Ioana Miriana Cismaru

Dr. Ioana Miriana Cismaru


Research Focus & Metrics

Academic Career Length

3Years (2024-Present)

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

Representative Publications

View All Publications
1 August 2025 in Antibiotics
Verified
Journal Article
Open access
PDF file
VMVioleta Melinte
Violeta Melinte
MRMARIA-ADELINA Radu
MARIA-ADELINA Radu
CVCristina Maria Văcăroiu
Cristina Maria Văcăroiu
MMMîrzan Mîrzan
Mîrzan Mîrzan
HHHolban Holban
Holban Holban
Valeriu GheorghițăValeriu Gheorghiță
Valeriu Gheorghiță
Introduction: Carbapenem-resistant Klebsiella pneumoniae (CRKP) represents a critical public health threat due to its rapid nosocomial dissemination, limited therapeutic options, and elevated mortality rates. This study aimed to characterize the epidemiology, carbapenemase profiles, and antimicrobial susceptibility patterns of CRKP isolates, as well as the clinical features and outcomes observed in infected or colonized patients. Materials and Methods: We conducted a retrospective analysis of clinical and microbiological data from patients with CRKP infections or colonization admitted between January 2023 and January 2024. Descriptive statistics were used to assess prevalence, resistance patterns, and patient outcomes. Two binary logistic regression models were applied to identify independent predictors of sepsis and in-hospital mortality. Results: Among 89 CRKP isolates, 45 underwent carbapenemase typing. More than half were metallo-β-lactamase (MBL) producers, with 44.4% co-harbouring NDM and OXA-48-like enzymes. Surgical intervention was associated with a significantly lower risk of sepsis (p < 0.01) and in-hospital mortality (p = 0.045), whereas intensive care unit (ICU) stay was a strong predictor of both outcomes. ICU admission conferred a 10-fold higher risk of sepsis (95%Cl 2.4–41.0) and a 40.8-fold higher risk of in-hospital death (95% Cl 3.5–473.3). Limitations: This single-center retrospective study included a limited number of isolates in certain groups. Additionally, cefiderocol (FDC) susceptibility was assessed by disk diffusion rather than by the broth microdilution method. Conclusions: Our study underscores the increasing prevalence of metallo-beta-lactamase-producing CRKP, particularly strains harbouring dual carbapenemases. Timely recognition of high-risk patients, combined with the implementation of targeted infection control measures and the integration of novel therapeutic options, is crucial to optimize clinical management and reduce mortality associated with CRKP.

11 April 2024 in Diagnostics
Verified
Journal Article
Open access
PDF file
VMVioleta Melinte
Violeta Melinte
MRMARIA-ADELINA Radu
MARIA-ADELINA Radu
CVCristina Maria Văcăroiu
Cristina Maria Văcăroiu
ICIoana Miriana Cismaru
Ioana Miriana Cismaru
AMAnca M. Oprescu Macovei
Anca M. Oprescu Macovei
Valeriu GheorghițăValeriu Gheorghiță
Valeriu Gheorghiță
Shiga-like toxin-producing Escherichia coli (STEC) is a well-known cause of foodborne acute diarrheic diseases, especially in children and the elderly. The potentially fatal complications associated with toxin production range from bloody diarrhea and ischemic colitis to kidney failure, hemolytic–uremic syndrome (HUS), and colon perforation. Here, we describe a case and literature review of STEC-induced colitis, highlighting the clinical features and the necessary tools for the best diagnostic approach and management. Facing challenging differential diagnosis, ranging from ischemic colitis and inflammatory bowel disease to infectious processes due to a pathogenic or opportunistic agent, we conducted a step-by-step exploration. Following bacteriological investigation, imagistic screening, and colonoscopy, we ruled out some of the initial suppositions and reached a final diagnosis, while also considering the pathological results. Although antibiotics are not indicated in this pathology, our patient did receive antibiotics, given the risk of translocation and colon perforation, without any associated complications such as HUS or peritonitis. Detailed and rigorous investigations conducted by a multi-specialty team are required for prompt medical support. Coping with the symptoms and refraining from further complications are the mainstem aims of treatment.

15 March 2024 in Preprints.org
Verified
Preprint
Open access
PDF file
VMVioleta Melinte
Violeta Melinte
Alexandra Daniela TudorAlexandra Daniela Tudor
Alexandra Daniela Tudor
ABAdrian Georgian Bujoi
Adrian Georgian Bujoi
MRMARIA-ADELINA Radu
MARIA-ADELINA Radu
CVCristina Maria Văcăroiu
Cristina Maria Văcăroiu
Valeriu GheorghițăValeriu Gheorghiță
Valeriu Gheorghiță
C. auris is a newly emerging yeast, raising public health concerns due to its outbreak potential, lack of protocols for decontamination and isolation of patients or contacts, increased resistance to common antifungals and associated high mortality. This research aimed to describe the challenges related to identifying the outbreak, limiting further contamination, and treating affected individuals. We retrospectively analysed all cases of C. auris detected between October 2022 and August 2023, but our investigation focused on a three-month-long outbreak in the department of cardio-vascular surgery and the related intensive care unit. Along with isolated cases in different wards, we identified 13 patients who became infected or colonized in the same area and time, even though the epidemiological link could be traced only in 10 patients, according to the epidemiological investigation. In conclusion, our study emphasizes the substantial challenge encountered in clinical practice when attempting to diagnose and limit the spread of an outbreak. Therefore, it is crucial to promptly apply contact precaution measures and appropriate environmental cleaning, from the first case detected positive.

7 February 2024 in Preprints.org
Verified
Preprint
Open access
PDF file
VMVioleta Melinte
Violeta Melinte
CVCristina Maria Văcăroiu
Cristina Maria Văcăroiu
MRMARIA-ADELINA Radu
MARIA-ADELINA Radu
ICIoana Miriana Cismaru
Ioana Miriana Cismaru
ACAmalia Loredana Călinoiu
Amalia Loredana Călinoiu
Valeriu GheorghițăValeriu Gheorghiță
Valeriu Gheorghiță
Shiga-like toxin producing Escherichia coli (STEC) is a well-known cause of foodborne acute diarrheic diseases especially in children and the elderly. The potentially fatal complications associated with toxin production range from bloody diarrhoea and ischemic colitis to kidney failure, haemolytic-uremic syndrome (HUS) and colon perforation. We describe a case and literature review of STEC – induced colitis, highlighting the clinical features, and the necessary tools for the best diagnosis approach and management. Facing challenging differential diagnosis ranging from ischemic colitis, inflammatory bowel disease, to infectious process due to a pathogenic or opportunistic agent, we practiced a step-by-step exploration. Beginning with bacteriological investigation, imagistic screening, and colonoscopy, we could rule out some of initial suppositions and reach the final diagnosis, also considering the pathological results. Although antibiotics are not indicated in this pathology, our patient did receive antibiotics, given the risk of translocation and colon perforation, without associating any complications, as HUS or peritonitis. Detailed and rigorous investigations along with a multi-speciality team are required for a prompt medical support. Coping the symptoms and refraining from further complications are the mainstem of the treatment.