Clinical Profile and Outcomes of Pseudomonas aeruginosa Infection at Maternity and Children Hospital, Buraydah, Qassim Region, Saudi Arabia

Background/Objectives: Pseudomonas aeruginosa is a major cause of healthcare-associated infections with increasing antimicrobial resistance. This study investigated its clinical characteristics, antimicrobial susceptibility patterns, and factors associated with in-hospital mortality. Materials and Methods: This single-center retrospective cohort study was conducted at Maternity and Children Hospital, Buraydah, Qassim Region, Saudi Arabia, from January 2022 to January 2025. Medical records of patients with clinically confirmed P. aeruginosa infection were reviewed. Demographic, clinical, microbiological, antimicrobial susceptibility, and outcome data were collected. Statistical analyses were performed using SPSS version 22 and R version 4.4.1. Results: Among 198 patients, 62.1% were children aged 1–10 years, and 24.7% were admitted to the neonatal intensive care unit (NICU)/neonatology ward. Respiratory tract infection was the most common diagnosis (22.7%). Among the tested isolates, susceptibility was highest to amikacin (170/182, 93.4%), gentamicin (142/159, 89.3%), piperacillin/tazobactam (155/183, 84.7%), cefepime (65/77, 84.4%), imipenem (146/176, 83.0%), meropenem (62/75, 82.7%), and ceftazidime (145/181, 80.1%). Agents with intrinsic resistance or limited/non-applicable activity against P. aeruginosa were not interpreted as evidence of acquired antimicrobial resistance. Firth multivariable logistic regression identified NICU/neonatology admission (adjusted odds ratio [AOR] = 7.16, 95% CI: 2.77–19.87; p < 0.001) and bloodstream infection (AOR = 13.20, 95% CI: 2.25–80.44; p = 0.005) as independent predictors of in-hospital mortality. Conclusions: Pseudomonas aeruginosa demonstrated substantial antimicrobial resistance, although several clinically relevant antipseudomonal agents, particularly amikacin, retained high activity. NICU/neonatology admission and bloodstream infection were associated with increased mortality, highlighting the importance of early recognition and continued local antimicrobial resistance surveillance.