23 DOI: https://doi.org/10.1016/j.jgeb.2026.100802 English eng Yomna Rabie Elsherif Contributor <div class="abstract author" id="as0005" style="margin: 0px 0px 8px; padding: 0px; color: rgb(31, 31, 31); font-family: ElsevierGulliver, Georgia, "Times New Roman", Times, STIXGeneral, "Cambria Math", "Lucida Sans Unicode", "Microsoft Sans Serif", "Segoe UI Symbol", "Arial Unicode MS", serif, sans-serif; font-size: 16px;"><h3 class="u-h4 u-margin-m-top u-margin-xs-bottom" id="st0010" style="margin-right: 0px; margin-left: 0px; padding: 0px; margin-top: 24px !important; margin-bottom: 8px !important; font-size: 20px !important; line-height: 30px !important;">Background</h3><div class="u-margin-s-bottom" id="sp0030" style="margin-top: 0px; margin-right: 0px; margin-left: 0px; padding: 0px; margin-bottom: 16px !important;">Bacterial pneumonia is one of the most serious diseases worldwide. The emergence of antimicrobial resistance (AMR) magnifies its threat. Diagnosis of pneumonia is hampered by multiple causative pathogens and similar symptoms. Despite global concern, resistant strains are expand<strong style="margin: 0px; padding: 0px;">ing with a</strong> remarkable surveillance gap, especially in low- and middle-income countries <strong style="margin: 0px; padding: 0px;">(</strong>LMICs).</div></div><div class="abstract author" id="as0010" style="margin: 0px 0px 8px; padding: 0px; color: rgb(31, 31, 31); font-family: ElsevierGulliver, Georgia, "Times New Roman", Times, STIXGeneral, "Cambria Math", "Lucida Sans Unicode", "Microsoft Sans Serif", "Segoe UI Symbol", "Arial Unicode MS", serif, sans-serif; font-size: 16px;"><h3 class="u-h4 u-margin-m-top u-margin-xs-bottom" id="st0015" style="margin-right: 0px; margin-left: 0px; padding: 0px; margin-top: 24px !important; margin-bottom: 8px !important; font-size: 20px !important; line-height: 30px !important;">Aims</h3><div class="u-margin-s-bottom" id="sp0035" style="margin-top: 0px; margin-right: 0px; margin-left: 0px; padding: 0px; margin-bottom: 16px !important;">1) Highlighting the prevalence, diagnostic approaches, and therapeutic guidelines of <em style="margin: 0px; padding: 0px;">Klebsiella pneumoniae</em>, <em style="margin: 0px; padding: 0px;">Pseudomonas aeruginosa</em>, and <em style="margin: 0px; padding: 0px;">Staphylococcus aureus</em> as key pneumonia-causing bacteria, and 2) addressing factors that impede effective surveillance.</div></div><div class="abstract author" id="as0015" style="margin: 0px 0px 8px; padding: 0px; color: rgb(31, 31, 31); font-family: ElsevierGulliver, Georgia, "Times New Roman", Times, STIXGeneral, "Cambria Math", "Lucida Sans Unicode", "Microsoft Sans Serif", "Segoe UI Symbol", "Arial Unicode MS", serif, sans-serif; font-size: 16px;"><h3 class="u-h4 u-margin-m-top u-margin-xs-bottom" id="st0020" style="margin-right: 0px; margin-left: 0px; padding: 0px; margin-top: 24px !important; margin-bottom: 8px !important; font-size: 20px !important; line-height: 30px !important;">Methods</h3><div class="u-margin-s-bottom" id="sp0040" style="margin-top: 0px; margin-right: 0px; margin-left: 0px; padding: 0px; margin-bottom: 16px !important;">Relevant keywords were used in various databases. Results were filtered by time frame 2019-2025, followed by data selection using the Microsoft Excel application.</div></div><div class="abstract author" id="as0020" style="margin: 0px 0px 8px; padding: 0px; color: rgb(31, 31, 31); font-family: ElsevierGulliver, Georgia, "Times New Roman", Times, STIXGeneral, "Cambria Math", "Lucida Sans Unicode", "Microsoft Sans Serif", "Segoe UI Symbol", "Arial Unicode MS", serif, sans-serif; font-size: 16px;"><h3 class="u-h4 u-margin-m-top u-margin-xs-bottom" id="st0025" style="margin-right: 0px; margin-left: 0px; padding: 0px; margin-top: 24px !important; margin-bottom: 8px !important; font-size: 20px !important; line-height: 30px !important;">Results</h3><div class="u-margin-s-bottom" id="sp0045" style="margin-top: 