The emergence and spread of antimicrobial resistance have been significant global health challenges, exacerbated by the COVID-19 pandemic. As healthcare systems faced unprecedented pressures, the management of non-COVID conditions, including urinary tract infections (UTIs), also encountered obstacles due to changes in microbial flora and antibiotic usage patterns. This cross-sectional study aimed to characterize the antimicrobial resistance trends among bacterial uropathogens isolated from patients in the Western region of Romania, between January 2020 and December 2022. The objectives were to map the resistance patterns and observe the pandemic’s influence on antimicrobial resistance, particularly among enterobacterial Gram-negative species, to guide treatment and infection control strategies. From a total of 2472 urine samples collected during the study period, 378 positive samples were analyzed. This study found that Escherichia coli was the most commonly isolated uropathogen, making up 46.3% of the cases (n = 175), with Klebsiella pneumoniae at 20.6% (n = 78). There was a high resistance of Klebsiella pneumoniae to several antibiotics, while carbapenemase production increased to 52.5% and extended-spectrum beta-lactamase (ESBL) present in 24.3% of the strains. Escherichia coli showed high resistance rates to amoxicillin–clavulanic acid (from 45.4% in 2020 to 53.8% in 2022) and trimethoprim/sulfamethoxazole (from 27.5% in 2020 to 47.2% in 2022). The increasing trend of antimicrobial resistance noted during the pandemic, especially in Gram-negative enterobacterial species, highlights the urgent need for robust infection control measures and rational antibiotic use. This study underscores the critical importance of continuous surveillance to adapt antibiotic therapies effectively and prevent the further spread of resistance, thereby ensuring effective management of UTIs in the evolving healthcare landscape influenced by the pandemic.

Background and objectives: Sexual function commonly declines during late pregnancy and early postpartum, but recovery is heterogeneous and influenced by obstetric and psychosocial factors. We aimed to (i) describe longitudinal Female Sexual Function Index (FSFI) trajectories from the first trimester to 12 months postpartum and (ii) test whether sleep quality and relationship satisfaction are independently associated with sexual function at 6–12 months postpartum, beyond obstetric factors and depressive symptoms. Methods: In this single-center prospective cohort study, pregnant women (singleton pregnancy, ≥18 years, enrolled ≤20 gestational weeks) completed the FSFI at six timepoints: first trimester, second trimester, third trimester, 6–8 weeks postpartum, 3 months postpartum, and 6–12 months postpartum. At 6–12 months postpartum, participants also completed the Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms, the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, WHOQOL-BREF for quality of life, a brief body-image disturbance scale, and a 1–5 relationship satisfaction rating. Delivery was categorized as vaginal low trauma, vaginal higher trauma, or cesarean. Multivariable linear and logistic regression modeled FSFI at 6–12 months postpartum and FSFI-defined dysfunction (FSFI < 26.55). Results: Among 112 women, FSFI-defined dysfunction at 6–12 months postpartum affected 58.0% (65/112). Mean FSFI declined from the first trimester (26.5 ± 4.1) to 6–8 weeks postpartum (18.8 ± 4.3) and recovered by 6–12 months postpartum (25.4 ± 5.0) (time effect p < 0.001). Dysfunction prevalence differed by delivery group (42.2% vaginal low trauma, 63.2% cesarean, 75.9% vaginal higher trauma; p = 0.012). In adjusted models, worse sleep quality and higher-trauma vaginal birth increased the odds of dysfunction, whereas higher relationship satisfaction was protective. Depressive symptoms and sleep quality were independently associated with lower FSFI in linear models. Conclusions: Late-postpartum sexual function follows a nadir-then-recovery trajectory shaped by additive psychosocial (sleep, mood, relationship) and obstetric trauma factors, supporting multi-domain postpartum screening and targeted referral pathways.

