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.

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.

Leuconostoc pseudomesenteroides is a rare pathogen that can cause bacteremia in immunocompromised patients, particularly those with hematological conditions like acute myeloid leukemia. In this case, a 56-year-old woman developed Leuconostoc bacteremia following chemotherapy and multiple infections, including invasive aspergillosis. Despite broad-spectrum antibiotic treatments, her fever persisted until the blood cultures identified Leuconostoc pseudomesenteroides. Switching to intravenous ampicillin led to the resolution of symptoms. This case highlights the challenges in diagnosing and treating rare, glycopeptide-resistant bacteria in immunosuppressed patients and underscores the importance of repeated blood cultures and automated diagnostic systems. It also highlights the need for more rapid ways of diagnosing and treating such rare infections.