Molecular Diagnostics, Antimicrobial Resistance, and Outcomes in Pneumonia: A Prospective Study from Jordan

Objectives: Pneumonia is associated with high morbidity, hospitalization, and mortality, with its etiology often unknown. Antimicrobial resistance (AMR) has grown in recent decades. This study aimed to investigate microbial isolates, antimicrobial susceptibility, and pneumonia outcomes. Methods: Adults aged ≥18 years hospitalized with pneumonia at a private hospital in Amman, Jordan, were prospectively included. Respiratory specimens were collected for culture and molecular testing, along with clinical data on antibiotic susceptibility and comorbidities. Results: The study included 111 participants with a mean age of 64·0 years (SD = 20·6), where 58·6% were male. Shortness of breath (54.1%) was the most common symptom, and hypertension (38.7%) was the most prevalent comorbidity. The majority of pneumonia cases were community-acquired (78.4%). Pathogen detection was higher with PCR (74.8%) than culture (57.7%), with PCR demonstrating greater sensitivity (96.9% vs. 86.3%, p=0.039). The mortality rate was 27%, with a significant association between non-guideline-concordant antibiotic use and poorer outcomes (p=0.023). Antimicrobial resistance (AMR) patterns showed significant variability. Conclusions: PCR offers superior sensitivity in pathogen detection, supporting better clinical decision-making and antimicrobial stewardship. The study highlights the need for national guidelines to address AMR variability in Jordan and advocates for a personalized approach to treatment.