Lung cancer and pulmonary tuberculosis are two significant public health problems that continue to take millions of lives each year. They may have similar symptoms and, in some cases, are diagnosed simultaneously or may have a causal relationship. In tuberculosis disease, the chronic inflammation, different produced molecules, genomic changes, and fibrosis are believed to be important factors that may promote carcinogenesis. As a reverse reaction, the development of carcinogenesis and the treatment may induce the reactivation of latent tuberculosis infection. Moreover, the recently used checkpoint inhibitors are a debatable subject since they help treat lung cancer but may lead to the reactivation of pulmonary tuberculosis and checkpoint-induced pneumonitis. Pulmonary rehabilitation is an effective intervention in post-tuberculosis patients and lung cancer patients and should be recommended to improve outcomes in these pathologies.

Candida auris poses a serious threat to infection control and patient care since it can produce invasive infections that have a high fatality rate, has been linked to outbreaks in hospital environments, and is typically resistant to several antifungal medications. Since its first description in 2009, six clades have been described. The emerging fungal pathogen possesses adhesins that allow it to adhere to host tissues and medical devices, can form biofilms, produces various hydrolytic enzymes, employs several strategies to evade host immune responses, and exhibits high genetic diversity, which may contribute to its ability to adapt to different environmental conditions and evade host defenses. C. auris is very resistant to various disinfectants and may be difficult to detect.

Nosocomial fungal infections caused by Candida auris pose a threat to public health due to their increased resistance to common antifungal drugs. Four thiourea derivatives of 2-thiophenecarboxylic acid were evaluated for their antifungal and antioxidant activity. The antifungal activity of the compounds was tested against strains of C. auris isolated from a hospital in Romania. With a notable inhibitory effect on C. auris biofilm growth and microbial adherence, the ortho-methylated derivative (SB2) showed the highest antifungal activity. Furthermore, emphasizing the impact of structural factors on the electron-donating capacity of these compounds, antioxidant activity assays (DPPH, FRAP, TEAC and CUPRAC) identified the SB2 compound as having the highest antihemolytic and antioxidant effects. The low cytotoxicity validated by hemocompatibility assays makes these compounds options for antifungal treatment. The results show that antifungal and antioxidant action is greatly influenced by structural modifications, especially the position of the methyl group on the aromatic ring. The possible clinical uses of these molecules as drugs for the treatment of multidrug-resistant C. auris infections needs further investigation.

Background: Antifungal resistance among Candida species represents a growing clinical challenge, particularly in the context of increasing prevalence of non-albicans species. Methods: We conducted a retrospective analysis of 747 fungal isolates collected between 2021 and 2026, evaluating species distribution, antifungal susceptibility profiles, minimum inhibitory concentration (MIC) patterns, and temporal trends in resistance. Results: Non-albicans Candida species accounted for 67.5% of isolates, exceeding the proportion of Candida albicans. Fluconazole and flucytosine exhibited the highest resistance rates (16.1% and 17.4%, respectively), while amphotericin B showed the highest susceptibility rate (82.1%). MIC analysis revealed elevated MIC90 values for azoles in Candida glabrata and Candida krusei, consistent with reduced susceptibility. A significant association between antifungal agent and susceptibility profile was observed (χ² = 33.81, p < 0.001; Cramér’s V = 0.205). Temporal analysis demonstrated fluctuating resistance patterns rather than a consistent increase over time. Multidrug resistance was uncommon (2.5%), although non-susceptibility to multiple agents was more frequent (20.3%). Conclusions: The study highlights substantial variability in antifungal susceptibility across Candida species and antifungal agents, emphasizing the importance of continuous surveillance and species-specific treatment strategies.

Background: Klebsiella pneumoniae is a leading cause of healthcare-associated infections and a major vehicle for the dissemination of antimicrobial resistance (AMR). Romania ranks among the most affected European countries for carbapenem-resistant K. pneumoniae (CRKP), yet data from specialized pulmonology–critical care settings remain limited. Objective: This study aimed to characterize the antimicrobial resistance profiles of K. pneumoniae clinical isolates—including MDR/XDR/PDR classification, carbapenem and colistin resistance rates, specimen and ward distribution, and category-specific resistance patterns—at a tertiary pulmonology–critical care institution in Bucharest, Romania. Methods: A retrospective, single-centre analysis of 203 K. pneumoniae clinical isolates from critical patients, which were collected at the Institute of Pneumology Marius Nasta, Bucharest, between July 2021 and May 2026. Susceptibility testing was performed using the VITEK^®2 system (bioMérieux), with results interpreted per EUCAST breakpoints. Results: Of 203 isolates, 112 (55.2%) were PDR, 36 (17.7%) XDR, six (3.0%) MDR, and 49 (24.1%) non-MDR. Carbapenem resistance was present in 134 isolates (66.0%); colistin resistance was present in 49 of 73 isolates tested (67.1%). Bronchial/tracheal aspirate was the dominant specimen source (61.1%), and intensive care units accounted for 61.1% of isolates. Resistance rates exceeded 75% for monobactams, first/second-generation cephalosporins, and fluoroquinolones. Conclusions: This cohort demonstrates severe AMR burden in this setting, consistent with the most concerning reports for K. pneumoniae in the literature. The findings underscore the urgent need for enhanced antimicrobial stewardship, strengthened infection control in ICU settings, and molecular surveillance of carbapenemase-producing high-risk clonal lineages in Romanian tertiary care.

Background: Candida species are among the most frequently isolated fungi from respiratory specimens in hospitalised patients, yet the clinical significance of their presence—infection versus colonisation, treatment versus observation—remains an unresolved challenge in clinical microbiology. Data from dedicated pulmonology centres in Eastern Europe are scarce. This study aimed to characterise the three-year epidemiology, species distribution, temporal trends, colony-load profiles, and longitudinal mycological trajectories of fungal respiratory isolates at a Romanian tertiary pulmonology hospital. Methods: We retrospectively analysed 1000 microbiological records from bronchial aspirates and other respiratory specimens collected between January 2022 and December 2024. Variables included patient demographics, clinical ward, primary diagnosis, fungal species, and semi-quantitative colony counts. Patients with multiple records were identified and analysed as a longitudinal sub-cohort. Results: Candida albicans predominated (45.5%), with a declining proportional trend across the study period. Candida krusei—intrinsically resistant to fluconazole—increased from 5.3% of isolates in 2022 to 9.7% in 2024. The intensive care unit (ICU) accounted for 25.8% of all records. Patients were predominantly male (67.5%) with a mean age of 63.4 years; acute respiratory failure was the most frequent underlying diagnosis (41.7%). High-load colonisation (>100 colony-forming units/mL) was documented in 19.0% of quantified specimens. Among 91 patients with serial cultures, 26 demonstrated inter-sample species shifts—several consistent with antifungal selection pressure—and 29 showed escalating colony loads, suggesting progression from colonisation toward probable infection. Conclusions: In a clinical setting where fluconazole has historically served as the default empirical antifungal agent, a C. krusei proportion approaching 10% of annual isolates constitutes a clinically actionable finding. Species-level identification of all fungal respiratory isolates is strongly warranted, as it directly influences therapeutic decision-making in approximately one in ten cases.