Nela Daniela Efrim

Dr. Nela Daniela Efrim

orcid

Research Focus & Metrics

Academic Career Length

5Years (2022-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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23 March 2022 in BRAIN. BROAD RESEARCH IN ARTIFICIAL INTELLIGENCE AND NEUROSCIENCE
Verified
Journal Article
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EDElena Dumea
Elena Dumea
NENela Daniela Efrim
Nela Daniela Efrim
APAdina Petcu
Adina Petcu
LALucretia Anghel
Lucretia Anghel
CPCristina Gabriela Puşcaşu
Cristina Gabriela Puşcaşu
Healthcare workers (HCWs) are important players in the COVID-19 pandemic management and are inescapably in the first line to be exposed to the SARS CoV-2 virus. They were at risk of losing their lives while caring for their duty for COVID patients. This pandemic has substantial psychological impact on HCWs. This study describes the prevalence of burnout between HCWs handle with COVID-19 pandemic. The study explored the level of burnout in this population and examined factors involved in development of this psychological consequence. This cross-sectional survey was conducted on personnel from an Infectious Diseases monospecialty Hospital, which provides care for COVID-19 patients. The study was attended at 12 months after the outbreak. A questionnaire- based survey using Maslach Burnout Inventory (MBI) was conducted for all personnel. Participation was voluntary and anonymous. Age, gender, job category and the level of burnout in each subscale was measured. 186 persons completed the questionnaire (79%from employees). 61.86% experienced medium and high levels of burnout comparable with other country studies. The mean score and SD in emotional exhaustion, depersonalization and lack of personal accomplishment were 23.26+8.45, 11.11+4.05, and 22.62+6.83, respectively. The prevalence of burnout in the hospital`s personnel was 38.179% in low rates, 46.77% had medium level and 15.05% high level. Doctors and administrative staff were more affected than others. Nevertheless, there are no significant statistical differences in the level of the three domains of burnout studied regarding the age and job profile. In conclusion, in our hospital, designated to treat moderate and severe COVID-19 patients burnout is equally present among HCWs.

30 August 2023
Verified
Book Chapter
Open access
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NENela Daniela Efrim
Nela Daniela Efrim
EDElena Dumea
Elena Dumea
RCRoxana Carmen Cernat
Roxana Carmen Cernat
More prevalent than initially considered, histoplasmosis is primarily a non-contagious disease of the reticuloendothelial system, producing a broad spectrum of clinical manifestations, ranging from asymptomatic or self-limited infection, in immunocompetent patients to life-threatening, disseminated disease in immunocompromised ones. The causative agent is H. capsulatum, a thermally dimorphic, intracellular fungus, discovered in 1906, by the pathologist Samuel Darling, when examined tissues from a young man whose death was mistakenly attributed to miliary tuberculosis. Since then, histoplasmosis was described on six continents, with high and low endemicity areas. H. capsulatum is a soil-based fungus, commonly associated with river valleys in the temperate zone, and with the presence of bird and bat guano. Infection occurs when saprophytic spores are inhaled and change to the pathogenic yeast in the lungs, where H. capsulatum overcomes many obstacles to cause host injuries. Depending on geographic distribution, morphology, and clinical symptoms, three varieties have been historically recognized, two of them (var. capsulatum and var. duboisii) being pathogen to humans, and the third (var. farciminosum) has predominantly been described as an equine pathogen. In endemic areas, patients with AIDS or people who receive immunosuppressive therapies should be counseled to avoid high-risk activities; otherwise, precautionary measures should be taken.

