Constantin Catalin Marc

Background: Urinary tract infections (UTIs) are among the most common types of infections during childhood. Limited data are available on the prevalence of UTI in children from Romania, with most being available for hospitalized children. For this reason, we conducted a retrospective observational study in consecutive non-hospitalized children to assess the number of positive UTI samples and the antibacterial resistance of causative pathogens. Methods: This study included 7222 consecutive urine cultures collected from children aged 1 to 18 years who are residents of Arad County, Western Romania. Urine samples were analyzed for leukocyturia and cultures for the presence of monomorphic bacteria. Results: The overall number of positive UTI samples was 10.44%. A higher number of positive UTI samples was observed in females when compared to males and in children aged 6–12 and 12 to 18 years when compared to those aged 1–5 years. The antibiotic susceptibility testing of E. coli isolates revealed high sensitivity to most tested antibacterials. Near-complete susceptibility was observed for fosfomycin (99.71%) and nitrofurantoin (96.01%), while high susceptibility rates were also observed for ciprofloxacin (85.43%) and amoxicillin–clavulanic acid (75.05%). In contrast, high resistance was found for ampicillin (62.28% resistant) and trimethoprim–sulfamethoxazole (36.53% resistant). Conclusions: Given the clinical risks associated with UTI in children, our findings underscore the urgent need for the continued monitoring of multidrug-resistant strains. Our study provides important epidemiological and resistance data to guide empirical treatment and strengthen pediatric antimicrobial resistance surveillance. Future studies should focus on different regions and regularly update resistance patterns to keep treatment and prevention strategies aligned with local conditions.

Background and Objectives: Adequate levels of vitamin D are vital for both growth and immunomodulation in children. To evaluate the levels of vitamin D in children from Western Romania and to identify significant age, seasonal, and geographical disparities. Materials and Methods: This study evaluates the level of 25-hydroxyvitamin D levels assessed on Cobas 6000’s module e601 in 1698 children aged 1–18 years between 1 January 2018 and 31 December 2021 from Western Romania. Results: Children aged 1–6 years predominantly present sufficient levels (>30 ng/mL), while older age groups showed a marked decline. Adolescents aged 13–18 years were most affected, with over half displaying insufficient levels (20–30 ng/mL). Rural children were more likely to achieve sufficiency compared to urban peers. Males demonstrated significantly higher vitamin D levels when compared to females. Seasonal variations showed the highest vitamin D levels during late summer and early autumn (September: aOR = 5.47; 95% CI: 3.17–9.42, p < 0.001). Multivariate analysis revealed a significant improvement in vitamin D levels during 2019–2020. Conclusions: Our findings suggest the need for targeted screening programs and health policies to address vitamin D deficiency, particularly among older children, urban residents and during winter months.