Background and Objectives: Klebsiella pneumoniae is a major nosocomial pathogen with a remarkable ability to develop resistance to multiple antibiotics, posing significant treatment challenges. This study aims to evaluate the antimicrobial resistance patterns among multidrug-resistant (MDR) and non-MDR strains of K. pneumoniae isolated over a six-year period (2018–2023) at the Clinical Hospital of Infectious Diseases and Pulmonology “Dr. Victor Babes” in Timisoara, Romania. The objectives include categorizing isolates based on their antibiotic resistance profiles and identifying trends in resistance to key antibiotics to optimize treatment strategies and enhance infection control measures. Materials and Methods: A cross-sectional analysis was conducted on K. pneumoniae isolates obtained from various clinical samples between January 2018 and December 2023. Identification was performed using standard bacteriological procedures, and antimicrobial susceptibility testing was conducted using the Kirby–Bauer disk diffusion method in accordance with EUCAST guidelines. Isolates were classified as susceptible, resistant, MDR, extensively drug-resistant (XDR), or pandrug-resistant (PDR) based on ECDC definitions. Data were analyzed using GraphPad Prism 6, with chi-square tests and Cochran–Armitage trend tests applied where appropriate. Statistical significance was set at p < 0.05. Results: A total of 1,081 K. pneumoniae isolates were identified over the six-year period, increasing from 118 isolates in 2018 to 319 in 2023. The proportion of XDR and PDR strains showed a significant upward trend from 30.5% in 2018 to 57.4% in 2023 (p < 0.001). Specifically, XDR strains increased from 22.9% in 2018 to 39.8% in 2023, while PDR strains rose from 7.6% to 17.6%. Among monomicrobial infections in 2023, XDR and PDR strains accounted for 42.4% and 16.5%, respectively. Resistance to carbapenems also showed a significant increase; for instance, resistance to ertapenem rose from 35.6% in 2018 to 54.2% in 2023 (p < 0.001). Subgroup analysis revealed that isolates from bronchial aspirates had the highest rates of XDR and PDR strains in 2023, at 38.0% and 17.2%, respectively. Additionally, polymicrobial infections where both K. pneumoniae and co-infecting pathogens were XDR/PDR increased from 24.2% in 2018 to 46.6% in 2023 (p < 0.001). Conclusions: The study demonstrates a significant escalation in antimicrobial resistance among K. pneumoniae isolates over the six-year period, particularly in XDR and PDR strains. The rising trend of resistance to critical antibiotics like carbapenems underscores the urgent need for enhanced antimicrobial stewardship and infection control measures. Targeted interventions are essential to curb the spread of these resistant strains and to optimize therapeutic strategies.

Background and Objectives: Secondary bacterial pneumonia can substantially worsen the clinical trajectory of patients hospitalized for Coronavirus Disease 2019 (COVID-19). This study aimed to characterize bacterial superinfections in COVID-19, including pathogen profiles, resistance patterns, inflammatory responses, severity scores, and ICU admission risk. Methods: In a retrospective cohort design, we reviewed 141 patients admitted to a single tertiary-care hospital between February 2021 and December 2024. A total of 58 patients had laboratory-confirmed bacterial superinfection by sputum, bronchoalveolar lavage, or blood cultures (superinfection group), whereas 83 had COVID-19 without any documented bacterial pathogens (COVID-only group). We collected detailed microbiological data from sputum, bronchoalveolar lavage (BAL), and blood cultures. Antibiotic sensitivity testing was performed using standard breakpoints for multidrug resistance (MDR). Inflammatory markers (C-reactive protein, procalcitonin, neutrophil-to-lymphocyte ratio, and systemic immune-inflammation index) and the severity indices Acute Physiology and Chronic Health Evaluation (APACHE) II, Confusion, Urea, Respiratory rate, Blood pressure (CURB), and National Early Warning Score (NEWS) were measured at admission. Primary outcomes included intensive care unit (ICU) admission, mechanical ventilation, and mortality. Results: Patients in the superinfection group showed significantly elevated inflammatory markers and severity scores compared to the COVID-only group (mean APACHE II of 17.2 vs. 13.8; p < 0.001). Pathogens most frequently isolated from sputum and BAL included Klebsiella pneumoniae (27.6%) and Pseudomonas aeruginosa (20.7%). Multidrug-resistant strains were documented in 32.8% of isolates. The superinfection group had higher ICU admissions (37.9% vs. 19.3%; p = 0.01) and more frequent mechanical ventilation (25.9% vs. 9.6%; p = 0.01). Mortality trended higher among superinfected patients (15.5% vs. 7.2%; p = 0.09). A total of 34% of the cohort had prior antibiotic use, which independently predicted MDR (aOR 2.6, p = 0.01). The presence of MDR pathogens such as Klebsiella pneumoniae (OR 2.8), Pseudomonas aeruginosa (OR 2.5), and Staphylococcus aureus (OR 2.1) significantly increases the risk of ICU admission. Conclusions: Bacterial superinfection exacerbates inflammation and worsens outcomes in COVID-19 patients, such as a higher risk of ICU admission.

