Introduction: Bloodstream infections are the most severe infections that cause the highest mortality rate, especially in patients admitted to the intensive care unit (ICU). In this study, we aimed to analyze the distribution, resistance patterns and prevalence of MDR (multidrug-resistant) pathogens isolated in blood samples collected from patients with severe invasive infections hospitalized in the ICU. Methods: A retrospective study of bacterial pathogens was performed on 490 patients admitted to the ICU between 2017 and 2020. The resistance patterns were analyzed using Vitek 2 Compact system. Results: In total, 617 bacterial isolates were obtained. Four hundred and twenty-seven isolates (69.21%) were Gram positive and 190 isolates (30.79%) were Gram negative bacteria. The most frequently isolated micro-organisms identified in the blood samples for the entire period (2017– 2020) were Coagulase-negative staphylococci (CoNS) (318– 51.54%), followed by Klebsiella pneumoniae (70– 11.34%), Methicillin-Resistant Staphylococcus aureus (MRSA) (58– 9.40%), Acinetobacter baumannii (45– 7.29%) and Enterococcus faecalis (42– 6.80%). The number of Klebsiella pneumoniae strains significantly increased in 2020, compared to the previous year (p < 0.05). The Acinetobacter baumannii prevalence was significantly higher in the age group of 20– 64 years (10.89%) and over 65 years (3.53%) (p < 0.001). The difference between the prevalence of CoNS in the elderly (67.84%) and in adults (20– 64 years) (52.47%) was also statistically significant (p < 0.001). High rates of MDR were found for Acinetobacter baumannii (97.77%), Pseudomonas aeruginosa (65%), Klebsiella pneumoniae (50%), Enterococcus faecalis (47.61%) and MRSA (46.55%). More than 60% of the Klebsiella pneumoniae strains were found to be resistant to carbapenems. Conclusion: The study revealed an alarming prevalence of MDR strains isolated in blood samples of the patients admitted to the ICU, indicating the necessity of consistent application of the measures to control.

Background/Objectives: In this research, we aimed to analyze the trend of the antimicrobial resistance pattern of Gram-negative isolated in blood samples collected from patients with severe invasive infections hospitalized in the intensive care unit in selected periods during and after COVID-19. Methods: A retrospective study of bacterial pathogens was performed on 481 patients admitted to the ICU between 2020 and 2023. The resistance patterns were analyzed using the Vitek 2 Compact system. Results. A total of 686 Gram-negative bacterial isolates were obtained. The most frequently detected Gram-negative pathogens were Klebsiella spp. (30.91%), Acinetobacter spp. (24.64%), and Escherichia coli (18.95%). Almost 50% of all the pathogens were multidrug-resistant, with a statistically significant increase post-pandemic (p < 0.05). Post-pandemic, the study highlighted a significantly higher percentage of the Klebsiella strains (p < 0.05), and a significant increase in the antibiotic resistance rate against colistin (p < 0.001) and tigecycline (p = 0.005). A very high percentage of MDR Acinetobacter spp. isolates was found, with a significant increase in the antibiotic resistance rate against colistin (p < 0.001). A significantly lower resistance was recorded for the Escherichia coli strains in the case of ceftazidime (p = 0.03) and aminoglycosides (gentamicin—p = 0.01, amikacin—p < 0.001). An increase in the percentage of carbapenem-resistant Klebsiella spp., Acinetobacter spp., and Enterobacter spp. strains was observed, and a significant decrease in the in the case of Proteus spp. (p = 0.01). Conclusions: Our findings revealed a statistically significant increase in the resistance rate to last-line antibiotics and in the percentage of MDR Gram-negative strains isolated in the blood samples in the post-COVID-19 era.

