Search Results (308)

Background/Objectives: Multidrug-resistant (MDR) nosocomial infections remain a major challenge in intensive care units (ICUs), where delays in diagnosis and suboptimal antimicrobial therapy significantly impact outcomes. This narrative review synthesizes international literature and local epidemiological data from Western Romania to examine the role of rapid molecular diagnostics in the management of MDR infections and their integration with prevention and antimicrobial stewardship (AMS) strategies. Methods: Evidence was collected through a narrative literature review using PubMed, WHO, and ECDC sources published between 2010 and 2025. Key terms included “rapid molecular diagnostics,” “sepsis,” “ICU,” “UNYVERO,” “GeneXpert,” “BioFire,” and “carbapenem resistance.” Studies were selected based on clinical relevance to rapid diagnostics and MDR pathogens; no PRISMA-based systematic methodology was applied. Results: Diagnostic performance varies by platform and clinical syndrome. UNYVERO Hospitalized Pneumonia panel demonstrates a sensitivity range of 88.8–91.4% and specificity of 94.9–99.5% in respiratory infections, with a turnaround time of approximately 4–5 h. The GeneXpert Carba-R assay identifies major carbapenemases within 45–60 min with reported sensitivity 96–100% and specificity of 93–99%. BioFire^® Pneumonia and Blood Culture Identification panels similarly provide rapid syndromic results within 1 h, enabling earlier optimization of antimicrobial therapy. Local ICU data from Western Romania identified a substantial burden of carbapenem-resistant Acinetobacter baumannii, underscoring the need for rapid resistance detection to guide therapy. Conclusions: Rapid molecular diagnostics, when integrated with prevention bundles and AMS programs, facilitate earlier targeted therapy, support responsible antimicrobial use, and improve clinical decision-making in MDR infections. Their value is amplified in settings with high resistance prevalence. Wider implementation, combined with surveillance and access to novel antimicrobials, is essential to improve outcomes in critically ill patients. Full article

This study aims to evaluate the genetic diversity of the species Robinia pseudoacacia L. using several populations selected from places located in the Crișana Region. The first six ISSRs tested gave distinct bands, with a total of 59 loci, of which 45 were polymorphic (63.85%). The percentage of polymorphic loci varied within populations from 33.33% to 100%. The average number of observed alleles (Na) is 1.7627 and the average effective number of alleles (Ne) is 1.4926, indicating that the effective variability is lower than the observed variability. For the Nei (h) gene diversity index, we recorded an average value of 0.2795, and for allelic entropy, the average value of the Shannon index (I) was 0.4137. The study finds a significant differentiation between populations, with a Gst coefficient value of 0.43 indicating that 43% of the variability is due to interpopulation differences. Full article

We studied Lycaena helle (Lepidoptera: Lycaenidae) population genetics in lowlands and mountains of East-Central Europe using the microsatellite markers previously applied in population studies mainly in mountains of Western Europe. As in the West, the East-Central populations are genetically diverse (mean expected/observed heterozygosity 0.67/0.49), affected by drift processes (mean inbreeding coefficient 0.277) and widely differentiated (mean F_ST 0.209). The Polish lowland populations, all of them bivoltine in contrast to mountain populations, are less differentiated than Romanian populations, which are bivoltine in low and univoltine in high altitudes. The lowland Romanian population Vad is extremely genetically impoverished. A transferred CZ population from Western Europe is impoverished relative to its donor population, but the genetic parameters remain within a range of other studied so far. Dendrogram of allelic frequencies suggests that the populations form two branches, one rooted in southeastern Poland and branching towards Carpathians in Romania, one encompassing populations in central and northern Poland. We conclude that the lowland Romanian populations, plus populations in unglaciated southeastern Poland, represent sites where the species survived the glacial cycles in situ, comprising rear edge of subsequent upslope expansion, while northern Poland was colonised from more easterly regions. Full article

