The rise of multidrug-resistant bacteria (MDR) has resulted in limited treatment options and poorer outcomes for patients. The objective of this study was to analyze the overall antibiotic resistance trends and distribution for pathogens identified in urine samples at the National Institute of Infectious Diseases “Prof. Dr. Matei Balș” from Bucharest, Romania, over a 5-year period. Antibiotic susceptibility testing was performed using automatic systems and the disk diffusion method. ESBL- and carbapenemases-producing strains were identified using immunochromatography tests, and ROSCO Diagnostica kits were used for definitive confirmation. All results were interpreted according to EUCAST clinical breakpoints. Gram-negative rods (GNR) had overall resistance rates higher than 50% for penicillin and 40% for 3rd- and 4th-generation cephalosporins. Escherichia coli resistance to fosfomycin (3%) and nitrofurantoin (2%) remains low, and 33.30% of E. coli, 48% of Klebsiella spp., and 37% of Pseudomonas aeruginosa isolates were multidrug-resistant (MDR). All Acinetobacter baumannii isolates were MDR by the last year of the study. For Gram-positive cocci (GPC), 37% of all Enterococcus faecium strains and 2% of Enterococcus faecalis were vancomycin-resistant (VRE). E. coli’s incidence in UTIs’ etiology is on a downward trend. The incidence of Klebsiella spp. and GPCs is rising. Antibiotic stewardship strategies should be implemented after carefully considering regional variations in etiology and resistance trends.

Klebsiella pneumoniae is one of the top pathogens causing bloodstream infections (BSIs) worldwide. The rise of carbapenem-resistant K. pneumoniae (CRKP) and multidrug-resistant (MDR) strains is of particular concern as therapeutic options are limited. Analyzing local resistance profiles is essential for the success of antibiotic stewardship strategies. This study aims to explore the resistance profiles of K. pneumoniae strains identified in BSI in a tertiary care hospital over 7 years. Automated systems were used to test antibiotic susceptibility. Results were interpreted according to EUCAST clinical breakpoints. The rate of multidrug resistance (MDR) was 57.6%. The percentage of ESBL producers was 54.5%, and the percentage of carbapenemase producers was 43.2%. Overall resistance rates to other antibiotics were 47.1% to ciprofloxacin, 31.4% to gentamicin, 25.7% to amikacin, 20.9% to colistin, 19.6% to Fosfomycin, and 44.5% to trimethoprim/sulfamethoxazole. The highest resistance to colistin was recorded in 2023 (28%). More than half of the strains in the study were MDR and ESBL producers. K. pneumoniae resistance to colistin has increased during the last 7 years. The rates of carbapenemase-producing bacteria (CPB) are on the rise. The most frequently co-harboring carbapenemases were NDM and OXA-48. Local antibiotic resistance rates are crucial in implementing an effective antibiotic stewardship strategy.

Background: Bloodstream infections (BSIs) caused by multidrug-resistant non-fermenting Gram-negative bacilli, particularly Pseudomonas aeruginosa and Acinetobacter baumannii, represent a growing public health concern, especially in tertiary care settings. This study aimed to describe the epidemiological and antimicrobial resistance trends of P. aeruginosa and A. baumannii isolated from blood cultures over an eight-year period (2017–2024) at a tertiary infectious disease hospital in Bucharest, Romania, especially in the context of the disruption caused by the SARS-CoV-2 pandemic. Methods: A retrospective study was conducted on 43,951 blood cultures processed at the National Institute of Infectious Diseases. Species identification and antibiotic susceptibility testing (AST) were performed using VITEK2, MALDI-TOF MS, and supplementary phenotypic methods. AST interpretation followed EUCAST guidelines. Results: Out of all of the positive blood cultures, 112 (3.63%) were P. aeruginosa and 158 (5.12%) A. baumannii. Multidrug-resistance (MDR) was identified in 46% of P. aeruginosa and 90.73% of A. baumannii isolates. Resistance trends varied, with P. aeruginosa showing a decrease in MDR rates post-COVID-19 pandemic and following antimicrobial stewardship implementation. In contrast, A. baumannii displayed persistently high resistance, with carbapenem and aminoglycoside resistance rates reaching 100% by 2024. Colistin resistance, though low overall, increased in the latter years. Conclusions: The findings highlight the dynamic nature of antimicrobial resistance among P. aeruginosa and A. baumannii. Effective infection control and antimicrobial stewardship programs are crucial in curbing the rise of MDR strains, particularly amid healthcare system disruptions such as the COVID-19 pandemic.

