The world has changed forever as a result of the COVID-19 pandemic. Antimicrobial resistance is a primary global health concern that places a significant financial and health burden on nations. Patients with Campylobacter-caused infections were the subject of the retrospective investigation. The data show that children aged 1–6 are the most commonly affected by Campylobacter enteritis. Resistance levels fluctuated over the course of the two periods. Nine isolates were sensitive to macrolides, and only one was responsive to tetracycline, which indicated inadequate sensitivity across all classes throughout the pandemic. This pattern raises serious concerns about the potential impact on public health. Tetracyclines and fluoroquinolones rank highest in terms of bacterial resistance. Regardless of the species, macrolides remain a practical and sufficient treatment for Campylobacter enteritis. Reassurance is still provided by much lower numbers in the post-pandemic period. There is no evidence to support the alarming claims made in the international literature about macrolides in Romania.
Background/Objectives: Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Identifying reliable biomarkers that reflect the underlying immune pathophysiology of sepsis and support early risk stratification remains a major clinical priority. This prospective study aimed to evaluate the prognostic value of interleukin-6 (IL-6) measured at ICU admission in patients with sepsis and septic shock. Methods: This prospective observational study included adult patients with sepsis and septic shock admitted to the Intensive Care Unit (ICU) of the Clinical Hospital of Infectious Diseases Constanța between 2021 and 2025. Receiver operating characteristic (ROC) curve analysis with DeLong comparisons, Kaplan–Meier survival analysis, and Cox proportional hazards regression modeling were performed to assess the association between baseline IL-6 levels, in-hospital mortality, and time to death. Results: Among the analyzed biomarkers, IL-6 demonstrated the highest discriminatory performance for in-hospital mortality (AUC = 0.956; 95% CI: 0.893–0.987; p < 0.0001). The optimal cut-off value (>135.14 pg/mL) yielded a sensitivity of 87.65% and specificity of 92.86% (Youden index = 0.805). However, despite this excellent discrimination between survivors and non-survivors, baseline IL-6 levels were not significantly associated with time-to-death in Cox proportional hazards regression analysis. Conclusions: Admission IL-6 showed excellent discriminatory performance for mortality risk stratification but was not associated with survival duration in time-to-event analyses. These findings suggest that IL-6 should be interpreted primarily as an early risk stratification biomarker rather than a predictor of survival duration in patients with sepsis.
Background: Sepsis is a life-threatening organ dysfunction that results from an exaggerated host immune response to disseminated infection. The relationship between lymphopenia and sepsis has been extensively studied, and in particular, sepsis-induced lymphopenia is gradually being recognized as an essential factor in the prognosis of sepsis. Notably, sepsis-induced lymphopenia has been associated with worse outcomes, including increased risk of secondary infections, multiple organ failure, and death. Few studies have directly compared the dynamic evolution of lymphocyte counts between different etiologies of sepsis or evaluated their prognostic value using serial measurements. This study aims to explore the temporal dynamics of lymphopenia, but also of neutrophil-to-lymphocyte (NLR) ratio in patients with severe systemic infections and to assess their relationship with in-hospital mortality. Methods: A prospective cohort of 95 adult patients was analyzed. Absolute lymphocyte counts (ALCs) and neutrophil-to-lymphocyte (NLR) ratio values were recorded on Days 1, 3, 5, and 7. Comparisons were made between different infectious etiologies and outcomes, and ROC analysis assessed predictive performance. Results and Conclusions: Patients with viral sepsis (“COVID-19”) showed a significant and sustained decrease in lymphocyte counts (p < 0.001) and a progressive increase in NLR (p < 0.001), unlike patients with bacterial sepsis. In correlation with outcome, regardless of etiology, lymphocyte counts were significantly lower in non-survivors from Day 3 onward, while NLR was significantly higher on Day 7 (p = 0.002). Early NLR and ALC had limited predictive value, but longitudinal trends were associated with poor prognosis.
