Purpose: We report an outbreak of urinary tract infections (UTIs) caused by Myroides odoratimimus, which occurred in the largest clinical hospital in western Romania. Patients and methods: From June to August 2017, four strains of M. odoratimimus were isolated from the urine samples of patients hospitalized in the urology, diabetes, and surgery departments. Hospital records of all patients whose urine cultures were positive for M. ­odoratimimus were reviewed retrospectively. We also reviewed the cases reported in the literature. Results: All UTIs, except one, were hospital-acquired infections. All patients with M. odoratimimus UTIs were immunocompromised. Three patients underwent urinary catheterization with a Foley’s catheter upon admission in the emergency department and one presented for replacement of ureterostomy tubes. All Myroides isolates were resistant to almost all the tested antibiotics. Two patients were successfully treated with tigecycline and one was receiving antimicrobial treatment for another infection at the time of isolation of the microorganism. Conclusion: Although M. odoratimimus is an uncommon pathogen, clinicians should be aware of its ability to cause UTI outbreaks, especially in the immunocompromised population. Due to its multi-drug resistance, it is important to rapidly identify Myroides spp. in order to choose the best treatment regimen.

Purpose: Critically ill patients hospitalized in the intensive care unit (ICU) have an increased infection risk. The aim of this study was to determine the bacterial and fungal superinfections rate in Coronavirus disease 2019 (COVID-19) patients stationed in the ICU, identify risk factors associated with their development and to determine whether superinfection plays a role in patients’ outcome in this population. Patients and Methods: In this retrospective, non-interventional, single centre, cohort study, medical records of 302 consecutive patients with SARS-COV-2 pneumonia admitted into the COVID-19 ICU of the largest university hospital from Western Romania between October 2020 and May 2021, were reviewed, of whom 236 patients met the inclusion criteria. Results: One hundred and nineteen patients developed a superinfection ≥ 48 h after being admitted to the hospital. Superinfection rate in the ICU was 50.42%. Coagulase-negative Staphylococci (CoNS) and Enterococcus spp. were predominantly isolated from blood cultures, while Acinetobacter baumannii, Staphylococcus aureus and Candida spp. from tracheobronchial aspirates. Significant independent risk factors regarding bacterial/fungal superinfection in COVID-19 patients were obtained for the following variables: number of days of central venous catheter (HR = 1.13 [1.07– 1.20], p < 0.001) and prior administration of corticosteroids (HR = 2.80 [1.33– 5.93], p = 0.007). Four independent predictive risk factors were associated with unfavorable outcome: age (HR = 1.07 [95% CI 1.03– 1.12], p = 0.001); Carmeli Score (HR = 6.09 [1.18– 31.50], p = 0.031); body mass index (HR = 1.11 [1.02– 1.21], p = 0.011) and the presence of a central venous catheter (HR = 6.49 [1.93– 21.89], p = 0.003). Conclusion: The superinfection rate in COVID-19 patients was high in this study group. Exogenous risk factors were associated with superinfection more than endogenous factors. Only a small percentage of uninfected COVID-19 patients were not prescribed antibiotics during their hospitalization, raising serious concerns regarding the judicious prescribing of antibiotics in viral infections.

Background and Objectives: Proteus and Providencia are related genera of opportunistic pathogens belonging to the Morganellaceae family, often a cause of infections in the immunocompromised hosts, such as diabetic patients. Their clinical significance has increased due to their intrinsic resistance to polymyxins, which is often associated with acquired resistance mechanisms. In this study we evaluated the infections caused by Proteus mirabilis and Providencia stuartii in two groups of patients, with diabetes (group 1) and without diabetes (group 2) admitted to the intensive care unit and surgical wards. The infections were investigated in terms of infection type, risk factors, clinical course, predictive factors for unfavourable outcomes and antibiotic resistance profile. Materials and Methods: An observational, retrospective, cross-sectional study was conducted, comprising all patients infected with these pathogens. Bacterial identification and antibiotic sensitivity testing were performed using the Vitek2C automated system. Results: Comparison of the two groups showed that the statistically significant common infectious risk factors were found less frequently among diabetic patients when compared with non-diabetic patients, and that antimicrobial resistance was significantly lower in the diabetic patient group. However, survival rates did not differ between the two groups, drawing attention to the implications of diabetes as comorbidity. Additionally, with regard to the antibiotic resistance profile, 38.89% of P. stuartii strains isolated from diabetic patients belonged to the difficult-to-treat (DTR) phenotype, contributing to the severity of these infections compared with those caused by P. mirabilis, of which 32% were wild type strains and 0% were DTR phenotype. The DTR/extended spectrum beta-lactamase producing P. stuartii isolates more than doubled the risk of mortality, while the presence of nasogastric nutrition tripled the risk. Conclusions: P. stuartii infections that occurred in diabetic patients proved to be more difficult to treat, the majority of them being healthcare-associated bacteremias.