Background/Objectives: Antimicrobial resistance (AMR) in companion animals is a growing One Health concern due to the close interaction between pets and humans. Staphylococcus aureus (S. aureus) and Staphylococcus schleiferi (S. schleiferi) are common colonizers of the canine ear canal and can act as reservoirs of resistance. This study aimed to assess the prevalence and antimicrobial resistance profiles of S. aureus and S. schleiferi isolated from dogs with otitis externa and clinically healthy dogs in western Romania. Methods: A total of 973 canine ear swabs were collected, 503 from dogs with otitis externa and 470 from healthy dogs. Isolates were identified using MALDI-TOF MS. Antimicrobial susceptibility testing was performed using the VITEK^® 2 Compact system, bioMérieux, Marcy-l’Étoile, France, and interpreted according to CLSI VET01 guidelines, with 13 antimicrobials representing multiple drug classes. Results: S. aureus was more prevalent in healthy dogs (20%) than in otitis cases (4%), while S. schleiferi was more common in otitic samples (7.5% vs. 4%). Among S. aureus isolates from otitic dogs, penicillin resistance was highest (65%), and 25% were multidrug-resistant (MDR). In healthy dogs, S. aureus showed 54.3% penicillin resistance and 16% MDR prevalence. Four MRSA strains (4.3%) were identified only in healthy dogs. S. schleiferi exhibited the highest resistance to clindamycin, with MDR rates of 10.6% in otitic and 5.6% in healthy dogs. No MRSS strains were detected. Conclusions: Clinically healthy dogs may serve as asymptomatic carriers of resistant Staphylococcus strains, including MRSA. Routine antimicrobial susceptibility testing is essential to inform treatment choices and mitigate resistance dissemination within veterinary and public health contexts. Full article

West Nile Virus (WNV) is a mosquito-borne zoonosis with recurrent equine and human cases in Romania. Horses, although dead-end hosts, act as sentinels for local viral circulation. Farm-level risk conditions remain under-characterized. This pilot, exploratory cross-sectional study assessed 42 equine facilities in western Romania (2024). A standardized 10-item checklist was applied and a Composite Environmental Risk Score (CERS) (0–10, unweighted) was computed per facility. Spatial analysis in QGIS included distances to nearby water bodies. No serological or entomological data were collected; these are recommended for future validation. Stagnant water occurred at 71.4% (30/42) of facilities, uncovered rain-collecting containers at 64.3% (27/42), and outdoor housing of horses at 81.0% (34/42). Insect screens were present at 21.4% (9/42) and chemical/biological control at 33.3% (14/42). By design, the CERS ranged from 0 to 10; in our sample the observed range was 0–8 because not all assessed risk conditions co-occurred across sites. Overall, 42.9% (18/42) were classified as high risk (≥6). Neurological signs were reported anecdotally by some managers but were not analyzed. Mosquito-favorable conditions are widespread in Romanian equine facilities. CERS shows promise as a low-cost, rapid tool for routine facility-level assessment of environmental conditions favoring mosquito presence and prioritization of preventive actions. Integrating environmental risk scoring with entomological and serological surveillance could strengthen One Health early-warning systems. Such integration would support prevention of WNV and other mosquito-borne zoonotic pathogens in endemic European settings. Full article

At the European level, potato cultivation is highly polarized. In Western Europe (Germany, France, the Netherlands, Belgium, Denmark), yields are high, agricultural technology is advanced, and production systems ensure stability and competitiveness. In contrast, in Eastern and Southern Europe (including Romania, Poland, Italy, and Spain), yields are considerably lower due to the use of outdated agricultural practices, a low degree of mechanization, and increased exposure to adverse climatic factors. In Romania, potato cultivation is marked by significant territorial disparities and structural imbalances, influenced by land fragmentation, agro-pedoclimatic variability, and the lack of capital necessary for investments in modern technologies and irrigation systems. This study analyzes these regional disparities in relation to the country’s real agricultural potential and quantifies the economic impact of its failure to realize it. The methodology applied is based on descriptive statistical analysis of data at the county and regional level for the period 2003–2024, including minimum, maximum, average, and standard deviations of yields. These were integrated into a production function that correlates cultivated areas with average prices, highlighting major intra-regional differences and significant economic consequences at the national level. The results indicate a double crisis: a drastic reduction in the areas cultivated with potatoes (from 196,000 ha in 2017 to 76,000 ha in 2024) and consistently low yields (12,000–18,000 kg/ha), which led to the collapse of total production (from 3.1 million tons in 2017 to under 1 million tons in 2024). As a result, Romania registers a productivity three to four times lower than the reference Western European countries. Moreover, Romania has moved from being a net exporter to a net importer of potatoes, with the food self-sufficiency indicator decreasing from 100.3% in 2017 to 48.1% in 2023. Although domestic production could theoretically cover consumption needs, structural problems regarding yields, the sharp reduction in cultivated areas, and distribution deficiencies have seriously affected the balance of the domestic market. While per capita consumption has remained relatively constant, the decline in production has led, after 2021, to an increasing dependence on imports. These trends highlight the need for urgent structural reforms, technological modernization, and targeted agricultural policies to increase productivity and restore food security in the Romanian potato crop system. Full article

