Abrar K. Thabit

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.

Objectives: To conduct a Delphi process to inform an international, consensus definition of manuscript peer review. Design: Three-round Delphi consensus study including two surveys and one virtual consensus meeting. Peer review features identified through a prior scoping review were rated on a 5-point Likert scale in Rounds 1 and 2 and voted on using include, exclude, and abstain options in Round 3. Consensus was defined as _≥ 80% agreement. Setting: International experts representing interest holders affected by manuscript peer review across the fields of biomedical, health, and social sciences, economics, and healthcare-related industries. Participants: Round 1 participants were purposively recruited via email from corresponding authors of articles included in the preceding scoping review. Round 2 participants were those who completed Round 1. Round 3 participants were purposely selected to address gaps in representation from earlier rounds, with attention to diversity of perspectives and equity-relevant characteristics informed by PROGRESS-Plus (e.g., geographic location, gender, race/ethnicity, occupation, and socioeconomic context). Participants were required to communicate in English. Main outcome measures: Consensus on the terminology, scope, characteristics, functions, processes, and reviewer characteristics that should inform a definition of manuscript peer review. Results: Across the three rounds (N=143, 109, and 16 participants, respectively), 44 peer review features across six domains ( Characteristics, Function, Motivation, Assessment, Process, and Challenges ) and six peer reviewer characteristics met the consensus threshold for inclusion. Consensus was also reached on terminology to describe manuscript peer review and the peer review workflow. Results were synthesized into a final conceptualization of manuscript peer review, consisting of one definition and eight pillars.The consensus definition is: “Manuscript peer review is a structured process by which human reviewers assess scholarly manuscripts, with the aim of improving the quality and trustworthiness of published research in line with norms of reciprocity to the research community.” The eight pillars characterize manuscript peer review and are as follows: Principled, Constructive, Timely, Transparent, Professional, Quality, Confidential, and Pluralistic. Conclusions: This three-round international Delphi established a consensus-based, normative conceptualization of manuscript peer review as a distinct, human-led process to improve the quality and trustworthiness of scholarly research. The resulting definition and eight pillars may provide a shared foundation for research, evaluation, education, and improvement across publishing contexts while allowing operational features to remain adaptable.

Background Hybrid and gold open-access (OA) are common publishing models. The latter requires fees to allow full-text visibility, whereas hybrid journals offer the option to publish gold OA or for free (subscription-based) where users with access can get the full-text. We evaluated the association of the publishing model and other factors with medical journals’ impact. Methods A sample of hybrid and gold OA medical journals indexed in Web of Science (WOS) and Scopus were included. The association of the publishing model and other factors with journals’ impact factor (IF), CiteScore, quartile, and number of citations was assessed. Results A total of 402 journals were included, 201 in each group. Hybrid and gold OA journals had a median age of 32 and 21 years, respectively ( P 0.05). However, the gold OA model was not significantly associated with the Scopus Q1 ranking (OR, 0.52; 95% CI, 0.34-0.80), indicating that hybrid journals were more likely to have such a ranking. Conclusion These findings indicate that gold OA publishing does not result in higher impact or journal ranking. Therefore, authors can continue to submit their work to high impact hybrid journals if their interest is getting published in reputable prestigious journals regardless of their publishing model.

Background Hybrid and gold open-access (OA) are common publishing models. The latter requires fees to allow full-text visibility, whereas hybrid journals offer the option to publish gold OA or for free (subscription-based) where users with access can get the full-text. We evaluated the association of the publishing model and other factors with medical journals’ impact. Methods A sample of hybrid and gold OA medical journals indexed in Web of Science (WOS) and Scopus were included. The association of the publishing model and other factors with journals’ impact factor (IF), CiteScore, quartile, and number of citations was assessed. Results A total of 402 journals were included, 201 in each group. Hybrid and gold OA journals had a median age of 32 and 21 years, respectively ( P 0.05). However, the gold OA model was not significantly associated with the Scopus Q1 ranking (OR, 0.52; 95% CI, 0.34-0.80), indicating that hybrid journals were more likely to have such a ranking. Conclusion These findings indicate that gold OA publishing does not result in higher impact or journal ranking. Therefore, authors can continue to submit their work to high impact hybrid journals if their interest is getting published in reputable prestigious journals regardless of their publishing model.

