A Five-Year Analysis of Antibiotic Resistance Trends among Bacteria Identified in Positive Urine Samples in a Tertiary Care Hospital from Bucharest, Romania.

The rise of multidrug-resistant bacteria (MDR) has resulted in limited treatment options and poorer outcomes for patients. The objective of this study was to analyze the overall antibiotic resistance trends and distribution for pathogens identified in urine samples at the National Institute of Infectious Diseases "Prof. Dr. Matei Balș" from Bucharest, Romania, over a 5-year period. Antibiotic susceptibility testing was performed using automatic systems and the disk diffusion method. ESBL- and carbapenemases-producing strains were identified using immunochromatography tests, and ROSCO Diagnostica kits were used for definitive confirmation. All results were interpreted according to EUCAST clinical breakpoints. Gram-negative rods (GNR) had overall resistance rates higher than 50% for penicillin and 40% for 3rd- and 4th-generation cephalosporins. Escherichia coli resistance to fosfomycin (3%) and nitrofurantoin (2%) remains low, and 33.30% of E. coli, 48% of Klebsiella spp., and 37% of Pseudomonas aeruginosa isolates were multidrug-resistant (MDR). All Acinetobacter baumannii isolates were MDR by the last year of the study. For Gram-positive cocci (GPC), 37% of all Enterococcus faecium strains and 2% of Enterococcus faecalis were vancomycin-resistant (VRE). E. coli's incidence in UTIs' etiology is on a downward trend. The incidence of Klebsiella spp. and GPCs is rising. Antibiotic stewardship strategies should be implemented after carefully considering regional variations in etiology and resistance trends.

Fusobacterium necrophorum intratonsillar abscess as a source of bacteremia in a patient with a history of substance abuse.

A 22-year-old male, with a history of recreational drug use, was admitted with a 24-hour history of sore throat, bilateral otalgia, fever, chills, sweats, and pain in the upper chest. The blood cultures were positive for Fusobacterium necrophorum. A thoracic and neck soft tissue computed tomography (CT) scan revealed an intratonsillar abscess and pulmonary septic emboli. Initial treatment with Piperacillin-tazobactam and Clindamycin was de-escalated after 5 days. The patient made a complete recovery after 22 days of antibiotic treatment.

Septic cutaneous emboli revealing a severe case of Klebsiella pneumoniae liver abscess syndrome.

INTRODUCTION: Klebsiella pneumoniae liver abscess syndrome (KLAS) is characterized by bacteraemia, liver abscesses and metastatic infection caused by a hypervirulent strain of Klebsiella pneumoniae, usually belonging to the capsular serotype K1 or K2. Initially, KLAS was described in Eastern Asia; recently isolated cases have been reported from different parts of the world. CASE PRESENTATION: We describe the case of a woman with KLAS including meningeal, ocular and cutaneous metastatic infection and organ dysfunctions (coagulation abnormalities, thrombocytopenia and increased creatinine level). The identification of a hypermucoviscous strain of Klebsiella pneumoniae was possible by culture from one of the cutaneous emboli and subsequently confirmed by blood cultures. The patient fully recovered after abscess drainage and prolonged antibiotic treatment. CONCLUSION: We have pointed out about the importance of sampling each septic focus in order to identify the aetiology of a disseminate infection.

Considerations on the isolation of Listeria monocytogenes and other Listeria spp. in food products.

Listeria monocytogenes, a Gram positive bacillus, is well adapted for survival as a saprophyte in soil and decaying vegetation, but also able to cause serious infections, due to its ability of intracellular multiplication and meningeal and placental dissemination. A total number of 43 Listeria spp. strains isolated from food were investigated. Bacterial identification was performed according to standard methodology, based on: Gram staining affinity, morphology, culture aspects on blood agar (examined in oblique light), catalase test, beta/hemolysis (on sheep blood agar), CAMP test and carbohydrates breakdown, i.e., trehalose, mannitol, mannose, rhamnoze, xylose. Out of the 43 analyzed strains, the biochemical and serological assay evidenced: 10 strains of L.monocytogenes (8 belonging to serotype la and 2 strains to the serotype 4 b), 27 of L. innocua, 2 of L. grayi and 4 of L. welshimeri. L. innoqua was the most frequently identified species. L. monocytogenes strains typing confirms that the serotype la is most commonly found in food and serotype 4b was detected in imported foods. This observation has an epidemiological importance for our country.