Background/Objectives: Patients with diabetes (DM) are at an increased risk of infection, with urinary tract infections (UTIs) being common among individuals with type 2 DM (T2D). The aim of this study was to determine the prevalence and risk factors for UTIs among hospitalized T2D patients from Timișoara, Romania. Methods: The hospital records of 1139 T2D adult inpatients who were ordered to provide urine cultures during hospitalization were reviewed. Results: The prevalence of UTIs among T2D patients was 19.7%, and was higher in women than in men (27.5% vs. 9.8%, p < 0.0001). Patients with UTIs presented a significantly older age, a longer duration of DM, a higher BMI, higher levels of HbA1c, higher renal function parameters, and more frequent DM-related complications and comorbidities than patients without UTIs. The following predictors were associated with increased UTI risk: age (OR = 1.05, p < 0.0001); duration of DM (OR = 1.04, p < 0.0001); BMI (OR = 1.05, p < 0.0002); HbA1c levels (OR = 1.58, p < 0.0001); female gender (OR = 3.47, p < 0.0001); and the presence of retinopathy (OR = 1.47, p = 0.0118), chronic kidney disease (OR = 3.98, p < 0.0001), distal symmetric polyneuropathy (OR = 7.65, p < 0.0001), and cerebrovascular disease (OR = 4.88, p < 0.0001). The use of sodium-glucose co-transporter 2 (SGLT2) inhibitors did not influence the risk of developing UTIs. Conclusions: T2D patients with prolonged disease duration, poor glycemic control, and DM-related complications are at an increased risk of developing UTIs. Therefore, a targeted therapeutic strategy addressing these risk factors is essential.

Background and aims: There is evidence that patients with diabetes have an increased risk of asymptomatic bacteriuria and urinary tract infections (UTIs). UTI is the most common bacterial infection in diabetic patients. The aim of this study was to assess the prevalence of UTIs among hospitalized diabetic patients and to identify the most frequent bacteria responsible for UTI. Material and methods: The study population included 1470 diabetic patients (847 women and 623 men), admitted to the Diabetes Clinic of the Emergency Clinical County Hospital Timişoara, between January and December 2012. We collected patients’ personal history data and performed urine cultures. For statistical analysis we used Graph Pad Prism 5; the significance of the difference between the percentage values was assessed using Fisher’s exact test. Results: From the total number of patients, 158 had positive urine cultures, meaning 10.7%. Out of the total number of 158 UTIs, 124 (78.4%) were asymptomatic bacteriuria. The most frequent bacteria involved in UTI was Escherichia coli (68.9%). Conclusion: UTIs are frequent in diabetic patients. Because of the great proportion of asymptomatic forms among diabetic patients, the urine culture should be performed in all hospitalized patients with diabetes.

Background: The COVID-19 pandemic has intensified concerns over bacterial infections and antimicrobial resistance, particularly in Romania. This systematic review explores bacterial infection patterns and resistance during the pandemic to address critical gaps in knowledge. Methods: A systematic review, following PRISMA guidelines, was conducted using databases such as PubMed and Scopus, focusing on studies of bacterial infections from 2020 to 2022. Articles on bacterial infections in Romanian patients during the pandemic were analyzed for demographic data, bacterial trends, and resistance profiles. Results: A total of 87 studies were included, detailing over 20,000 cases of bacterial infections. The review found that Gram-negative bacteria, particularly Escherichia coli and Klebsiella pneumoniae, were the most frequently identified pathogens, alongside Gram-positive Staphylococcus aureus and Enterococcus spp. Multidrug resistance (MDR) was noted in 24% of the reported strains, with common resistance to carbapenems and cephalosporins. Conclusions: The pandemic has amplified the complexity of managing bacterial infections, particularly in critically ill patients. The rise in MDR bacteria underscores the need for stringent antimicrobial stewardship and infection control measures. Continuous monitoring of bacterial trends and resistance profiles will be essential to improve treatment strategies in post-pandemic healthcare settings.