Autosomal recessive (AR) disorders represent a significant public health challenge, as asymptomatic carriers are often unaware of their reproductive risks. This study provides the first comprehensive assessment of AR gene variant frequencies and their molecular landscape in a fertile Western Romanian population. Genetic results from 604 unrelated, unaffected Caucasian individuals of reproductive age, tested at a single genetic center between 2020 and 2024, were retrospectively analyzed. Next-generation sequencing (NGS) with a multi-gene panel targeting 300 AR-associated genes was used for molecular profiling. Variants were identified in 156 genes, with 75% of individuals carrying at least one AR variant (mean 1.77 variants/person). A subgroup with >3 pathogenic variants comprised 7.5%, posing a notable risk for future offspring. The most frequent variants were detected in HFE (1:5), CFTR (1:9), BTD (1:16), GJB2 (1:17), and CYP21A2 (1:19). Four variants (HFE, c.187C>G; BTD, c.1330G>C; CFTR, c.1210-34TG[11]T[5]; GALT, c.-119_-116del) were particularly prevalent, each exceeding 3% frequency. Considerable allelic heterogeneity was observed for distrinctive variants in CFTR (14), PAH (12), USH2A (12), and ATP7B (9). Several variants were linked to severe disorders, with CFTR, GALT, ATP7B, and SMN1 identified as “red zone” genes associated with high morbidity and mortality. Low-frequency variants formed a “long tail” (83.9%), reflecting marked population heterogeneity and potential hidden disease risks. The study reveals high allelic diversity and a strong prevalence of AR variants in Western Romania. Variant-based gene classification supports population-level screening, highlighting the public health value of a national program to identify carriers and prevent severe inherited disorders. Full article

Background and Objectives: The present study evaluates documentation and control of cardiovascular risk factors (RFs) in patients with coronary heart disease (CHD) during routine outpatient visits at a single tertiary center in western Romania and places these findings in descriptive context relative to SURF-CHD reports from Europe. Materials and Methods: We have enrolled 136 consecutive patients between 18 and 80 years old with coronary artery disease attending routine outpatient clinic check-ups between May 2019 and July 2020. All patients had been diagnosed with acute coronary syndrome or stable angina pectoris and had been treated either by PCI or CABG. Comparisons with SURF-CHD were primarily descriptive due to non-harmonized denominators and lack of patient-level data; inferential testing was limited to variables with clear n/N in both cohorts. Results: Most patients (81%) were males with a mean age of 61.7 years. 93.4% of the patients had undergone PCI, and 4.4% had coronary artery bypass graft (CABG). Regarding risk factors, 25% were current smokers, while 50% were former smokers and the mean BMI value was 29.9 (±6.07). While most patients (80.1%) revealed no previous history of dyslipidemia, 62.5% had no previous history of arterial hypertension, and 84.6% had no previous history of diabetes mellitus. Mean LDL cholesterol levels after a major coronary event remained 93.55 (±43.52) mg/dL, mean HbA1c levels were 7.86 (±1.40)%, while mean systolic blood pressure was 129 (±14.9) mmHg. Conclusions: In this single-center audit, several modifiable RFs remained suboptimally controlled despite established CHD. These results should not be generalized nationally; rather, they highlight center-level opportunities for improving secondary prevention and underscore the need for multicenter, nationally representative registries in Romania. Full article