Background and objectives: Urinary incontinence (UI) frequently coexists with female sexual dysfunction (FSD). Magnetic chair therapies—high-intensity focused electromagnetic stimulation (HIFEM) and extracorporeal magnetic innervation (ExMI)—are increasingly used for UI, but sexual outcomes are less well synthesized. We reviewed open-access clinical studies reporting Female Sexual Function Index (FSFI) and/or Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ) outcomes. Methods: Following PRISMA 2020 and an OSF-registered protocol, we searched PubMed, Scopus, and Web of Science to 25 October 2025. Eligible studies enrolled adult women with UI, used chair-based magnetic stimulation, and reported FSFI and/or PISQ before and after treatment. Data were narratively synthesized. Results: Five studies (n ≈ 219; FSFI n ≈ 170; PISQ n = 49) met the criteria. Randomized and controlled data showed clinically relevant advantages for active therapy: FSFI between-group gains were +6.3 at 8 weeks for HIFEM+PFMT vs. PFMT and +5.63 at 14 weeks for pulsed magnetic stimulation vs. sham. Single-arm cohorts reported FSFI increases of +8.1 at 3 months and +9.4 to +10.0 by ~6–12 months. PISQ-12 improved by +3.86 at 12 weeks when magnetic stimulation was combined with optimized PFMT. UI severity also decreased (ICIQ-UI SF −9.85; 74.4% at 12 weeks; ~71–72% reduction at 9–12 months). Adverse events were uncommon and mild where reported. Conclusions: Across heterogeneous designs, chair-based magnetic stimulation is associated with meaningful improvements in sexual function and continence in women with UI, with signals that combining stimulation with PFMT may enhance benefits. Standardized, longer-term trials centered on FSFI/PISQ are warranted.

Background and Objectives: Sexual function often fluctuates during pregnancy, yet the contributions of body image-related quality of life (BI-QoL)—operationalized via body image instruments such as the Body Exposure during Sexual Activities Questionnaire (BESAQ) and pregnancy-specific body image scales—and relationship satisfaction remain inconsistently quantified. This systematic review aimed to synthesize evidence on the associations between BI-QoL, relationship satisfaction, and female sexual function in pregnant women. Methods: Following PRISMA 2020, PubMed/MEDLINE, Scopus, and Web of Science were searched up to 23 August 2025. Eligible studies enrolled pregnant women and reported quantitative data on BI-QoL and/or relationship satisfaction alongside sexual outcomes. Risk-of-bias used design-appropriate tools; findings were narratively synthesized due to heterogeneity. Results: Thirteen studies met criteria (predominantly cross-sectional; sample sizes 107–472; one RCT; several couples/longitudinal cohorts). Female Sexual Function Index (FSFI) means clustered in the mid-20s; in a randomized trial, the intervention arm improved FSFI by +1.76 points (22.95 → 24.71; p = 0.002). Overall female sexual dysfunction reached 54.7% in the largest cross-sectional sample. Higher body exposure anxiety was associated with ~4.24-fold greater odds of dysfunction across trimesters. Marital satisfaction explained ≈36% of FSFI variance in multivariable models. Pregnancy context factors related to BI-QoL included planned pregnancy (β = −0.273) and third trimester (β = −0.280) indicating better BI-QoL, while more children predicted worse BI-QoL (β = +0.317). In one cohort, BI during sexual activity worsened postpartum versus pregnancy (p = 0.01). Conclusions: Across diverse settings, poorer BI-QoL and lower relationship satisfaction were consistently linked to reduced sexual function during pregnancy, with desire/arousal most affected. Routine screening and couple-sensitive counseling should be considered as promising, yet still under-tested, strategies that warrant further evaluation in intervention studies.