Introduction: The COVID-19 pandemic caused by the new coronavirus has led to enormous pressure on health systems around the world, with an increase in the number of hospitalizations for pneumonia with a higher incidence of healthcare-associated infections (1). Material and Method: We performed a retrospective analysis of 40 cases hospitalized in the first pandemic wave between March 2020-May 2020, addmited in the Intensive Care Unit of the Clinical Hospital for Infectious Diseases Constanta, including patients with a diagnosis of SARS-CoV-2 infection and Bacterial superinfection. Multiple parameters were analysed: clinical, biological, bacterial culture results, resistance profile of isolated strains, as well as patient’s evolution. Results and Conclusions: In terms of patient profile, the average age was 62.3 years, with the male sex being the majority represented by a number of 30 cases (75%). All patients had associated comorbidities. The clinical picture presented by the patients was characteristic of severe forms of infection, with respiratory failure. The observed bio-humoral changes characteristic of bacterial superinfections were found in all patients, leukocytosis with marked neutrophilia, significant biological inflammatory syndrome and positive procalcitonin. During the period analysed we observed a significant increase in carbapenem-resistant strains. The resistant strains were represented by Klebsiella Pneumoniae found in 35 samples (54%), Acinetobacter Buamanni was isolated in 15 culture samples (23%). The antibiotic regimen used consisted of a combination of 2 or 3 classes of antibiotics depending on the resistance profile, monotherapy is not recommended in infections with multi-resistant germs. All patients required oxygen therapy, the average length of hospital stay was 28 days. Death was recorded in 10 cases (25%).
Introduction: One of the most common neurologic disease in Acquired Immunodeficiency Syndrome (AIDS) caused by Human Immunodeficiency Virus (HIV) is represented by progressive multifocal leukoencephalopathy (PML), being caused by John Cunningham (JC) polyoma virus. Case presentation: We report a case of a 27 years old women, HIV-positive since childhood, under specific antiretroviral therapy with good adherence to it in that period but starting with adolescence adherence to highly active antiretroviral therapy (HAART) decreased. In this context her HIV viral load increased to a 690.000 copies/ml, and CD4 collapsed at 57 cells/mmc. She presented in our clinic with ataxic left hemiparesis, truncal ataxia and left hemi-hypoesthesia. Cerebrospinal fluid (CSF) showed a slightly pleocytosis and polymerase chain reaction performed from CSF diagnosed John Cunningham (JC) virus. Once diagnosis established, we reinitiated HAART, but some neurologic disorders persisted like difficulty of the left upper member, having the modified Rankin scale (mRS) of 5. The patient started a multidisciplinary rehabilitation (MDR) treatment, specifically adapted. It consisted of 4 sessions of neuromotor treatments, 20 sessions of massages, and 12 sessions of occupational therapy. According to MDR, the patient improved the ataxic walking, without support, presenting an improvement mRS of 3. Conclusions: AIDS patients with PML could require a prolonged MDR treatment for neurological disorders and rehabilitation treatment promptly should be applied when such diagnosis is suspected. Key words: progressive multifocal leukoencephalopathy, human immunodeficiency virus, neurological disorder, multidisciplinary rehabilitation,
First described by Bright in 1836, who reports two cases secondary to suppurative angiocolitis and pilephlebitis, intrahepatic suppurations were, until the era of the discovery of antibiotics, one of the most dreaded causes of mortality, reaching a rate of almost 100%. Today, both the incidence of liver abscesses and the mortality rate have been significantly reduced, as the introduction of antibiotics has dramatically reduced the number of septic piles due to peritoneal outbreaks. Their etiology is more recently, most frequently, a biliary or neoplastic disease. On the other hand, the improvement of germ isolation techniques has made it possible to identify anaerobic germs with maximum frequency, and diagnostic and treatment performance has increased so much with the advent of non-invasive or minimally-invasive procedures that the overall mortality rate of 70% in 1975 is now about 30–38%. We present the case of a 75-year-old male patient with no known history of ilnesses who is admitted for fever, chills, myalgia, arthralgia and visual disturbances with onset of approximately one week. Biologically he presents with leukocytosis with marked neutrophilia, mild thrombocytopenia and significant biological inflammatory syndrome. Suspicion is raised for a diagnosis of Sepsis with unspecified starting point with possible pyogenic cavernous sinus thrombosis, a complication suggested by the presence of visual disturbances. Neuro-imaging evaluation by CT and brain MRI is performed, with the diagnosis of thrombosis being refuted. Abdominal CT is performed which identifies a space replacement formation in the left hepatic lobe for which MRI evaluation is required. MRI detects an expansive hepatic formation with semiology suggestive of liver abscess. Treatment was instituted with a combination of broad-spectrum antibiotics and antifungal treatment, but the evolution was unfavourable with maintenance of leukocytosis with marked neutrophilia and progression of inflammatory samples. It was necessary to evaluate the case by a multidisciplinary team (infectious disease specialist, gastroenterologist, surgeon) to establish the appropriate therapeutic management, with surgical resolution of the case, with a favourable postoperative evolution.