Background: Colorectal cancer (CRC) is a leading cause of cancer-related mortality worldwide, with Romania reporting among the highest rates in the European Union. Regional outcome data remain scarce. Methods: We performed a retrospective cohort study of 302 patients with surgically treated colorectal adenocarcinoma at a Romanian tertiary hospital between 2003 and 2005, with a median follow-up of 60 months. Survival was analyzed using Kaplan–Meier and Cox regression. Results: Radical resection with R0 margins was achieved in 72% of cases. The overall 5-year survival was 38%, with significantly lower outcomes in advanced stages. Independent predictors of poor prognosis included advanced stage, emergency surgery, incomplete resection, and older age. Conclusions: Survival outcomes in this Romanian cohort were substantially lower than those reported in Western Europe, reflecting the burden of late-stage presentation. These findings emphasize the urgent need for nationwide CRC screening programs and wider access to modern multimodal therapies. Full article

The Mangalia–Limanu coastal lake system, located in southeastern Romania along the Black Sea, represents a transitional aquatic environment shaped by the interplay between freshwater and marine influences. This study provides an integrated assessment of its physicochemical water parameters, sedimentological and geochemical properties, and benthic macroinvertebrate communities, aiming to evaluate its current ecological status and environmental dynamics. Field measurements using a multiparameter sonde revealed a predominantly freshwater to oligohaline system with moderate spatial heterogeneity. DO levels frequently reached supersaturation (>180%), coupled with high pH (~9.1), indicating intense daytime photosynthetic activity. Conductivity, TDS, and salinity increased longitudinally toward the port water area, while nitrate concentrations showed stronger signals upstream. Sediments were dominated by organic matter (18–88%), with lower carbonate (3–53%) and siliciclastic (8–49%) contents. Organic-rich deposits prevailed in the western-central sector, where reduced hydrodynamics and submerged vegetation favor autochthonous organic accumulation, whereas the eastern sector, exposed to marine action, showed more siliciclastic-rich substrates. Geochemical analyses revealed localized exceedances of Cr, Ni, Cu, Zn, and Pb regulatory thresholds (Order 161/2006), suggesting potential contamination hotspots. Benthic communities included 26 taxa, dominated by polychaetas, gammarids, and gastropods, with moderate diversity (H′ < 2). The results highlight a system under moderate anthropogenic pressure but retaining transitional lagoon characteristics, emphasizing the need for continued ecological monitoring and integrated management measures. Full article

Oak forests provide critical ecosystem services, but are being increasingly exposed to climate variability, drought, and insect outbreaks that threaten their long-term resilience. This study aims to integrate structural canopy indicators with climate-derived indices to detect early-warning signals of decline in temperate oak stands. We monitored eight Forest Management Units in western Romania between 2017 and 2021, combining field-based assessments of crown morphology, vitality traits, defoliation, and epicormic shoot frequency with hydroclimatic indices such as the Forest Aridity Index. Results revealed strong spatial and temporal variability: several stands showed advanced canopy deterioration characterized by increased defoliation, dead branches, and epicormic resprouting, while others maintained stable conditions, suggesting resilience and suitability as reference sites. Insect defoliators, particularly Geometridae, contributed additional stress, but generally at subcritical levels. By synthesizing these metrics into conceptual models and a risk scorecard, we identified the causal pathways linking climatic anomalies and biotic stressors to structural decline. The findings demonstrate that combining structural and climatic indicators offers a transferable framework for forest health monitoring, providing robust early-warning tools to guide adaptive silviculture and resilience-based management. Beyond the Romanian context, this integrative approach supports sustainability goals by strengthening conservation strategies for temperate forests under global change. Full article

Background/Objectives: Delayed graft function (DGF) is a major complication after kidney transplantation, affecting graft and patient survival. Although well-studied in Western populations, data from Eastern Europe are limited, and the prognostic significance of DGF severity, particularly renal replacement therapy (RRT) duration, is not well-defined. Methods: We conducted a retrospective analysis of 479 adult recipients of brain-dead donor (DBD) kidney transplants at a high-volume transplant center in Romania (2017–2024). DGF was defined as the need for dialysis within seven days’ post-transplant. Baseline characteristics, graft function, and survival outcomes were compared between DGF and non-DGF groups. Kidney function was evaluated using the Estimated Glomerular Filtration Rate (eGFR). Patient and graft survival were assessed using Kaplan–Meier curves and log-rank tests. DGF severity was stratified by RRT duration (≤14 vs. >14 days). Results: DGF occurred in 28.8% of patients (adjusted 24%). Those with DGF had a higher Body Mass Index (BMI), greater comorbidity (Charlson Index, Estimated Post-Transplant Survival (EPTS) score), longer pre-transplant dialysis, and higher Kidney Donor Profile Index (KDPI) donor kidneys. DGF was associated with lower graft survival at one, three, and five years and reduced patient survival at three and five years. Longer RRT was associated with progressively worse outcomes, with the poorest prognosis in patients needing >14 days. Conclusions: Delayed graft function was significantly associated with reduced graft and patient survival. Prolonged DGF time was found to be predictive for poorer outcomes. Full article

