Elena Mocanu

Dr. Elena Mocanu

orcid

Research Focus & Metrics

Academic Career Length

5Years (2022-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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28 April 2025 in Biomedicines
Verified
Journal Article
Open access
PDF file
ATAndreea Elena Topa
Andreea Elena Topa
CIConstantin Ionescu
Constantin Ionescu
APAnca Daniela Pinzaru
Anca Daniela Pinzaru
EMElena Mocanu
Elena Mocanu
AIAna-Maria Iancu
Ana-Maria Iancu
SCSIMONA CLAUDIA CAMBREA
SIMONA CLAUDIA CAMBREA
Background/Objectives: Urinary tract infections (UTIs) represent a significant public health challenge, with Escherichia coli being the primary causative pathogen. The rise in antimicrobial resistance (AMR), further intensified by shifts in antibiotic prescribing practices during and after the COVID-19 pandemic, poses substantial difficulties in treatment optimization and clinical management. Methods: This retrospective study analyzed 644 E. coli strains from urine samples collected in a southeastern Romanian hospital during two periods: pre-pandemic (2018–2019, N = 361) and post-pandemic (2023–2024, N = 283). Antimicrobial susceptibility was assessed using the VITEK automated system for key antibiotic classes. Results: A significant increase in fluoroquinolone resistance was observed, especially for ciprofloxacin (p = 0.02), alongside rising ceftriaxone resistance (p = 0.004), suggesting the spread of ESBL-producing strains. Resistance to trimethoprim/sulfamethoxazole, ampicillin, and amoxicillin/clavulanic acid remained high, limiting their empirical use. Carbapenem resistance was low (p > 0.1), while nitrofurantoin and fosfomycin retained high efficacy (p = 0.26 and p = 0.64). Conclusions: The post-pandemic period showed a concerning rise in resistance to fluoroquinolones and third-generation cephalosporins, highlighting the need for stricter antimicrobial stewardship. Carbapenems remain effective for severe infections, while nitrofurantoin and fosfomycin are reliable first-line options for uncomplicated UTIs. Continuous AMR surveillance is essential to optimize treatment and curb multidrug-resistant strains.

2 March 2022 in Current Oncology
Verified
Journal Article
Open access
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CTCampeanu Adriana Teodora
Campeanu Adriana Teodora
EDElena Dumea
Elena Dumea
MRMihaela RUS
Mihaela RUS
CFClaudia Fodor
Claudia Fodor
AIAnita Cristina Ionescu
Anita Cristina Ionescu
Irina Magdalena DumitruIrina Magdalena Dumitru
Irina Magdalena Dumitru
Lesions commonly associated with HIV infection include oral candidiasis, herpes simplex infection, oral Kaposi’s sarcoma, hairy leukoplakia, periodontal diseases (linear gingival erythema and necrotizing ulcerative periodontitis), xerostomia, human papillomavirus-associated warts, aphthous ulcers, non-Hodgkin’s lymphoma, histoplasmosis, carcinoma, exfoliative cheilitis, and HIV salivary gland disease. Non-Hodgkin’s lymphoma (NHL) is the most common cancer in people living with HIV (PLWH), and the incidence is increased for aggressive B-cell NHL. Plasmablastic lymphoma (PbL) is a rare and aggressive B-cell malignancy that is often unresponsive to chemotherapy and usually has a poor prognosis. We hereby present the case of a patient with a recent history of COVID-19 infection who was diagnosed with HIV and NHL, with manifestations in the oral cavity and a favorable evolution after the introduction of antiviral therapy, specific chemotherapy, and radiotherapy. Dental expertise is necessary for the appropriate management of oral manifestations of HIV infection or AIDS, and lymphoma should be included in the differential diagnosis of any oral lesions.

