{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T22:08:45Z","timestamp":1790114925528,"version":"4.0.1"},"reference-count":57,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T00:00:00Z","timestamp":1744761600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u201cVictor Babes\u201d University of Medicine and Pharmacy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background: The COVID-19 pandemic in Romania exacerbated pediatric antimicrobial resistance (AMR). Overuse of broad-spectrum antibiotics may be related to increased multidrug-resistant bacteria. The main aim of this study was to assess pediatric AMR trends and phenotypes, while a secondary objective was to investigate the potential links with hospital abandonment. Methods: This retrospective study from the Children\u2019s Emergency Hospital \u201cLouis \u021aurcanu\u201d, Timi\u0219oara, focused on AMR patterns in 2019 pre-pandemic, 2021 pandemic, and 2023 post-pandemic. The following phenotypes were assessed: MRSA, MRCoNS, VRE, ESBL, CRO, MDR, XDR, and PDR. Results: There were 3530 total patients and 6885 total samples. There were 69.92% of the total samples resistant to at least one antimicrobial class, (72.69% in 2019, 67.05% in 2021, 69.16% in 2023). Specifically, resistance towards penicillins remained high across the entire period (57.45\u201360.93%), while the following classes presented elevated resistance in the pandemic: cephalosporins (42.91%), combination therapies (40.95%), reserve antibiotics (38.89%), and cyclines (13.83%). As for resistance phenotypes, MRSA and MRCoNS peaked during the pandemic (36.08% and 81.43%, respectively) while VRE remained relatively constant. Overall ESBL declined in 2023 to 14.45%, while overall CRO peaked during the pandemic (8.81%). Overall MDR fell during the pandemic (64.47%), while overall XDR peaked in 2019 (9.87%). No PDR cases were observed. Pediatric abandonment was an increasing concern, with regional cases rising from 5.42% (2019) to 9.83% (2023). Compared to the general population, increased antimicrobial resistance in abandoned patients was observed for fluoroquinolones (50.00%), Aminogycolsides (60.00%), reserve antibiotics (70.00%), cephalosporins (60.00%), and urinary antibiotics (60.00%). Resistance to cephalosporins (OR = 5.17, p = 0.0304) and reserve antibiotics (OR = 5.64, p = 0.0049) were key predictors of abandonment risk. Conclusions: The COVID-19 pandemic influenced resistance trends, with notable peaks in MRSA, MRCoNS, and CRO. Post-pandemic patterns suggest continued escalation of resistance. The association between resistant infections and pediatric abandonment highlights the need for robust antimicrobial stewardship and social intervention policies.<\/jats:p>","DOI":"10.3390\/antibiotics14040411","type":"journal-article","created":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T08:09:17Z","timestamp":1744790957000},"page":"411","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Impact of the COVID-19 Pandemic on Pediatric Microbial Resistance Patterns and Abandonment Rates in Western Romania\u2014An Interdisciplinary Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1046-7272","authenticated-orcid":false,"given":"Dan Dumitru","family":"Vulcanescu","sequence":"first","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Department of Microbiology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Multidisciplinary Research Center on Antimicrobial Resistance (MULTI-REZ), Microbiology Department, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Clinical Laboratory, \u201cLouis Turcanu\u201d Emergency Hospital for Children, Timisoara, Iosif Nemoianu Street 2, 300011 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3099-8249","authenticated-orcid":false,"given":"Iulia Cristina","family":"Bagiu","sequence":"additional","affiliation":[{"name":"Department of Microbiology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Multidisciplinary Research Center on Antimicrobial Resistance (MULTI-REZ), Microbiology Department, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Clinical Laboratory, \u201cLouis Turcanu\u201d Emergency Hospital for Children, Timisoara, Iosif Nemoianu Street 2, 300011 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiberiu Liviu","family":"Dragomir","sequence":"additional","affiliation":[{"name":"Medical Semiology II Discipline, Internal Medicine Department, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virgiliu Bogdan","family":"Sorop","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mircea","family":"Diaconu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Octavia","family":"Harich","sequence":"additional","affiliation":[{"name":"Department of Functional Sciences, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia Aniela","family":"Tanasescu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florin","family":"Szasz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3614-7253","authenticated-orcid":false,"given":"Luiza","family":"Vlaicu","sequence":"additional","affiliation":[{"name":"Department of Social Assistance, Faculty of Sociology and Psychology, Western University, Vasile Parvan Boulevard 4, 300223 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cosmin","family":"Goian","sequence":"additional","affiliation":[{"name":"Department of Social Assistance, Faculty of Sociology and Psychology, Western University, Vasile Parvan Boulevard 4, 300223 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6133-0204","authenticated-orcid":false,"given":"Florin George","family":"Horhat","sequence":"additional","affiliation":[{"name":"Department of Microbiology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Multidisciplinary Research Center on Antimicrobial Resistance (MULTI-REZ), Microbiology Department, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Clinical Laboratory, \u201cLouis Turcanu\u201d Emergency Hospital for Children, Timisoara, Iosif Nemoianu Street 2, 300011 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Dascalu, S. 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