22 September 2026 in Pathogens
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Journal Article
Open access
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RCRoxana Cernat
Roxana Cernat
OIOana-Elena Ioniţă
Oana-Elena Ioniţă
MVMaria-Elena Vodarici
Maria-Elena Vodarici
NMNicola-Maria Militaru
Nicola-Maria Militaru
RCRares Alexandru Constantin
Rares Alexandru Constantin
Irina Magdalena DumitruIrina Magdalena Dumitru
Irina Magdalena Dumitru
Carbapenem-resistant Klebsiella pneumoniae (CRKP) is the pathogen driving the deterioration of the European antimicrobial resistance landscape, and the burden falls disproportionately on Romania and South-Eastern Europe. The objective of this review was to synthesise evidence published between 2020 and 2025 on the epidemiology, molecular characteristics, clinical impact, and pandemic-era trajectory of CRKP healthcare-associated infections across South-Eastern Europe, including Romania. This retrospective, qualitative narrative review combined the international literature with a deliberately multilingual search of national-language sources in Romanian, Bulgarian, Greek, Croatian, Slovenian, and Serbian, including congress abstract books, doctoral theses, national reference-laboratory reports, and agency surveillance series that are absent from PubMed. Three findings emerge. First, the region is not epidemiologically uniform: estimated incidence of carbapenem-resistant K. pneumoniae bloodstream infection in 2024 ranged from 0.62 per 100,000 population in Slovenia to 20.31 in Romania, against a European Union/European Economic Area (EU/EEA) figure of 3.46, and the steepest relative rise between 2019 and 2024 was recorded in Bulgaria (+374.1%). Second, a distinctive molecular signature has consolidated in the northern half of the region: co-production of a metallo-β-lactamase with an OXA-48-like enzyme (OXA-48, a class D, oxacillinase-type carbapenemase), reported in 44.4–61.2% of characterised Romanian isolates across independent centres, which removes ceftazidime-avibactam from the therapeutic repertoire and leaves aztreonam-avibactam and cefiderocol as the principal remaining options. Third, the pandemic did not produce a single regional signal but a consistent sequence—a transient interruption of upward trends during 2020, a marked acceleration from 2021, and persistence of the elevated level after 2022—with national-language surveillance from Croatia and Slovenia showing that the direction of the apparent pandemic effect depends on whether incidence or resistance proportion is measured. The national-language literature adds granularity unavailable in English, but the evidence base remains structurally uneven: Albania, Kosovo, and North Macedonia contribute almost no primary data, and no country in the region has published a CRKP-attributable mortality estimate for the review period. CRKP in Romania and South-Eastern Europe now maps onto three molecular zones—OXA-48 predominance in the Western Balkans and Croatia, a KPC-to-metallo-β-lactamase transition in Greece, and metallo-β-lactamase plus OXA-48-like co-production in Romania and increasingly Bulgaria—that require different empirical therapy; the COVID-19 pandemic did not create this burden but accelerated and entrenched it, and closing the region’s mortality-data and Western Balkan surveillance gaps should be a priority for future research.

2 September 2026 in Preprints.org
Verified
Preprint
Open access
PDF file
RCRoxana Cernat
Roxana Cernat
OIOana-Elena Ioniţă
Oana-Elena Ioniţă
MVMaria-Elena Vodarici
Maria-Elena Vodarici
NMNicola-Maria Militaru
Nicola-Maria Militaru
RCRares Alexandru Constantin
Rares Alexandru Constantin
Irina Magdalena DumitruIrina Magdalena Dumitru
Irina Magdalena Dumitru
Carbapenem-resistant Klebsiella pneumoniae (CRKP) is the pathogen driving the deterioration of the European antimicrobial resistance landscape, and the burden falls disproportionately on Romania and South-Eastern Europe. This narrative review synthesises evidence published between 2020 and 2025 on the epidemiology, molecular characteristics, clinical impact and pandemic-era trajectory of CRKP healthcare-associated infections across Romania, Bulgaria, Greece, Croatia, Slovenia, Serbia, Bosnia and Herzegovina, Montenegro, North Macedonia, Albania and Kosovo. The search was deliberately multilingual: alongside the international literature we interrogated national-language sources in Romanian, Bulgarian, Greek, Croatian, Slovenian and Serbian, including congress abstract books, doctoral theses, national reference-laboratory reports and agency surveillance series that are absent from PubMed. Three findings emerge. First, the region is not epidemiologically uniform: estimated incidence of carbapenem-resistant K. pneumoniae bloodstream infection in 2024 ranged from 0.62 per 100,000 population in Slovenia to 20.31 in Romania, against an EU/EEA figure of 3.46, and the steepest relative rise between 2019 and 2024 was recorded in Bulgaria (+374.1%). Second, a distinctive molecular signature has consolidated in the northern half of the region: co-production of a metallo-β-lactamase with an OXA-48-like enzyme, reported in 44.4–61.2% of characterised Romanian isolates across independent centres, which removes ceftazidime-avibactam from the therapeutic repertoire and leaves aztreonam-avibactam and cefiderocol as the principal remaining options. Third, the pandemic did not produce a single regional signal but a consistent sequence — a transient interruption of upward trends during 2020, a marked acceleration from 2021, and persistence of the elevated level after 2022 — with national-language surveillance from Croatia and Slovenia showing that the direction of the apparent pandemic effect depends on whether incidence or resistance proportion is measured. The national-language literature adds granularity unavailable in English, but the evidence base remains structurally uneven: Albania, Kosovo and North Macedonia contribute almost no primary data, and no country in the region has published a CRKP-attributable mortality estimate for the review period.