Objective: The aim of the study was to assess the long-term impact of laparoscopic sleeve gastrectomy (LSG) on lipid profile, uric acid level and metabolic syndrome. Materials and methods: A prospective study was performed between 2009-2014, evaluating long-term percentage of excesso body mass index loss (%EBMIL), lipid profile, uric acid level and metabolic syndrome. Results:Overall sixty subjects were followed-up. %EBMIL increased significantly, reaching a maximum (86,9 +/- 6,3%) at 5 years post-LSG. Therapeutic success rate (%EBMIL >= 60%) was 80% at 5 years. The triglyceride level decreased significantly (148 +/- 72.1 mg/dL baseline vs 130.7 +/- 57.5 mg/dL at 1 month vs 110.7 +/- 42.6 mg/dL at 3 months vs 92.5 +/- 35.2 mg/dL at 1 year vs 84.2 +/- 32.3 mg/dL at 5 years; p < 0.05 for all). HDL-cholesterol increased and uric acid decreased significantly in the first year postoperatively, remaining stable afterwards (46.9 +/- 12.3 mg/dL baseline vs 47.4 +/- 10 mg/dL at 1 month vs 49.8 9.3 mg/dL at 3 months vs 55.4 +/- 10.2 mg/dL at 1 year; p < 0.05 for all for HDL-cholesterol and 6.4 +/- 2 mg/dL baseline vs 6 +/- 13 mg/dL at 1 month vs 5.2 +/- 1.3 mg/dL at 3 months vs 4.8 +/- 1 mg/dL at 1 year; p < 0.05 for all for uric acid).The prevalence of metabolic syndrome decreased from 66.7% baseline to 8.3% at 5 years postoperatively (p < 0.01). Conclusions: LSG was effective in terms of %EBMIL and metabolic traits improvement for Romanian patients.

High-density lipoproteins (HDLs) can exert anti-atherogenic effects. On top of removing excess cholesterol through reverse cholesterol transport, HDLs play beneficial actions on endothelial function and integrity. In particular, HDLs are strong determinant of endothelial progenitor cells (EPCs) number and function. To gain further insights into such an effect we characterized in vitro functionality of circulating “early” EPCs obtained from 60 type 2 diabetes individuals with low HDL-cholesterol (HDL-C) and 59 with high HDL-C levels. After an overnight fast, venous blood was drawn in EDTA tubes and processed within 2-h from sampling. Peripheral blood mononuclear cells were isolated and plated on fibronectin coated culture dishes; after 3 days culture, adherent cells positive for Dil-ac-LDL/Lectin dual fluorescent staining were identified as monocytic angiogenic cells (MACs). After 5–7 days culture in EBM-2 medium, adherent cells were evaluated for viability/proliferation (MTT assay), senescence (beta-galactosidase activity detection), migration (modified Boyden chamber using VEGF as chemoattractant), adhesion capacity (on fibronectin-coated culture dishes) and ROS production (ROS-sensitive fluorescent probe CM-H₂DCFDA). MACs obtained from diabetic individuals with high HDL-C had 23% higher viability compared to low HDL-C (111.6 ± 32.7% vs. 90.5 ± 28.6% optical density; p = 0.002). H₂O₂ exposure impaired MACs viability to a similar extent in both groups (109.2 ± 31.7% vs. 74.5 ± 40.8% in high HDL-C, p < 0.0001; 88.3 ± 25.5% vs. 72.3 ± 22.5% in low-HDL, p = 0.004). MACs senescence was comparable in the two groups (102.7 ± 29.8% vs. 99.2 ± 27.8%; p = 0.703) and was only slightly modified by exposure to H₂O₂. There was no difference in the MACs migration capacity between the two groups (91.3 ± 34.2% vs. 108.7 ± 39.5%; p = 0.111), as well as in MACs adhesion capacity (105.2 ± 32.7% vs. 94.1 ± 26.1%; p = 0.223). Finally, ROS production was slightly thought not significantly higher in MACs from type 2 diabetes individuals with low- than high-HDL. After stratification of HDL-C levels into quartiles, viability (p < 0.0001) and adhesion (p = 0.044) were higher in Q4 than in Q1–Q3. In logistic regression analysis, HDL-C was correlated to MACs viability and adhesion independently of HbA1c or BMI, respectively. Our data suggest that in type 2 diabetes subjects, HDL-cholesterol is an independent determinant of circulating MACs functional capacities—mainly viability, to a lesser extent adhesion—likely contributing also through this mechanism to cardiovascular protection even in type 2 diabetes.