The COVID-19 pandemic and the global lockdown have affected regular immunization uptake worldwide. Saudi Arabia’s vaccination program has a historically high coverage rate. However, the impact of the pandemic on vaccine-preventable diseases (VPDs) and parental attitudes toward childhood vaccination remains insufficiently explored in Saudi Arabia. We assessed changes in childhood VPDs rates in Saudi Arabia before and after the COVID-19 pandemic and the potential change in parental attitudes toward childhood vaccination after the pandemic. A mixed-methods design was employed. It involved analysis of epidemiological data from the Saudi Ministry of Health’s registry of childhood VPDs rates before and after the COVID-19 pandemic (from 2019 to 2023), and a cross-sectional study (between January-September 2024) via in-person interviews with parents of children aged 0-9 years in four major cities in Saudi Arabia. Vaccination coverage rates exceeded 96% for all significant childhood VPDs from 2019 to 2023. VPDs incidence remained low. However, a slight numerical increase in the incidence/100,000-population of rubella and hepatitis B infections was observed from 0.12 and 19.9 in 2019 to 0.54 and 22.72 in 2023, respectively. Among the 385 parents surveyed, 86.4% reported fully vaccinating their children, and 64.9% received vaccine information from primary care providers. No difference in VPD rates was observed between children who received all childhood vaccines, some of them, or none of them based on parental recall. However, the reports from the parents were subject to recall and social desirability biases. Most correlations between various factors and reasons for vaccine hesitancy were weak-to-negligible, with the highest correlation being reported between a history of pertussis infection before the COVID-19 pandemic with being influenced by advice from a family member/friend against vaccination ( r =0.22; P <0.0001). Most parents (83.8%) stated no change in their children’s vaccine routine since COVID-19. The vaccination program in Saudi Arabia proved resilient during the pandemic and maintained high vaccination coverage despite unprecedented global disruptions. After the pandemic, increases in some VPDs rates indicate that vigilance is necessary. The study emphasizes the need to continue addressing parental concerns about vaccine safety and to reinforce public health strategies to curtail disease resurgence.

Background: Urinary tract infections (UTIs) are among the most prevalent bacterial infections worldwide, with notable variations in antimicrobial resistance (AMR) patterns influenced by age and sex. Local surveillance of resistance trends is essential for optimizing empirical treatment. Methods: This retrospective study analyzed urine culture data collected over a span of 7-year (2017– 2023) from a tertiary hospital in Saudi Arabia. The distribution of Pathogens and patterns of AMR were examined based on sex, age group, and year. Logistic regression was used to assess predictors of resistance. Results: The analysis included 3,201 urinary isolates from patients with culture-confirmed UTIs. E.coli was the predominant pathogen in most years, reaching up to 47.5%, but noted a decline in 2020 to 22.7% and further to 22% in 2023. In contrast, K. pneumoniae exhibited steady increase, peaking at 43.1% in 2023. The prevalence of antibiotic resistance to E coli was notably higher among older males (> 19 years), with exception of nitrofurantoin in younger males and ampicillin, ciprofloxacin, and sulfamethoxazole-trimethoprim in younger females (≤ 18 years). In K. pneumoniae, younger males exhibited increased resistance to ampicillin, amoxicillin, and 3rd-generation cephalosporins, while females showed overall higher resistance levels, with the exception of ampicillin and nitrofurantoin, where younger females showed greater resistance. Male sex was significantly associated with resistance in E. coli to ampicillin (OR: 1.53, p=0.021), ciprofloxacin (OR: 1.47, p=0.026), imipenem (OR: 5.83, p=0.009), and in K. pneumoniae to gentamicin (OR: 1.85, p=0.001), ceftriaxone (OR: 2.44, p=0.008), ceftazidime (OR: 1.64, p=0.006), and imipenem (OR: 1.95, p=0.001). Age was inversely associated with imipenem resistance in E.coli (OR: 0.97, p=0.007). Conclusion: This study demonstrates significant variability in UTI pathogens and their resistance patterns based on sex and age. The findings support the need for targeted empirical treatment protocols and underscore the importance of ongoing monitoring of AMR. Plain Language Summary: Urinary tract infections (UTIs) are common and often treated with antibiotics. However, growing resistance to antibiotics makes treatment harder, especially when bacteria no longer respond to commonly used drugs. In this study, we analyzed 7 years of lab data from a large hospital in Saudi Arabia to understand which bacteria are causing UTIs and how resistant they are to antibiotics, especially among different age groups and between males and females. We found that E. coli and Klebsiella pneumoniae were the most common bacteria causing UTIs. Over time, Klebsiella infections increased and even became more common than E. coli in some years. Antibiotic resistance patterns were different depending on the patient’s age and sex. For example, older males had higher resistance to many antibiotics, while younger patients also showed resistance to certain drugs. We also found that male patients were more likely to have infections resistant to multiple antibiotics. These results show the importance of regularly monitoring local bacteria and their resistance to help doctors choose the right treatment. Understanding how resistance varies by age and sex can lead to more effective care and help reduce antibiotic misuse.

