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Microbial Etiology and Antimicrobial Resistance in Pneumonia Among Hospitalized Patients in Kazakhstan: A Systematic

Radmir Sarsenov¹, Maxim Solomadin², Alyona Lavrinenko³

¹Department of Biology, School of Sciences and Humanities Nazarbayev University Astana Kazakhstan.

Health Science Reports

|April 20, 2026

Abstract

Background And Aims:

Pneumonia is an inflammatory condition of the lower respiratory tract, commonly caused by infection and associated with substantial morbidity and healthcare utilization. The burden of pneumonia on healthcare is exacerbated by limited data on pathogenic causes and associated antimicrobial resistance (AMR). Here, we conducted a literature review and synthesized data on the microbial causes and AMR in hospitalized pneumonia patients from Kazakhstan.

Methods:

We searched PubMed, Medline, Embase, Web of Science, the Cochrane Central Register of Controlled Trials, eLIBRARY, and CyberLeninka for observational studies of hospitalized pneumonia patients reporting microbiologically confirmed pathogen and antimicrobial resistance data from Kazakhstan. Exclusion criteria were unclear pneumonia definitions or absence of pathogen-specific AMR data. We assessed study quality using the Joanna Briggs Institute checklist and extracted data on microbial prevalence and resistance rates by pathogen-antibiotic combinations. We synthesized microbial etiology and AMR patterns and performed random-effects meta-analysis of prevalence data.

Results:

Nine studies represented 1534 isolates from 1474 inpatients (2008-2022). The most prevalent pathogens were Streptococcus pneumoniae (17.8%), Streptococcus spp. (17.3%), Haemophilus influenzae (12.6%), and Klebsiella pneumoniae (10.7%). Hospital-acquired pathogens comprised 48% of isolates. Acinetobacter baumannii had the highest resistance, exceeding 70% across major antibiotic classes. Escherichia coli had high resistance to β-lactams (> 66%) and fluoroquinolones (63%). Pseudomonas aeruginosa had 60% fluoroquinolone and 27% carbapenem resistance. Fluoroquinolone resistance was widespread across multiple pathogens. K. pneumoniae had relatively lower resistance rates. Pathogen distribution varied by clinical setting and patient population.

Conclusion:

Data on the etiologic causes and AMR in pneumonia are sparse in Kazakhstan and methodologically heterogeneous. Hospital-acquired pneumonia pathogens were highly prevalent and associated with high AMR rates. These findings underscore the need for improved pathogen surveillance and antimicrobial stewardship in Kazakhstan to address the high burden of antibiotic-resistant and hospital-acquired pneumonia.

Insights

Limited data exists on pneumonia causes and antimicrobial resistance (AMR) in Kazakhstan. Hospital-acquired pneumonia pathogens show high prevalence and resistance, necessitating improved surveillance and stewardship.

Area of Science:

Medical Microbiology
Infectious Diseases
Public Health

Background:

Pneumonia is a significant cause of morbidity and healthcare use.
Limited data on microbial causes and antimicrobial resistance (AMR) in Kazakhstan exacerbates the burden of pneumonia.
This study addresses the data gap by reviewing microbial etiology and AMR in hospitalized pneumonia patients in Kazakhstan.

Purpose of the Study:

To synthesize available data on microbial causes of pneumonia in Kazakhstan.
To determine antimicrobial resistance patterns of common pneumonia pathogens in Kazakhstan.
To inform strategies for combating antibiotic-resistant pneumonia.

Main Methods:

A comprehensive literature search was conducted across multiple databases (PubMed, Embase, Web of Science, etc.).
Included observational studies reporting microbiologically confirmed pathogens and AMR data from hospitalized pneumonia patients in Kazakhstan.
Data on microbial prevalence and resistance rates were extracted and synthesized, including random-effects meta-analysis for prevalence data.

Main Results:

Nine studies analyzed 1534 isolates from 1474 inpatients (2008-2022).
Key pathogens included *Streptococcus pneumoniae*, *Streptococcus* spp., *Haemophilus influenzae*, and *Klebsiella pneumoniae*.
High resistance rates were observed, particularly *Acinetobacter baumannii* (>70% across classes), *Escherichia coli* (> 66% to β-lactams), and *Pseudomonas aeruginosa* (60% fluoroquinolone resistance). Hospital-acquired pathogens constituted 48% of isolates.

Conclusions:

Data on pneumonia etiology and AMR in Kazakhstan are sparse and heterogeneous.
Hospital-acquired pneumonia pathogens are prevalent and exhibit high antimicrobial resistance.
Enhanced pathogen surveillance and antimicrobial stewardship are crucial for managing pneumonia in Kazakhstan.

Read full analysis

Keywords:

ESKAPE pathogens antimicrobial resistance community‐acquired pneumonia hospital‐acquired infections pneumonia prevalence meta‐analysis

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