15 February 2026 in Antibiotics
Verified
Journal Article
Open access
PDF file
CVCorina Voinea
Corina Voinea
EMElena Mocanu
Elena Mocanu
EDElena Dantes
Elena Dantes
SJSanda Jurja
Sanda Jurja
NANeculai Ana-Maria
Neculai Ana-Maria
SRSorin Rugina
Sorin Rugina
Background/Objectives: Healthcare-associated infections (HAIs) remain a major source of morbidity, mortality, and healthcare burden, and were profoundly affected by the COVID-19 pandemic through changes in case mix, care organization, and antimicrobial use. This study aimed to compare the epidemiology, etiology, ward distribution, risk factors, and outcomes of HAIs during the pandemic and post-pandemic periods in southeastern Romania, with particular emphasis on Clostridioides difficile infection (CDI), multidrug-resistant (MDR) pathogens, and in-hospital mortality. Methods: This retrospective observational study included 3929 patients with confirmed HAIs reported by 10 hospitals in one Romanian county between March 2020 and December 2024, divided into a pandemic period (March 2020–March 2022) and a post-pandemic period (April 2022–December 2024). Sociodemographic, clinical, ward-related, therapeutic, and microbiological variables, together with discharge status and cause of death, were analyzed using Fisher’s exact test, Z-tests with Bonferroni correction, the Mann–Whitney U test, and multivariable models, applying national and ECDC-aligned surveillance definitions for HAIs. Results: Patients were predominantly older adults (median age 67 years), with a slight male and urban predominance. Hospital stays were longer during the pandemic. Immunosuppression, previous surgery, antisecretory therapy, and chemotherapy were more frequent post-pandemic. HAIs were mainly reported from medical wards, with a relative shift towards intensive care units during the pandemic; pediatric wards carried a smaller burden. CDI was the leading HAI (about half of all cases) with higher post-pandemic prevalence, whereas SARS-CoV-2 infections predominated in medical and surgical wards; Acinetobacter baumannii and Klebsiella pneumoniae clustered in intensive care units during the pandemic, and were more often associated with mortality. Overall, 59.7% of patients improved and 17.5% died, with higher mortality during the pandemic, while post-pandemic deaths were more frequently unrelated to HAIs. Conclusions: This study demonstrates a substantial and ongoing burden of healthcare-associated infections in southeastern Romania, with elderly patients with prolonged hospital stays and complex medical conditions being most affected and experiencing considerable mortality, particularly in medical and intensive care units. After the pandemic, Clostridioides difficile infections became more prevalent in the context of repeated antibiotic use and immunosuppression. Mortality among patients with HAIs was higher during the pandemic, whereas in the post-pandemic period deaths were more often unrelated to HAIs, underscoring the need to strengthen antimicrobial stewardship programs and infection prevention strategies.

21 November 2025 in Journal of Clinical Medicine
Verified
Journal Article
Open access
PDF file
CVCorina Voinea
Corina Voinea
EMElena Mocanu
Elena Mocanu
EDElena Dantes
Elena Dantes
SJSanda Jurja
Sanda Jurja
NANeculai Ana-Maria
Neculai Ana-Maria
SRSorin Rugina
Sorin Rugina
Background: Healthcare-associated infections (HAIs) are a significant public health problem, having a decisive impact on the prognosis of patients hospitalized with COVID-19. In Romania, the absence of a uniform reporting system and the lack of epidemiological data comparable to European standards limit the real assessment of their incidence and consequences. Methods: In this context, the present study aimed to conduct an integrated analysis of the clinical, epidemiological, and microbiological factors involved in the mortality of patients with COVID-19 and HAIs in a county located in southeastern Romania. This research was based on a retrospective observational study that included 295 patients with a confirmed diagnosis of COVID-19 and at least one documented HAI between January 2020 and December 2022. Data were extracted from standardized reporting forms, and statistical analyses included tests (Fisher’s exact test, Mann–Whitney U), ROC curves, Kaplan–Meier survival analysis, and Cox proportional hazard regression. Results: The analysis revealed a mortality rate of 32.5%, significantly associated with advanced age, gastrointestinal surgery, and respiratory infections. Clostridioides difficile was the predominant pathogen (84.1%), and the threshold of ≥63.5 years demonstrated predictive value for mortality. In multivariate models, age greater than 63 years and gastrointestinal surgery were confirmed as independent predictors of death. Conclusions: The findings highlight the substantial impact of HAIs on the clinical progression of COVID-19 patients, underscoring the need for comprehensive systemic interventions, including enhanced prevention and control strategies, prudent antimicrobial therapy, and standardized epidemiological monitoring. Implementing these measures is crucial to mitigating HAIs’ effects and improving patient outcomes in similar situations.

