Introduction: Antimicrobial resistance amongst Klebsiella pneumoniae isolates imposes a significant clinical and public health burden, requiring a large healthcare expense for the treatment of infections. The last decade has seen an incremental rise in antimicrobial resistance, not only toward carbapenems, but also last-resort antimicrobials, urging the need for collaboration between infectious diseases specialists and microbiology peers toward the development of novel therapeutic methods. This study aims to provide a two-year overview in carbapenem-resistant Klebsiella pneumoniae (CRKP) in an infectious diseases tertiary hospital in Romania, focusing on antimicrobial resistance patterns and carbapenemase distribution. Methods: Clinical samples collected from patients admitted to the “Prof. Dr. Matei Bals” National Institute of Infectious Diseases in Bucharest, Romania, between 1st August 2023 and 31st July 2025 have undergone standard cultivation, bacterial identification and antimicrobial susceptibility testing according to standard laboratory protocol. All carbapenem-non-susceptible Klebsiella pneumoniae strains (meropenem minimum inhibitory concentration > 0.125 μg/mL) further underwent extended-spectrum beta-lactamase (ESBL) and carbapenemase production testing via phenotypical methods. Results: A number of 340 non-duplicate, carbapenem-non-susceptible Klebsiella pneumoniae strains have been isolated from various clinical samples. The majority of them (> 90%) exhibited carbapenemase production: n = 164, 53.59% double NDM and OXA-48-type carbapenemase producers, followed by NDM ( n = 74, 24.18%), OXA-48-type ( n = 44, 14.38%), KPC ( n = 14, 5.56%) and NDM+KPC ( n = 7, 2.29%). In addition, 309 strains were deemed ESBL producers. In terms of antimicrobial resistance, more than > 90% of the strains exhibited resistance to fluoroquinolones, third generation cephalosporins, penicillins and monobactams, > 75% resistance to aminoglycosides and novel beta-lactam/beta-lactamase inhibitor combinations and > 70% resistance to colistin and imipenem-relebactam. Overall cefiderocol resistance was 32.05%. Upon classification, 25.00% ( n = 85) of isolates were multidrug-resistant (MDR), 56.47% ( n = 192) extensively drug-resistant (XDR) and 17.06% ( n = 58) were pandrug-resistant (PDR). Moreover, 54.17% ( n = 104) of XDR isolates were only susceptible to one antimicrobial drug. Conclusion: Rates of resistance remain concerningly high amongst CRKP isolates, with double carbapenemase producers and XDR/PDR isolates dominating the landscape, implying the foreseeable need for updated means of approaching antimicrobial resistance, as last-resort antimicrobials become less effective through increasing resistance.

Background/Objectives: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is of great concern because of the difficulties encountered in the management of infections it may cause. This study aims to identify possible difficulties in the management of K. pneumoniae infections in the current context of antibiotic resistance, particularly regarding carbapenem resistance. Methods: This is a retrospective, cross-sectional study that analyses epidemiological, clinical and bacteriological features identified in all patients with CRKP infections/colonization admitted during 2024 in an infectious diseases hospital. Results: Carbapenemase-producing K. pneumoniae isolates were co-harboring NDM+OXA-48 in 55.2% of cases. NDM+OXA-48-producing K. pneumoniae (116 isolates, 55.2%) was correlated with high resistance to aztreonam (100%, p = 0.01), ceftazidime–avibactam (100%, p < 0.01), trimethoprim–sulfamethoxazole (99.1%, p < 0.01), gentamycin (94.8%, p < 0.01), amikacin (93.8%, p < 0.01), colistin (79.8%, p < 0.01). OXA-48-producing K. pneumoniae (29 isolates, 13.8%) was correlated with lower resistance to ceftazidime–avibactam (11.5%, p < 0.01), amikacin (48.1%, p < 0.01), colistin (51.7%, p = 0.01), and gentamycin (65.5%, p < 0.01). We found in vitro synergistic effects of ceftazidime/avibactam + aztreonam for 32/32 CRKP isolates and of colistin + tigecycline for 12/14 CRKP isolates. Higher recurrence of CRKP infections was recorded in patients with urinary tract conditions (RR = 11.58, 95%CI: 1.58–81.91) and upper urinary tract devices (RR = 3.53, 95% CI: 1.72–7.22). In this study, adequate antibiotic treatment, compared to excessive antibiotic treatment in CRKP infections, was associated with shorter treatment duration (p = 0.02) and shorter length of hospitalization (p = 0.04). Conclusions: In our study, CRKP is frequently coharboring NDM+OXA-48, having limited treatment options. Implementing new treatment strategies, testing antibiotic synergies for older antibiotics in order to identify alternative treatment options and avoiding unnecessary carbapenem consumption are essential for decreasing the burden of CRKP infections.