Botulism is a priority disease worldwide because it has a very severe course of evolution that can lead to death. This paper aims to describe the main epidemiological characteristics of botulism cases confirmed in Romania over 14 years (2007–2020). We performed a retrospective study using the publicly available national surveillance data and reported to the National Institute of Public Health. A total of 325 cases of foodborne botulism were reported in Romania, with no infant or wound botulism. Most of the cases (125, 38.5%) were reported among young adults (25–44 years old), over half (205, 63%) of them living in rural areas. The incriminated food item was identified in 161 cases; in most cases (145, 90%) the food item was prepared in the household. The main food category was represented by meat and meat-based products (94, 68.6%). In almost all cases the identified type was BoNT/B (230/231, 99.5%). Fifteen deaths were recorded, and the case fatality rate was 4.6%. Botulism cases were reported annually in Romania. Surveillance data are essential for implementing control measures and adapting educational campaigns according to existing needs.

The long-term corrosion and antibacterial evaluation of bioactive coating obtained by matrix-assisted pulsed laser evaporation (MAPLE) on TiZrTaAg is crucial for assessing its potential in biomedical applications. The MAPLE deposition technique involves the formation of a dense and adherent layer on the surface of the alloy which can include a multitude of components such as bioactive glass, ZnO and graphene oxide. Long-term corrosion studies in simulated body fluids evaluate the stability and integrity of the coating over extended periods, ensuring its durability in the physiological environment. The results showed that the coatings, especially the one incorporating graphene oxide (GO), significantly reduced the corrosion rate of TiZrTaAg compared to the uncoated alloy. Antibacterial evaluation assesses the coating’s ability to inhibit bacterial colonization and biofilm formation, which are major concerns in implant-associated infections. The coatings demonstrated high antibacterial activity, with the one with the GO-containing film exhibiting the highest bacterial inhibition, achieving 83% against Staphylococcus aureus and 71% against Escherichia coli. The study concluded that the MAPLE-modified TiZrTaAg alloy with bioactive coatings, particularly the one with GO, shows promising potential for biomedical applications due to enhanced corrosion resistance and strong antibacterial properties.

Hepatitis E virus (HEV) is a common cause of acute hepatitis, with increasing incidence in Europe, including Romania. Concurrently, Romania has a high prevalence of chronic hepatitis B (CHB). There is limited research on the clinical presentation and outcomes of HEV infection in patients with pre-existing chronic hepatitis B (CHB), especially in resource-rich settings. Most literature data come from South, East, and Southeast Asia. A review of the literature on HEV and HBV co-infection indicates a severe prognosis, particularly in patients with underlying liver disease. However, the cases in this study, which did not display cirrhosis, showed varied outcomes. The role of anti-HBV treatment in improving prognosis remains uncertain and warrants further investigation. Acute HEV infection superimposed on chronic HBV infection poses significant clinical challenges, with outcomes ranging from full recovery to fatality. Preventive measures, including sanitation and vaccination against HBV, are crucial. More studies are needed to establish effective treatment protocols for this co-infection. In this study, we will analyze the clinical setting, diagnosis, particularities, and outcomes of five such cases of dual hepatotropic viral infection recorded over a period of 6 years (2018–2023) at a large Infectious Diseases clinic in Bucharest, Romania.