Background: Urinary tract infections (UTIs) are among the most common bacterial infections in children, with Escherichia coli as the leading pathogen. The rise in antimicrobial resistance, particularly extended-spectrum β-lactamase (ESBL) production, complicates empirical therapy, especially in countries with limited surveillance like Romania. Methods: We conducted a retrospective study on 248 pediatric patients aged 0–17 years diagnosed with E. coli UTI and admitted to a children hospital from Bucharest, Romania, between 2022 and 2024. Data collected included clinical presentation, laboratory values, and antimicrobial susceptibility testing. Patients were divided into ESBL and non-ESBL groups, and statistical comparisons were performed using SPSS v25. Results: Infants accounted for 68.1% of cases, with male sex predominating in this group (85.3%). ESBL-producing strains were identified in 19% of patients, more frequently in males (25% vs. 13.6%, p = 0.024). While inflammatory markers (CRP, leukocytes, neutrophils) were higher in complicated infections, they were paradoxically lower in ESBL cases. Non-ESBL isolates were highly susceptible to fosfomycin, third-generation cephalosporins, nitrofurantoin, and gentamicin. ESBL isolates showed resistance to most β-lactams but retained high susceptibility to fosfomycin (100%), carbapenems (>89%), cefoxitin (89.4%), and amikacin (85.1%). Conclusions: Our findings support the use of fosfomycin, nitrofurantoin, and selected aminoglycosides as viable empirical options in pediatric UTIs. Given the substantial ESBL prevalence and resistance to commonly used oral agents, local antibiogram data should guide empirical treatment strategies to preserve antibiotic efficacy and combat resistance.

Background: Functional somatic symptoms (FSSs) represent a significant clinical challenge in pediatric populations, with prevalence estimates ranging from 10 to 30%. The COVID-19 pandemic introduced unprecedented psychosocial stressors that may have influenced the presentation and precipitating factors of these conditions. This article aimed to characterize the clinical presentations, precipitating factors, and temporal patterns of functional somatic disorders in children admitted to a tertiary pediatric hospital in Bucharest, Romania, across pre-pandemic (2017–2019), pandemic (2020–2022), and post-pandemic (2023–2025) periods. Methods: This retrospective study included 1043 patients aged 3–17 years admitted with somatic symptoms without identifiable organic pathology. Data were extracted using ICD-10 diagnostic codes and confirmed through individual chart review. Variables analyzed included demographics, symptoms, precipitating factors, symptom duration, and family psychiatric history. Results: Female patients predominated (67.0%), with a median age of 14 years. Cardiovascular symptoms were most frequent (43.9%), followed by neurological (30.4%), digestive (19.0%), and respiratory (6.3%) manifestations. Family-related factors (38.6%) and school-related stress (32.7%) were the primary precipitating factors. Significant pandemic-related differences emerged: medical-related precipitating factors increased during the pandemic (18.5% vs. 10.7% pre-pandemic, p < 0.001), respiratory symptoms were more frequent (9.8% vs. 5.9% pre-pandemic), and symptom duration before admission was significantly longer (median 1 vs. 1 pre-pandemic and 0 months post-pandemic; p < 0.001). Conclusions: The COVID-19 pandemic substantially influenced pediatric somatic presentations, with increased health anxiety, respiratory symptoms, and delayed healthcare-seeking behavior. Post-pandemic patterns suggest the persistent influence of traditional stressors alongside pandemic-related effects.

Pediatric tuberculosis (TB) remains diagnostically challenging because of nonspecific presentations and the frequent absence of microbiological confirmation. We aimed to characterize pediatric TB patients presenting to a non-specialized tertiary hospital in Romania and to explore factors associated with bacteriological confirmation. We retrospectively analyzed children diagnosed with TB between 2017 and 2025 at a tertiary pediatric hospital in Bucharest. Clinical, epidemiological, laboratory, radiological, microbiological, and follow-up data were evaluated. Factors associated with bacteriological confirmation were assessed using univariate and exploratory multivariable analyses. Among 48 patients, the median age was 14 years (IQR 8.25–16), and 37.5% of cases were bacteriologically confirmed. Initial presentations were pleural effusion (47.9%), pneumonia (41.7%), and cavitary disease (10.4%). No patient with pleural effusion had a documented TB contact, compared with 45.0% with pneumonia and 40.0% with cavitary disease (p < 0.001). Bacteriologically confirmed patients were older and more frequently had cavitary lesions. In exploratory Firth penalized logistic regression, older age and the presence of cavitary lesions remained associated with bacteriological confirmation. Pediatric TB may mimic common respiratory diseases even without known TB contact. In exploratory Firth penalized logistic regression, older age and cavitary lesions were associated with bacteriological confirmation, although the estimates, particularly for cavitary lesions, were imprecise and should be interpreted cautiously, while the substantial proportion of clinically diagnosed cases highlights the importance of integrating clinical, radiological, immunological, and microbiological findings.