22 September 2025 in Journal of Clinical Medicine
Verified
Journal Article
Open access
PDF file
CVCorina Voinea
Corina Voinea
EMElena Mocanu
Elena Mocanu
Cristian Opariuc-DanCristian Opariuc-Dan
Cristian Opariuc-Dan
EDElena Dantes
Elena Dantes
AGAlexandra Cristiana Gache
Alexandra Cristiana Gache
SRSorin Rugina
Sorin Rugina
Background/Objectives: The COVID-19 pandemic has significantly disrupted healthcare systems worldwide, exposing longstanding weaknesses, particularly in the prevention and control of healthcare-associated infections (HAIs). Regional disparities in infection prevention and control (IPC) strategies offered valuable lessons for improving public health preparedness. This systematic review aims to identify and compare regional IPC approaches adopted during and after the pandemic, highlighting best practices to strengthen healthcare resilience. Methods: The review was conducted in line with PRISMA guidelines and registered in the PROSPERO database (CRD420251032525). Articles published between 1 January 2020 and 31 March 2025, were retrieved from PubMed, Scopus, and Web of Science. Only full-text studies in English were included. The risk of bias was assessed using the ROBINS-I tool. Results: Of the 63 articles initially identified, 8 met the inclusion criteria. The selected studies demonstrated substantial variability in the implementation of IPC. The availability of infrastructure, funding, coordination capacity, and training of medical staff had a significant impact on outcomes. In regions with well-defined protocols and a solid infrastructure, there was a significant decrease in HAIs, while in resource-poor areas, there was a significant increase. Effective measures included continuous monitoring, regular staff training, provision of adequate equipment, expansion of testing capacity, reorganisation of hospitals, and introduction of technological innovations in healthcare. Conclusions: COVID-19 emphasised the importance of adaptable IPC frameworks. Strengthening health systems requires context-specific standards, sustained investment in infrastructure, continuous training, and increased international cooperation to better prepare for future health emergencies.

27 October 2025 in Journal of Clinical Medicine
Verified
Journal Article
Open access
PDF file
Denisa Gabriela Ion-AndreiDenisa Gabriela Ion-Andrei
Denisa Gabriela Ion-Andrei
AGAlexandra Cristiana Gache
Alexandra Cristiana Gache
EMElena Mocanu
Elena Mocanu
APAndreea Cristina Postu
Andreea Cristina Postu
SLSimona-Alina Lupșă
Simona-Alina Lupșă
EDElena Dantes
Elena Dantes
Background: Accurate prognostic assessment in lung cancer is challenging, especially in settings with limited access to molecular testing. Routine hematological markers may complement TNM staging in identifying high-risk patients. Methods: We retrospectively analyzed 304 patients with histologically confirmed lung cancer to evaluate the prognostic value of hematological and inflammatory markers in relation to tumor stage and ECOG performance status. Survival was estimated using Kaplan–Meier analysis and independent predictors were identified through Cox regression. Cluster analysis integrated hematological markers with tumor characteristics. Results: Most patients presented with advanced disease (61.2% T4; 57.1% metastatic). Early stages (≤IIC) were associated with nearly double the median overall survival compared with stages ≥IIIA (p = 0.001). Nodal involvement and metastases further stratified outcomes. Among hematological markers, anemia (Hb < 11.85 g/dL) and leukocytosis (WBC > 11.71 × 109/L) predicted shorter survival and remained independent predictors in the multivariable Cox model (HR 1.70, p < 0.001; HR 1.54, p = 0.004), along with T4 stage (HR 1.47, p = 0.015). PLT count and fibrinogen were significant in univariate analysis but not after adjustment, while CRP and D-dimer showed no association. Cluster analysis identified two subgroups, with patients in Cluster 2 (T4 stage, anemia, leukocytosis) experiencing more than double the mortality risk compared with Cluster 1 (HR 2.33, p < 0.001). Conclusions: TNM stage remains the dominant prognostic factor in lung cancer. However, Hb and WBC count provide additional prognostic information, and cluster analysis may refine risk stratification by capturing clinically relevant heterogeneity.