Endometrial cancer is one of the most common malignancies seen in women in developed countries. While patients in the early stages of this cancer show better responses to surgery, adjuvant hormonal therapy, and chemotherapy, patients with recurrence show treatment resistance. Researchers have recently focused on cancer stem cells (CSCs) in the treatment of gynecologic cancer in general but also specifically in endometrial cancer. CSCs have been investigated because of their resistance to conventional therapies, such as chemo- and radiotherapy, and their ability to induce the progression and recurrence of malignancy. The activation of alternative pathways, such as WNT, PI3K, NF-kB, or NOTCH, could be the basis of the acquisition of these abilities of CSCs. Their specific markers and signaling pathways could be treatment targets for CSCs. In this article, we discuss the importance of obtaining a better understanding of the molecular basis and pathways of CSCs in endometrial cancer and the role of CSCs, aiming to discover more specific therapeutic approaches.

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.

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.

Despite the devastating consequences of fungal disease, research struggles to catch up to present needs. This study aims to give a broad perspective on the situation, investigating patterns and distribution of fungal pathogens and monitoring trends of resistance to antifungal drugs, over an 8-year timeframe, at the National Institute of Infectious Diseases “Prof. Dr. Matei Balș” in Bucharest, Romania. Samples were inoculated on Sabouraud or Brilliance Candida Agar media; strains were identified using MALDI-TOF MS; and antifungal sensitivity testing was performed using E-Tests strips, VITEK2 Compact and MICRONAUT-AM automatic systems. Candida albicans, accounting for 42% of the positive samples, was the most common pathogen observed, with only 17% of the isolates being susceptible to all antifungals tested, while it was also predominant and deadly in the ICU. The emerging Candidozyma auris, found in 8% of the candidoses, exhibited a fluconazole resistance rate of 96.3%. Of the Aspergillus fumigatus strains, 35.7% showed resistance to azoles, and 25% to amphotericin B. In the ICU, more than half of A. flavus-, A. fumigatus- or A. niger-related cases culminated in death. Antifungal resistance is not to be treated lightly, as it is still a complex and dynamic threat, with devastating consequences.

A 22-year-old male, with a history of recreational drug use, was admitted with a 24-hour history of sore throat, bilateral otalgia, fever, chills, sweats, and pain in the upper chest. The blood cultures were positive for Fusobacterium necrophorum. A thoracic and neck soft tissue computed tomography (CT) scan revealed an intratonsillar abscess and pulmonary septic emboli. Initial treatment with Piperacillin-tazobactam and Clindamycin was de-escalated after 5 days. The patient made a complete recovery after 22 days of antibiotic treatment.