Background: Students of Doctor of Pharmacy (PharmD) programs are presented with several career choices upon graduation. Most studies cross-sectionally evaluated pharmacy students’ career interests, but no study has evaluated the changes throughout the PharmD program. The change in career interests of PharmD students was assessed from early to late in the program and the potential influencing factors. Methods: The study took place at one of the largest colleges of pharmacy in Saudi Arabia, Faculty of Pharmacy, King Abdulaziz University, Jeddah. In this biphasic cross-sectional study, the responses were collected from 2 batches in 2 stages: the 2nd year (pre-phase) and the last year (internship; post-phase). The students were prompted to take the Pharmacist Pathway survey of the American Pharmacists Association. In the post-phase, the students were also asked about the factors that may have influenced the survey results. Results: Of the 97 students who completed both phases of the study, only 29 (29.9%) had their career choice results in the post-phase matching their pre-phase results based on their overall responses. The most popular careers in the post-phase results were “clinical pharmacy specialist” (11.3%), “pharmaceutical company: sales and marketing” (11.3%), and “Academia: Clinical practice” (10.3%). A significant increase in the result “pharmaceutical company: sales and marketing” was observed from the pre- to the post-phase (1% vs. 11.3%; P = .003). The most influential factors for career choice were the internship year (86.6%), salary/financial incentives (39.2%), and pre-vious graduates’ experiences (35.1%). Conclusion: These results can be used by decision-makers in pharmacy colleges to take measures, such as enhancing the training experience by allowing training in different pharmacy sectors and inviting previous graduates to share their experiences. Cite this article as: Thabit AK, Abutaleb WA, Aljahdali HM, Organji DA, Bagalagel AA. Assessing the change in career choice of doctor of pharmacy students from second to sixth year and the influencing factors: A biphasic cross-sectional study from Saudi Arabia. Trends in Pharmacy, 2026, 3, 0010, doi: 10.5152/TrendsPharm.2026.25010.

Background: Enterococcus species are involved in urinary tract infections (UTIs), and they are known to be intrinsically resistant to certain antibiotics. We aimed to investigate the clinical characteristics and treatment outcomes of enterococcal UTIs in three hospitals in Saudi Arabia and Oman. Methods: A retrospective cohort study was conducted on adults with clinically and microbiologically confirmed enterococcal UTI based on urinary symptoms and a urine culture of ≥100,000 CFU/mL, who received an antibiotic active against the pathogen. The primary endpoint was clinical cure. Secondary endpoints included microbiological cure, length of stay (LOS), in-hospital mortality, and recurrence. Results: E. faecalis and E. faecium were isolated from 188 (67.1%) and 92 (32.9%), respectively, of 280 included patients. Ampicillin/amoxicillin (25%) and vancomycin (22.1%) were the most-used antibiotics. Compared with E. faecium, E. faecalis was associated with higher clinical cure rates (75% vs. 57.6%; p = 0.003), lower in-hospital mortality (15.7% vs. 38.5%; p < 0.0001), and shorter LOS (12.5 vs. 25 days; p < 0.0001). No difference in recurrence was observed. Ciprofloxacin was associated with high odds of clinical cure (OR, 4.28; 95% CI, 1.18–15.56). Conversely, the recent cancer chemotherapy and growth of Enterococcus at another site were associated with lower odds of clinical cure. Urinary catheter removal was associated with lower recurrence odds (OR, 0.48; 95% CI, 0.24–0.98). Conclusions: This study highlights the clinical challenges posed by enterococcal UTIs, particularly by E. faecium. Ciprofloxacin remains an effective option, particularly against E. faecalis. Patients with advanced age, critical illness, complicated infections, and liver disease, as well as patients on hemodialysis, require close monitoring to improve outcomes.