The European mink Mustela lutreola is one of the most threatened carnivores in Europe, having suffered dramatic range contractions and severe population fragmentation. Accurate knowledge of its genetic diversity is crucial for conservation planning, yet earlier studies based on partial mitochondrial markers offered limited resolution and often underestimated haplotype richness. In this study, complete mitochondrial genomes from four extant populations (Russia, n = 11; Romania, n = 16; Germany, n = 24; France–Spain, n = 15) were analysed using a suite of non-parametric and asymptotic estimators (Fisher’s α, ACE, Jackknife1, Bootstrap, Chao1-based iNEXT) together with negative binomial modelling. A total of 41 haplotypes were detected, but extrapolated estimates indicated substantially higher richness, particularly in populations dominated by singletons. Rarefaction and extrapolation analyses revealed that sample sizes of 70–130 individuals per population are needed to approach complete haplotype detection. The France–Spain and Romania populations harboured the highest predicted richness, whereas Germany and Russia, both represented by ex situ stocks, showed lower diversity. These results refine earlier assumptions of extreme homogeneity in the Western population and demonstrate that significant mitochondrial variation persists at the continental scale. The study provides quantitative benchmarks for sampling design and genetic management, supporting preservation of evolutionary potential in this critically endangered species. Full article

Serological testing for SARS-CoV-2-specific antibodies, particularly those targeting the nucleocapsid protein, plays a key role in assessing past infection and estimating population-level seroprevalence. The seroprevalence of nucleocapsid antibodies against SARS-CoV-2 was evaluated in 1048 blood donors using the Elecsys Anti-SARS-CoV-2 electrochemiluminescence immunoassay. Participants completed a questionnaire to assess risk factors, symptoms during SARS-CoV-2 infection and vaccination status. The overall SARS-CoV-2 seroprevalence was 89.69%. Seroprevalence was not significantly associated with gender or age. In multivariate logistic regression, most investigated risk factors showed no significant association with seroprevalence. However, residence area and vaccination status were independently associated with SARS-CoV-2 seropositivity. Donors from rural areas had significantly higher odds of seropositivity (aOR = 1.68; 95% CI: 1.01–2.79; p = 0.045) compared to those from urban areas. Unvaccinated individuals were more likely to test positive for SARS-CoV-2 compared to vaccinated participants (aOR: 2.59; 95% CI: 1.35–4.99; p = 0.004). After three years of the COVID-19 pandemic, the prevalence of SARS-CoV-2 among blood donors was remarkably high, indicating that the vast majority of this population group had been exposed to the virus. This study highlights the risk factors for SARS-CoV-2 infection and the differences in antibody prevalence between vaccinated and unvaccinated individuals. Our findings underscore the pivotal role of vaccination in controlling the pandemic and provide valuable insights for policymakers in designing targeted strategies to curb future SARS-CoV-2 transmission. Full article

This study examines the effects of climate change on maize production in Romania between 2003 and 2024, focusing on yield dynamics, regional disparities, and economic losses. Maize, a key crop in Romanian agriculture, has become increasingly vulnerable to extreme weather events, particularly droughts, which remain the most frequent risk. The analysis highlights a marked decline in maize yields and cultivated area in recent years, strongly correlated with severe droughts in 2020, 2022, and 2024. The results show that western and northern counties display greater resilience, while southeastern regions face significant yield losses. The economic impact is substantial, with losses exceeding EUR 1 billion. These findings underscore the systemic nature of climate-related risks and call for region-specific adaptation strategies, expanded irrigation infrastructure, and index-based insurance schemes to strengthen resilience and ensure sustainable maize production under changing climatic conditions. Full article