Healthcare-Associated Infections with Pseudomonas spp. in a Neurosurgical Hospital: Epidemiological and Clinical Insights

Background and Objectives: Healthcare-associated infections (HAIs) caused by Pseudomonas aeruginosa represent a challenge for healthcare systems worldwide, with significant incidence, high mortality, and increasing antibiotic resistance. This paper aims to describe and analyze the epidemiology of HAI cases with Pseudomonas aeruginosa in a tertiary neurosurgical hospital in the northeastern region of Romania during 2020–2024. Materials and Methods: Study inclusion criteria were patients of any age (as the hospital also admits pediatric patients from the region) and a diagnosis of P. aeruginosa HAI, with a signed informed consent form by the adult patient or relatives for pediatric patients. Results: During 2020–2024, 163 cases of P. aeruginosa HAIs were identified. The annual incidence decreased from 4.41‰ in 2020 to 2.37‰ in 2024 (p = 0.0038). Most cases occurred in the intensive care unit (ICU) (119/163; 73.0%), followed by neurosurgery wards (37/163; 22.7%). Overall, 110 cases (67.5%) occurred in men and 53 (32.5%) in women. The analysis also showed a predominance of late-onset cases and the presence of antimicrobial-resistant phenotypes among the identified P. aeruginosa isolates. Conclusions: This study provides an integrated epidemiological characterization of P. aeruginosa HAIs in a regional neurosurgical hospital, highlighting the predominance of ICU-associated cases, late-onset infections, and antimicrobial-resistant phenotypes. These findings support the need for continued epidemiological surveillance and antimicrobial resistance monitoring in high-risk neurosurgical settings.