0px; margin-right: 0px; margin-left: 0px; padding: 0px; margin-bottom: 16px !important;">We summarized data from 161 publications, including 97 original papers, 48 reviews, 9 official websites, 6 guidelines, and 1 book chapter dealing with bacterial-hospital-, community-acquired pneumonia (HAP, CAP), and AMR. Exemplifying Egypt as a representative LMIC, the majority of isolates showed high resistance to β-lactams and aminoglycosides, while colistin was the most effective antibiotic. PCR results highlighted the high emergence of β-lactams- (ESBL) and carbapenem-resistance (CR) genes, especially the <em style="margin: 0px; padding: 0px;">bla</em><span style="margin: 0px; padding: 0px; font-size: 12px; line-height: 0; position: relative; vertical-align: baseline; bottom: -0.25em;"><em style="margin: 0px; padding: 0px;">OXA-48</em></span><em style="margin: 0px; padding: 0px;">, bla</em><span style="margin: 0px; padding: 0px; font-size: 12px; line-height: 0; position: relative; vertical-align: baseline; bottom: -0.25em;"><em style="margin: 0px; padding: 0px;">NDM</em></span><em style="margin: 0px; padding: 0px;">, bla</em><span style="margin: 0px; padding: 0px; font-size: 12px; line-height: 0; position: relative; vertical-align: baseline; bottom: -0.25em;"><em style="margin: 0px; padding: 0px;">VIM</em></span><em style="margin: 0px; padding: 0px;">,</em> and <em style="margin: 0px; padding: 0px;">CTX-M15</em> among Egyptian isolates. The co-existence of CR with triple-, quadrable-, or more-ESBL resistance genes was reported in Egyptian <em style="margin: 0px; padding: 0px;">K. pneumonia isolates</em>. For <em style="margin: 0px; padding: 0px;">P. aeruginosa</em>, combination of both <em style="margin: 0px; padding: 0px;">bla</em><span style="margin: 0px; padding: 0px; font-size: 12px; line-height: 0; position: relative; vertical-align: baseline; bottom: -0.25em;"><em style="margin: 0px; padding: 0px;">NDM-1</em></span> and <em style="margin: 0px; padding: 0px;">bla</em><span style="margin: 0px; padding: 0px; font-size: 12px; line-height: 0; position: relative; vertical-align: baseline; bottom: -0.25em;"><em style="margin: 0px; padding: 0px;">VIM-1</em></span> resistance genes or ESBL and metallo-β-lactamase (MBL) genes were reported in doublet or triplet in only one Egyptian isolate. Virulence genes were detected in both <em style="margin: 0px; padding: 0px;">S. aureus</em> and <em style="margin: 0px; padding: 0px;">P. aeruginosa</em> Egyptian isolates, while only one <em style="margin: 0px; padding: 0px;">K. pneumoniae</em> was found co-harboring both AMR and virulence genes.</div></div><div class="abstract author" id="as0025" style="margin: 0px 0px 8px; padding: 0px; color: rgb(31, 31, 31); font-family: ElsevierGulliver, Georgia, "Times New Roman", Times, STIXGeneral, "Cambria Math", "Lucida Sans Unicode", "Microsoft Sans Serif", "Segoe UI Symbol", "Arial Unicode MS", serif, sans-serif; font-size: 16px;"><h3 class="u-h4 u-margin-m-top u-margin-xs-bottom" id="st0030" style="margin-right: 0px; margin-left: 0px; padding: 0px; margin-top: 24px !important; margin-bottom: 8px !important; font-size: 20px !important; line-height: 30px !important;">Conclusions</h3><div class="u-margin-s-bottom" id="sp0050" style="margin-top: 0px; margin-right: 0px; margin-left: 0px; padding: 0px; margin-bottom: 16px !important;">1) Inappropriate use of antibiotics, maternal awareness/educational background and population's socio-cultural level play a significant role in AMR strains' spread, 2) Limited laboratory tools/infrastructure and healthcare facilities limit AMR strains' surveillance, and 3) Frequent updating national/global control plans is needed.</div></div> Elsevier September 2026 pdf Journal of Genetic Engineering and Biotechnology Antimicrobial resistance in three pneumonia-causing bacterial species: the global, regional, and local state of the art mixed material Elsevier