ArticleFrontiers in medicine2026
Evaluation of factors affecting Pneumonia Severity Index and antibiotic resistance status in culture-proven bacterial pneumonia.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: The Pneumonia Severity Index (PSI) is a widely used to assess disease severity and guide hospitalization decisions in patients with pneumonia. However, PSI does not incorporate microbiological characteristics, antimicrobial resistance patterns, or immune-inflammatory biomarkers. This study aimed to evaluate the impact of comorbidities, etiological agents, antimicrobial resistance, and immune-inflammatory markers on PSI scores in patients with culture-proven bacterial pneumonia. Materials and methods: This retrospective study included patients with culture-proven bacterial pneumonia treated at a tertiary care center between January 2019 and April 2023. Demographic characteristics, comorbidities, intensive care unit (ICU) admission, etiological agents, antimicrobial resistance patterns, and multidrug resistance (MDR) status were analyzed. Laboratory parameters, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), C-reactive protein, and albumin levels were evaluated in relation to PSI scores. Results: Most patients were aged ≥65 years and had at least one comorbidity. Gram-negative bacteria predominated, with Conclusion: In culture-proven bacterial pneumonia, comorbidity burden, antimicrobial resistance-particularly multidrug resistance-and elevated immune-inflammatory biomarkers are associated with higher PSI scores. These findings highlight the importance of considering community-onset healthcare-associated pneumonia and integrating local antimicrobial resistance surveillance and laboratory biomarkers into clinical risk stratification. Further multicenter prospective studies are warranted to validate these associations.
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