{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:36:48Z","timestamp":1792093008198,"version":"4.4.0"},"reference-count":48,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,22]],"date-time":"2026-02-22T00:00:00Z","timestamp":1771718400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background\/Objectives: Severe respiratory infections remain a major cause of morbidity and mortality in critically ill patients admitted to an intensive care unit (ICU), particularly in the context of increasing antimicrobial resistance (AMR). This study aimed to describe the clinical, microbiological and resistance profiles of ICU patients diagnosed with hospital-acquired or ventilator-associated pneumonia. Methods: We conducted a retrospective, single-center observational study including adult ICU patients admitted between January and December 2025, with clinically significant positive endotracheal aspirates. Clinical severity scores (APACHE II, SOFA, SOFA-2), inflammatory biomarkers (neutrophil-to-lymphocyte ratio\u2014NLR, platelets-to-lymphocyte ratio\u2014PLR, C-reactive protein\u2014CRP), microbiological findings, antimicrobial resistance patterns and ICU-related outcomes were analyzed. Results: Out of the 606 endotracheal aspirates collected, 76 (12.5%) were culture-positive and 62 (10.2%) patients met the final inclusion criteria. Ventilator-associated pneumonia accounted for 90% of infections, 25 episodes (44.6%) being classified as early-onset and 31 cases (55.4%) as late-onset, without significant differences in bacterial distribution between the two subtypes. In total, 85.5% of infections were monomicrobial, with Gram-negative bacteria representing 76% of isolates. Acinetobacter baumannii and Pseudomonas aeruginosa were the most frequently isolated pathogens, with high resistance rates. Acute kidney injury occurred in 25.8% of patients and was associated with higher APACHE II, SOFA, and SOFA-2 scores. Conclusions: Severe respiratory infections in critically ill patients were predominantly caused by Gram-negative, frequently drug-resistant pathogens and were associated with high disease severity and poor outcomes. These findings provide insight into the local epidemiology and antimicrobial resistance patterns of severe respiratory infections in critically ill patients.<\/jats:p>","DOI":"10.3390\/antibiotics15020232","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T10:00:52Z","timestamp":1771840852000},"page":"232","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Clinical and Microbiological Profile of Hospital-Acquired and Ventilator-Associated Pneumonia in Critically Ill Patients: A Retrospective Observational Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4299-0465","authenticated-orcid":false,"given":"Mihnea","family":"Miron","sequence":"first","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0622-8068","authenticated-orcid":false,"given":"Anca","family":"Ristescu","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"},{"name":"Anesthesiology and Intensive Care Unit, Regional Institute of Oncology, 700483 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihaela","family":"Blaj","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"},{"name":"Anesthesiology and Intensive Care Unit, \u201cSf. Spiridon\u201d County University Emergency Hospital, 700111 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Iosep","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5249-4562","authenticated-orcid":false,"given":"Alexandru-Florinel","family":"Oancea","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Iosep","sequence":"additional","affiliation":[{"name":"Anesthesiology and Intensive Care Unit, Clinical Hospital of Pneumology, 700115 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3732-0350","authenticated-orcid":false,"given":"Radu","family":"Cri\u0219an-Dabija","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"},{"name":"Pulmonology Department, Clinical Hospital of Pneumology, 700115 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Diculencu","sequence":"additional","affiliation":[{"name":"Medical Analysis Laboratory, Clinical Hospital of Pneumology, 700115 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1510-3398","authenticated-orcid":false,"given":"Costin","family":"Damian","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"},{"name":"Medical Analysis Laboratory, Clinical Hospital of Pneumology, 700115 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4694-9177","authenticated-orcid":false,"given":"Mihaela","family":"Luca","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy, 700115 Ia\u0219i, Romania"},{"name":"Clinic of Infectious Diseases, \u201cSf. Parascheva\u201d Clinical Hospital of Infectious Diseases, 700116 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1700582","DOI":"10.1183\/13993003.00582-2017","article-title":"International ERS\/ESICM\/ESCMID\/ALAT guidelines for the management of hospital-acquired pneumonia and ventilator-associated pneumonia: Guidelines for the Management of Hospital-Acquired Pneumonia (HAP)\/Ventilator-Associated Pneumonia (VAP) of the European Respiratory Society (ERS), European Society of Intensive Care Medicine (ESICM), European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and Asociaci\u00f3n Latinoamericana del T\u00f3rax (ALAT)","volume":"50","author":"Torres","year":"2017","journal-title":"Eur. Respir. 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