Distribution of Isolated Pathogens and Resistance Patterns in Non-Ventilator Hospital-Acquired Pneumonia at King Hamad University Hospital (KHUH), Bahrain: A Retrospective Study
Abstract
Background Non-ventilator hospital-acquired pneumonia (NV-HAP), defined as pneumonia developing ≥48 hours after admission in non-intubated patients, is increasingly recognized as a major contributor to hospital morbidity and mortality but remains under-studied compared with ventilator-associated pneumonia (VAP), particularly in the Gulf region. In Bahrain, published NV-HAP data are absent, limiting locally informed empiric therapy and antimicrobial stewardship. This study aimed to characterize bacterial pathogens causing culture-confirmed NV-HAP in adults at a tertiary center in Bahrain and to describe antimicrobial resistance patterns and temporal resistance trends. Materials and methods A retrospective cross-sectional study was conducted at King Hamad University Hospital (KHUH), Bahrain. Adult patients (≥18 years) with clinically and radiographically confirmed NV-HAP and positive sputum or bronchoalveolar lavage (BAL) cultures between January 2017 and March 2022 were included. NV-HAP required onset ≥48 hours after admission in non-intubated patients. Exclusion criteria included VAP, non-bacterial infections, prior antimicrobial therapy, restricted clinical trials, and immunocompromising conditions. ICD-10 code U69.01 was used for case identification, followed by manual chart review to confirm NV-HAP. Culture thresholds were >10⁴-10⁵ CFU/mL for sputum and >10³-10⁴ CFU/mL for BAL. Organism identification used MALDI-TOF, and susceptibility testing used the BD Phoenix M50…
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