Introduction: Carbapenem-resistant Klebsiella pneumoniae (CRKP) represents a critical public health threat due to its rapid nosocomial dissemination, limited therapeutic options, and elevated mortality rates. This study aimed to characterize the epidemiology, carbapenemase profiles, and antimicrobial susceptibility patterns of CRKP isolates, as well as the clinical features and outcomes observed in infected or colonized patients. Materials and Methods: We conducted a retrospective analysis of clinical and microbiological data from patients with CRKP infections or colonization admitted between January 2023 and January 2024. Descriptive statistics were used to assess prevalence, resistance patterns, and patient outcomes. Two binary logistic regression models were applied to identify independent predictors of sepsis and in-hospital mortality. Results: Among 89 CRKP isolates, 45 underwent carbapenemase typing. More than half were metallo-β-lactamase (MBL) producers, with 44.4% co-harbouring NDM and OXA-48-like enzymes. Surgical intervention was associated with a significantly lower risk of sepsis (p < 0.01) and in-hospital mortality (p = 0.045), whereas intensive care unit (ICU) stay was a strong predictor of both outcomes. ICU admission conferred a 10-fold higher risk of sepsis (95%Cl 2.4–41.0) and a 40.8-fold higher risk of in-hospital death (95% Cl 3.5–473.3). Limitations: This single-center retrospective study included a limited number of isolates in certain groups. Additionally, cefiderocol (FDC) susceptibility was assessed by disk diffusion rather than by the broth microdilution method. Conclusions: Our study underscores the increasing prevalence of metallo-beta-lactamase-producing CRKP, particularly strains harbouring dual carbapenemases. Timely recognition of high-risk patients, combined with the implementation of targeted infection control measures and the integration of novel therapeutic options, is crucial to optimize clinical management and reduce mortality associated with CRKP.

Candida auris is a newly emerging yeast, which is raising public health concerns due to its outbreak potential, lack of protocols for decontamination and isolation of patients or contacts, increased resistance to common antifungals, and associated high mortality. This research aimed to describe the challenges related to identifying the outbreak, limiting further contamination, and treating affected individuals. We retrospectively analyzed all cases of C. auris detected between October 2022 and August 2023, but our investigation focused on a three-month-long outbreak in the department of cardio-vascular surgery and the related intensive care unit. Along with isolated cases in different wards, we identified 13 patients who became infected or colonized in the same area and time, even though the epidemiological link could only be traced in 10 patients, according to the epidemiologic investigation. In conclusion, our study emphasizes the substantial challenge encountered in clinical practice when attempting to diagnose and limit the spread of an outbreak. Therefore, it is crucial to promptly apply contact precaution measures and appropriate environmental cleaning, from the first positive case detected.

With the increasing burden of carbapenem-resistant Klebsiella pneumoniae (CR-Kp), including high rates of healthcare-associated infections, treatment failure, and mortality, a good therapeutic strategy for attacking this multi-resistant pathogen is one of the main goals in current medical practice and necessitates the use of novel antibiotics or new drug combinations. Objectives: We reviewed the clinical and microbiological outcomes of seven patients treated at the “Agrippa Ionescu” Clinical Emergency Hospital between October 2023 and January 2024, aiming to demonstrate the synergistic activity of the ceftazidime–avibactam (C/A) plus aztreonam (ATM) combination against the co-producers of blaNDM + blaOXA-48-like CR-Kp. Material and Methods: Seven CR-Kp with blaNDM and blaOXA-48 as resistance mechanisms were tested. Seven patients treated with C/A + ATM were included. The synergistic activity of C/A + ATM was proven through double-disk diffusion in all seven isolates. Resistance mechanisms like KPC, VIM, OXA-48, NDM, IMP, and CTX-M were assessed through immunochromatography. Results: With a mean of nine days of treatment with the synergistic combination C/A + ATM, all patients achieved clinical recovery, and five achieved microbiological recovery. Conclusions: With the emerging co-occurrence of blaOXA-48 and blaNDM among Kp in Romania, the combination of C/A and ATM could be a promising therapeutic option.

Background/Objectives: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a high-priority healthcare-associated pathogen. This study aimed to estimate rectal CRKP carriage and characterize same-patient clinical-site CRKP detection. Methods: We conducted a single-center retrospective microbiological surveillance study in a Romanian tertiary-care hospital between 1 January 2025 and 1 April 2026. Patient-level prevalence used all 3123 screened patients, with each patient counted once. CRKP recovery from rectal screening specimens was classified as gastrointestinal carriage; non-rectal recovery was reported as clinical-site detection and not as confirmed infection because clinical adjudication was not systematic. Results: Among 3123 screened patients, 712 (22.8%) had a positive rectal screen, 294 (9.4%) had resistant rectal K. pneumoniae carriage, and 168 (5.4%) had rectal CRKP carriage. Of these 168 carriers, 83 (49.4%) also had a retained non-rectal CRKP isolate; rectal recovery occurred first in 45, non-rectal recovery first in 36, and collection timestamps were identical in 2. Healthcare exposures, prior carbapenem-resistant Enterobacterales carriage, and admission-relative timing were analyzed descriptively using the full 168-patient denominator, with unavailable values retained as unknown. Invasive-device, intensive-care, recent hospitalization or readmission, and recent antimicrobial exposures were frequently documented. Admission-relative timing identified early detections, probable within-admission screen conversions, hospital-onset detections without a preceding negative screen, and indeterminate cases. Conclusions: Rectal CRKP carriage was frequent and commonly associated with same-patient CRKP detection at non-rectal clinical sites, indicating a substantial hospital-associated burden. In critically ill patients with sepsis or septic shock, known CRKP carriage should inform the choice of empirical CRKP-active therapy, with prompt de-escalation once microbiological findings and clinical response allow.