Introduction: Nasal colonization plays a pivotal role in Methicillin-resistant Staphylococcus aureus (MRSA) carriage and transmission, especially in healthcare settings. Asymptomatic carriers amongst healthcare workers (HCWs) may serve as an important source for inner-hospital transmission, besides personal increased risks of endogenous infections. Medical students are an often-overlooked part of medical staff which, while not typically included in statistics concerning HCWs, are associated with increased patient contact and exposure to healthcare-associated pathogens. This study aimed to assess MRSA carriage rate amongst clinical-year medical students in the largest Romanian medical university, in addition to identifying potential risk factors. Nonetheless, a methodological aim was incorporated, in order to evaluate the effect of nasal swab pre-moistening with sterile saline on MRSA retrieval rate. Materials and Methods: A cross-sectional study was conducted among clinical-year students from the ‘Carol Davila’ University of Medicine and Pharmacy in Bucharest, Romania. Participants completed a survey regarding potential risk factors and underwent nasal swab sampling, being randomly assigned to the two swab collection methods—dry swab or pre-moistened swab with sterile saline, randomization ensuring comparable baseline characteristics. Samples were inoculated on chromogenic MRSA agar media and incubated for 24–48 h at 35–37 °C. Isolates exhibiting characteristic growth further underwent coagulase testing, bacterial identification and methicillin resistance confirmation. Results: The study comprised 156 medical students, with an overall prevalence of asymptomatic MRSA nasal carriage of 5.76% (n = 9, 95% CI: 3.05–10.58%). No statistically significant associations were identified between MRSA carriage and hospital exposure. The prevalence of MRSA positive cultures was 5.00% (n = 4/80) among the conventional dry swab sampling subgroup, while the subgroup undergoing pre-moistened swab collection presented a 6.57% prevalence (n = 5/76), revealing no statistical significance (p = 0.74). Conclusions: Asymptomatic MRSA carriage among medical students in this cohort suggests the potential role of this population in intra-hospital transmission. In addition, pre-moistening the nasal swab for collection of the sample showed no statistically significant impact on MRSA recovery rates, correlating with existing literature on the topic. These findings further emphasize the need for strict adherence to infection prevention and control measures in hospitals.

Background: Despite a decline observed in smoking rates amongst adults in many high-income countries, tobacco usage among adolescents remains a significant concern, particularly in Central and Eastern Europe, Romania being no exception. This cross-sectional study aims to assess the prevalence of smoking among teenagers enrolled in several public schools in Bucharest and the surrounding county, Ilfov, while also exploring their attitudes, perceptions, and experiences regarding tobacco. Methods: A public health campaign, conducted in collaboration with multiple institutions between September 2023 and March 2024, sought to provide secondary school students with updated information on smoking and its implications through presentations at schools. Following these presentations, students voluntarily completed anonymous on-paper questionnaires consisting of 10 multiple-choice questions designed to gauge their knowledge and attitudes towards smoking, conceptually inspired by internationally validated instruments such as the Global Youth Tobacco Survey. Results: A total of 945 teenagers participated in our study, with a median age of 13.04 years (standard deviation of ±1.08). Results indicate that 22.85% (n = 216) of teenagers had attempted smoking at the time of the investigation. Additionally, 57.88% (n = 547) of respondents reported exposure to second-hand smoke at home, and 40.42% (n = 382) had been invited to smoke previously. Conclusions: Various factors influence smoking behaviors among teenagers, with peer pressure and familial background playing significant roles in shaping their attitudes toward smoking. Our study highlights the vulnerability of the young Romanian population to these influences, emphasizing the need for initiatives aimed at mitigating tobacco use and fostering a healthier future environment. Nonetheless, these findings shall serve as an instrument for the development of school-based prevention programs and stricter tobacco usage policies.

The past decades have witnessed an increasing interest in the field of multimorbidity, as common risk factors such as obesity, arterial hypertension or diabetes have surged worldwide, thus posing a burden on public health systems all over the world. Defined as the presence of two or more conditions in the same individual, multimorbidity and its prevalence have shown large heterogeneity among countries and age groups. This cross-sectional study aimed to assess the presence of cardiovascular risk factors and multimorbidity in a cohort of 4200 patients of a Romanian private occupational medicine facility in order to provide a better outlook on this domain, adapted to patients in the active population group. The cohort selected by us for the present study comprised all 4200 patients who visited our facility over the course of three months. Upon clinical examination of all patients, data were collected via on-paper registration and included into each individual's medical file, afterwards being digitally registered. Finally, the prevalence of each risk factor and multimorbidity was analyzed using Microsoft Excel 2019 version data analysis software. Among all members of the cohort, 815 individuals (19.4%) had arterial hypertension, 614 patients (14.61%) were registered with obesity, 110 people (2.61%) had diabetes, and finally, 754 subjects (17.95%) had multimorbidity. Analysis of multimorbidity patterns showed a higher prevalence of multimorbidity among women (56.89%) and urban residents (68.03%). The present study found a lower prevalence of multimorbidity and cardiovascular risk factors than other similar data in the literature. While this can be explained by multiple factors, such as the general addressability of private occupational medicine services, we also raise awareness about the fact that further populational studies regarding this topic need to address larger and more heterogeneous cohorts in order to provide data of utmost accuracy.

Background: Ultraviolet (UV) radiation from the sunlight can harm skin cells, causing short-term effects, such as sunburns and long-term effects, such as pigmentation changes, changes in the skin's immune responses, and increased risk of skin cancer. These conditions can be largely prevented with proper sun protection measures and behavioural changes. This study aims to assess the knowledge on sun protection behaviour and baseline knowledge of medical students from the “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania. Methods: Data in this cross-sectional study were collected through a Google Forms questionnaire, which was distributed from November 2023 to December 2023 via digital communication channels to students across all academic years. STROBE guidelines were consulted for data synthesis; Results: A total of 668 stu-dents responded. The student cohort demonstrated a commendable level of awareness of the risks associated with sun exposure and the advantages of employing sun protection factor (SPF); how-ever, the incidence of sunburns remained notably elevated (72.3%). Further analysis revealed cor-relations among gender, academic year, presence of photosensitizing conditions, and adherence to SPF application. Additionally, there is a need to improve understanding of the appropriate appli-cation techniques for SPF, as only 11.5% of the students exhibited proficiency in this regard; Con-clusions: As future healthcare providers, medical students hold significance in promoting healthy behaviours in the broader community. This study indicates that while their knowledge about sun protection is satisfactory, there is scope for enhancement.