Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) are high-burden healthcare-associated pathogens that increase mortality, prolong hospitalisation, and drive substantial healthcare costs worldwide. These infections are associated with high morbidity, increased mortality, prolonged hospital stays, and significant costs, particularly among immunocompromised patients or those with extended hospitalizations. This systematic review was conducted and reported in accordance with PRISMA 2020, aiming to synthesise existing data on the epidemiology, resistance mechanisms, clinical manifestations, and strategies for the diagnosis, treatment, and prevention of MRSA and VRE infections. Data were qualitatively synthesised. A total of 113 records published between 2020 and 2025 met the inclusion criteria and were identified through searches in multiple bibliographic databases and publisher platforms (e.g., PubMed, Scopus, Web of Science). MRSA and VRE are implicated in numerous severe infections, including ventilator-associated pneumonia, catheter-associated urinary tract infections, endocarditis, and bacteraemia. Antimicrobial resistance is driven by the mecA, vanA, and vanB genes, while biofilm formation further complicates therapeutic efforts. Biofilm formation can promote antibiotic tolerance (slower killing without an increase in MIC) and persistence (survival of ‘persister’ cells), distinct from genetic resistance, and may complicate therapy in selected infections. Effective strategies include appropriate anti-MRSA/anti-VRE agents (e.g., ceftaroline for MRSA; linezolid or daptomycin for VRE), active screening, stringent infection prevention and control measures, and antimicrobial stewardship programmes. Implementation is often hindered by institutional barriers, limited resources, and insufficient staff training. A multidisciplinary, evidence-based approach is essential for the effective management of these infections. Reducing this burden requires coordinated implementation of rapid diagnostics, stringent infection prevention and control, and antimicrobial stewardship, supported by sustained institutional and public health investment.

Respiratory infections are the most common infectious diseases among children, representing a cause of death and generating a significant number of hospitalisations. The aim of the study was to analyse the epidemiological and clinical characteristics of viral pathogens causing respiratory tract infections in newborns and young children admitted to Galati pediatric hospital between October 2022 and December 2023. The diagnosis was performed using multiplex RT-PCR panels, which allowed simultaneous identification of respiratory pathogens (viruses and bacteria). From a total of 803 hospitalised patients with respiratory diseases, 607 (75.6%) children had a positive result for at least one respiratory virus and 96 patients (11.9%) were identified with bacterial infections. Mixed coinfections were found in almost half of the patients (44.5%). Most of RSV positive children had an increased length of stay, more than 7 days. It was shown a decline in severe cases of viral respiratory infections with prolonged hospitalisation as patients age up to 5 years.

Pertussis, a highly contagious disease, contributes to a great number of hospitalizations among children, with an increased risk of morbidity and mortality. The aim of the study was to investigate the epidemiological and clinical features of B. pertussis infections among hospitalized children and to compare the clinical course according to vaccination status and the presence of co-infections. We performed a retrospective study, which included patients positive for B. pertussis detected by multiplex RT-PCR panels, from September 2022 to May 2025. Out of 2493 samples, 84 tested positive for B. pertussis (3.37%). Age-appropriate immunization was achieved in 19.1% (16/84) cases, 10.7% (9/84) were incompletely vaccinated, 9.5% (8/84) did not meet the age criteria and 60.7% (51/84) were not vaccinated. Infants ≤ 3 months were more susceptible to mixed co-infections (52%), had a more severe course, with transfers to the ICU (32%) and a prolonged average length of stay (9.2 days). Co-infections were found in 39.3% cases, rhinovirus being the most common agent (17.9%). B. pertussis and rhinovirus co-infection was associated with a decreased SpO₂ level (<92%) and increased CRP and Ferritin levels.

This study showed the resistance profile of Klebsiella pneumoniae strains which were isolated between January 2018 - November 2021, from various samples at Emergency Clinical Hospital for Children “St. Ioan” in Galati, Romania. Identification of K. pneumoniae isolates was achieved by analyzing colony morphology, microscopic examination, and by performing biochemical tests and automatic methods using Vitek 2 system. Testing of antibiotics susceptibility was done by using the disk diffusion method and by determining the minimum inhibitory concentration (MIC). Further, 133 strains were identified, the most of them were isolated from the respiratory samples (74 strains representing 57.31%). Additional, 80 strains (60.15%) were isolated from patients under one year of age, 68 isolates (51.13%) from female patients, 72 isolates (54.14%) from patients living in urban areas. More than 80% of K. pneumoniae strains were susceptible to carbapenems, fosfomycin and amikacin while over 70% were susceptible to ciprofloxacin, nitrofurantoin and gentamicin. Over 42% of the isolates were multidrug resistant (MDR). Antimicrobial resistance in K. pneumoniae is a real threat that requires vigilant monitorization. This study revealed a low rate of resistance to carbapenems, fosfomycin and amikacin.

Mycoplasma pneumoniae (MP) is a frequent cause of pediatric pneumonia, but the clinical relevance of respiratory coinfections remains incompletely defined. We conducted a retrospective cohort study of 192 hospitalized children with multiplex RT-PCR-confirmed MP infection between April 2023 and November 2025. Patients were classified as MP monoinfection (123/192, 64.1%), MP with viral coinfection (34/192, 17.7%), or MP with bacterial/mixed coinfection (35/192, 18.2%) and children with coinfection were younger than those with MP infection alone, with median ages of 6.5 years (IQR 1–11) in the viral coinfection group and 5 years (IQR 1–7) in the bacterial/mixed coinfection group, compared with 11 years (IQR 7–14) in children with MP alone (p < 0.001). Respiratory failure occurred in 36% of children with MP infection alone, 65% of those with viral coinfection, and 31% of those with bacterial/mixed coinfection. In adjusted logistic regression, viral coinfection was independently associated with higher odds of respiratory failure relative to MP infection alone (aOR 3.37, 95% CI 1.49–7.94; p = 0.004), whereas bacterial/mixed coinfection was not (aOR 0.85, 95% CI 0.35–2.03; p = 0.725). In multinomial regression, increasing age was inversely associated with both viral coinfection (RRR 0.86, 95% CI 0.79–0.94; p < 0.001) and bacterial/mixed coinfection (RRR 0.79, 95% CI 0.72–0.87; p < 0.001). In negative binomial regression, evidence for longer hospitalization in the viral coinfection group was weaker and imprecise (IRR 1.16, 95% CI 0.99–1.37; p = 0.069). Fibrinogen differed across etiologic groups, with the lowest values in bacterial/mixed coinfection (p = 0.004). In this hospitalized pediatric cohort, MP coinfection was more frequent in younger children, and viral co-detection showed the clearest association with respiratory failure. These findings should be interpreted in the context of the retrospective design, modest subgroup sizes, and the limitations of upper-airway multiplex PCR co-detection.