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Background <p>Pulmonary infections remain a major cause of global morbidity and mortality, particularly in low- and middle-income countries (LMICs). The rapid emergence of antimicrobial resistance (AMR) has significantly limited therapeutic options and increased healthcare burden. This study aimed to investigate the bacterial profile and AMR patterns among patients with confirmed pulmonary infections at a tertiary referral hospital in Mongolia, where data from tertiary care settings and internationally disseminated studies on AMR are still scarce, especially in the context of pulmonary infections.</p> Methods <p>A retrospective descriptive study was conducted among patients with pulmonary disorders who submitted respiratory specimens for microbiological analysis at Mongolia–Japan Hospital, Ulaanbaatar, between 2023 and 2024. Data were extracted from the electronic medical record (EMR) system. To avoid duplication bias, only the first bacterial isolate recovered from each patient during a single hospitalization episode was included in the analysis. Antimicrobial resistance phenotypes were classified as multidrug-resistant (MDR), extensively drug-resistant (XDR), or pandrug-resistant (PDR) based on the Centers for Disease Control and Prevention (CDC) and the European Centre for Disease Prevention and Control (ECDC) criteria. Clinical characteristics, bacterial profiles, antimicrobial resistance patterns, and clinical outcomes were analyzed.</p> Results <p>A total of 354 patients were included, of whom 276/354 (78.0%) had an identified bacterial pathogen. The most frequently isolated organisms were <i>Klebsiella pneumoniae</i> 100/276 (36.2%), <i>Acinetobacter baumannii</i> 47/276 (17.0%), methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) 30/276 (10.9%), and <i>Pseudomonas aeruginosa</i> 17/276 (6.2%). Multidrug resistance was observed in 22/30 (73.3%) of MRSA isolates, while 15/47 (31.9%) of <i>Acinetobacter baumannii</i> isolates were classified as PDR. Patients with cardiovascular disease were significantly more likely to harbor MDR isolates (cOR: 2.669; 95% CI: 1.048–6.796). All-cause hospital mortality was higher among culture-positive than culture-negative patients (21/112 [18.8%] vs. 1/34 [2.9%], <i>p</i> = 0.024).</p> Conclusions <p>Gram-negative pathogens, particularly <i>Klebsiella pneumoniae</i> and <i>Acinetobacter baumannii</i>, predominated in pulmonary infections and demonstrated substantial AMR. The high burden of MDR/XDR pathogens highlights major therapeutic challenges and underscores the need for enhanced infection control, antimicrobial stewardship, and ongoing resistance surveillance.</p>

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Bacterial profile and antimicrobial resistance in patients with pulmonary infection: a retrospective tertiary hospital-based study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月1日

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  • Jargaltulga Ulziijargal,
  • Ekaterina Faermark,
  • Usukhbayar Khenchbish,
  • Tilyekbyergyen Bauyrjan,
  • Amgalanzaya Erdenebaatar,
  • Laila Jukhai,
  • Zesemdorj Otgon-Uul,
  • Ichinnorov Dashtseren

摘要

Background

Pulmonary infections remain a major cause of global morbidity and mortality, particularly in low- and middle-income countries (LMICs). The rapid emergence of antimicrobial resistance (AMR) has significantly limited therapeutic options and increased healthcare burden. This study aimed to investigate the bacterial profile and AMR patterns among patients with confirmed pulmonary infections at a tertiary referral hospital in Mongolia, where data from tertiary care settings and internationally disseminated studies on AMR are still scarce, especially in the context of pulmonary infections.

Methods

A retrospective descriptive study was conducted among patients with pulmonary disorders who submitted respiratory specimens for microbiological analysis at Mongolia–Japan Hospital, Ulaanbaatar, between 2023 and 2024. Data were extracted from the electronic medical record (EMR) system. To avoid duplication bias, only the first bacterial isolate recovered from each patient during a single hospitalization episode was included in the analysis. Antimicrobial resistance phenotypes were classified as multidrug-resistant (MDR), extensively drug-resistant (XDR), or pandrug-resistant (PDR) based on the Centers for Disease Control and Prevention (CDC) and the European Centre for Disease Prevention and Control (ECDC) criteria. Clinical characteristics, bacterial profiles, antimicrobial resistance patterns, and clinical outcomes were analyzed.

Results

A total of 354 patients were included, of whom 276/354 (78.0%) had an identified bacterial pathogen. The most frequently isolated organisms were Klebsiella pneumoniae 100/276 (36.2%), Acinetobacter baumannii 47/276 (17.0%), methicillin-resistant Staphylococcus aureus (MRSA) 30/276 (10.9%), and Pseudomonas aeruginosa 17/276 (6.2%). Multidrug resistance was observed in 22/30 (73.3%) of MRSA isolates, while 15/47 (31.9%) of Acinetobacter baumannii isolates were classified as PDR. Patients with cardiovascular disease were significantly more likely to harbor MDR isolates (cOR: 2.669; 95% CI: 1.048–6.796). All-cause hospital mortality was higher among culture-positive than culture-negative patients (21/112 [18.8%] vs. 1/34 [2.9%], p = 0.024).

Conclusions

Gram-negative pathogens, particularly Klebsiella pneumoniae and Acinetobacter baumannii, predominated in pulmonary infections and demonstrated substantial AMR. The high burden of MDR/XDR pathogens highlights major therapeutic challenges and underscores the need for enhanced infection control, antimicrobial stewardship, and ongoing resistance surveillance.