Background : Elizabethkingia meningoseptica are Gram-negative rod bacteria which are commonly found in the environment. The bacteria have also been associated with nosocomial infections, having been isolated on contaminated medical equipment, especially in neonatal wards. Case report : Here, we present the case of a premature female infant born at 33 weeks’ gestational age, with neonatal meningitis. The onset was marked by fever, in the 5th day of life, while in the Neonatal Intensive Care Unit. The patient was commenced on Gentamicin and Ampicillin, but her clinical condition worsened. Psychomotor agitation and food refusal developed in the 10th day of life, and a diagnosis of bacterial meningitis was made based on clinical and cerebrospinal fluid findings. A strain of Elizabethkingia meningoseptica sensitive to Vancomycin, Rifampicin and Clarithromycin was isolated from cerebrospinal fluid. First-line antibiotic therapy with Meropenem and Vancomycin was adjusted by replacing Meronem with Piperacillin/Tazobactam and Rifampicin. The patient’s clinical condition improved, although some isolated febrile episodes were still present. The cerebrospinal fluid was normalized after 6 weeks of antibiotic treatment, although periventriculitis and tetraventricular hydrocephalus were revealed by imaging studies. Neurosurgical drainage was necessary. Conclusion : Elizabethkingia meningoseptica can cause severe infection, with high risk of mortality and neurological sequelae in neonates. Intensive care and multidisciplinary interventions are crucial for case management.

Enterococci cause infections with various localizations, the most common being urinary infections. The purpose of the study was to identify the profile of the antimicrobial resistance of enterococci species (AMRE) isolated from patients hospitalized in three hospitals in Romania. We evaluated AMRE retrospectively (2019–2021) in various biological samples. The microbiological diagnosis was sustained by classical methods of bacteria culture and automatic identification. The sensitivity testing was performed by the Kirby–Bauer method, and the antibiotic minimum inhibitory concentration was tested by the automated Vitek system. We analyzed 86 strains of Enterococcus spp., identifying the following species: 47.7% E. faecalis, 47.7% E. faecium, 3.55% E. gallinarum, and 1% E. hirae. Most of the bacterial strains were isolated from urocultures (38.4%) and hemocultures (32.6%). Overall, the rate of vancomycin resistance was 5.8% for E. faecalis and 15.1%. for E. faecium. The prevalence of multidrug-resistant (MDR) strains was found to be 100% in E. gallinarum, 75.6% in E. faecium, and 21.9% in E. faecalis. The results confirm the high level of AMRE, which creates difficulties with adequate antibiotic prescriptions. The continuous monitoring of AMRE is essential for updating the local diagnostic and treatment protocols for enterococcal infections.

Purpose: To screen the neurocognitive impairment persistent post-COVID-19. Patients and Methods: We assessed the neuropsychiatric disorders associated with COVID-19 in a prospective study, by “Mini-Mental State Examination” (MMSE) and Montreal Cognitive Assessment (MoCA) questionnaires, applied in the discharge to COVID-19 hospitalized patients for moderate and severe forms of disease. They were followed-up in 6 and 12 months. Results: The tests were performed in the baseline and were reevaluated after 6 and 12 months. Baseline cognitive dysfunction was found in 12.4% of patients, according to the MMSE test and in 19.7% by the MoCA scores. Overall cognitive dysfunction in COVID-19 was returned to normal after 6 months, although some tasks are more severe and persistently impaired, such as attention, concentration, short memory, and execution skills. The male gender and the degree of hypoxia, related to the severity of COVID-19 infection, were related to cognitive dysfunction in the study group. Conclusion: Cognitive domain impairments related to COVID-19 could persist over 6 months post-acute infectious episode requiring systematic screening for early diagnosis of progressive brain pathologies and rehabilitation.

The COVID-19 pandemic is a new challenge for the diagnosis and treatment of infective endocarditis (IE). Fever and other unspecific symptoms of coronaviral infection could be misleading or masking its manifestations. We present the case of a young patient admitted for persistent fever, profuse sweating, headache, articular pain, myalgias, and weight loss. She reported regression taste and smell disorders compared to a month earlier when diagnosed with moderate COVID-19 pneumonia. While the RT-PCR SARS-COV-2 test was positive, she was admitted to a COVID-19 ward. Investigations of febrile syndrome revealed two positive blood cultures with Streptococcus gordonii and the presence of vegetations on the aortic valve, supporting a certain diagnosis of IE. After six weeks of antibiotic treatment, the patient had clinical and biologic favorable outcomes. Streptococcus gordonii is a common commensal related to the dental biofilm, although there were no caries in our patient. The influence of COVID-19 infection on the human microbiome by modifying the virulence of some commensal germs may be a risk factor for IE pathogenesis on native valves and requires the vigilance of clinicians for suspicion of this disease.