],"prefix":"10.3389","volume":"16","author":[{"given":"Samira M.","family":"Hamed","sequence":"first","affiliation":[{"name":"Department of Microbiology and Immunology, Faculty of Pharmacy, October University for Modern Sciences and Arts (MSA)","place":["Giza, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amira F.A.","family":"Hussein","sequence":"additional","affiliation":[{"name":"Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University","place":["Cairo, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moshira H.","family":"Ezz El Arab","sequence":"additional","affiliation":[{"name":"Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University","place":["Cairo, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed H.","family":"Al-Agamy","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutics, College of Pharmacy, King Saud University","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Aufy","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences, Division of Pharmacology and Toxicology, University of Vienna","place":["Vienna, Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Abdelmoteleb","sequence":"additional","affiliation":[{"name":"Botany Department, Faculty of Science, Mansoura University","place":["Mansoura, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mai M.","family":"Zafer","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Faculty of Pharmacy, Ahram Canadian University","place":["Cairo, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiph.2025.103118","article-title":"Molecular and bacteriological characterization of colistin and carbapenem-resistant nosocomial isolates of Acinetobacter baumannii isolated from different Iraqi hospitals","volume":"19","author":"Abbas","year":"2026","journal-title":"J. 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