Objectives. The aim of this study is to provide information about prevalence, etiology, risk factors, clinical characteristics and endoscopic features of various types of infectious esophagitis in children. Methods. We performed a total of 520 upper gastrointestinal tract endoscopies in Pediatric Clinic II, Emergency Hospital for Children, Cluj-Napoca. Indications for endoscopy in our cohort were gastrointestinal tract symptoms such as dysphagia, heartburn, or appetite loss. Results. The prevalence of infectious esophagitis in the study population was 2.11% (11 patients). Candida albicans (C. albicans) was the most frequent cause. Our data illustrates that herpes simplex virus (HSV)-induced esophagitis is common in immunocompromised patients and should be systematically suspected in cases of severe dysphagia, heartburn, or hematemesis. In the present study, all cytomegalovirus (CMV) esophagitis patients were immunocompromised. Immunodeficiency (81.8%) and prolonged antibiotic therapy with broad-spectrum antibiotics were by far the most important risk factors involved in the pathogenicity of the disease. Dysphagia, appetite loss, heartburn, epigastralgia, and hematemesis were the main clinical manifestations. Infectious esophagitis was associated with significant mortality. In four patients, endoscopy during life showed signs of infectious esophagitis; however, the precise etiology was only established post-mortem, in the pathological anatomy laboratory department. A risk factor involved in pathogenesis of post-mortem diagnosed infectious esophagitis is the DiGeorge syndrome for CMV and HSV patients. Conclusions. The study illustrates that infectious esophagitis should be considered in immunocompromised infants with prolonged antibiotic therapy with broad-spectrum antibiotics.

Introduction: Nosocomial infections caused by Pseudomonas aeruginosa producing carbapenemases represent an important cause of morbidity and mortality among immunosuppressed patients. The aim of our study was to detect the production of metallo-carbapenemases (MBLs) by phenotypic methods and to detect the presence of the MBLs encoding genes (blaIMP and blaVIM) by PCR in P. aeruginosa strains isolated from hospitalized patients to the

Introduction. The incidence of corrosive esophagitis, also known as caustic esophagitis in children, is still increasing in developing countries, according to different clinical reports. Acids and alkalis are, in the same manner, involved in the pathogenesis of corrosive esophagitis in children. The aim of our study was to determine the incidence and endoscopic grading of corrosive esophagitis in a cohort of children from a developing country. Materials and methods. We performed a retrospective analysis of all pediatric patients who were admitted for corrosive ingestion at Pediatric Clinic II, Emergency Hospital for Children, Cluj-Napoca, over 10 years. Results. A total of 22 patients consisting of 13 (59.09%) girls and 9 boys (40.91%) were found in the present research. The majority of children lived in rural areas (69.2%). The results of laboratory tests were not well correlated with the degree of the injury. White blood cell counts over 20,000 cells/mm3, an increase in the C-reactive protein level and hypoalbuminemia were noticed only in three patients with strictures. The lesions were associated with increased levels of the pro-inflammatory cytokines, including interleukin (IL)-2, IL-5 and Interferon-gamma. Severe late complications such as strictures have been noticed in children with grade 3A injuries. The endoscopic dilation was done after the six months endoscopy. None of the patients treated with endoscopic dilation required surgical intervention for esophageal or pyloric perforation or dilation failure. The majority of complications (such as malnutrition) were noticed in children with grade 3A injuries. In consequence, prolonged hospitalization has been required. The second endoscopy (done six months after ingestion) revealed stricture as the most common late complication (n = 13, 60.60%: eight patients with grade 2B and five with grade 3A). Conclusion. There is a low incidence of corrosive esophagitis in children in our geographic area. Endoscopic grading is a predictor of late complications such as strictures. Grade 2B and 3A corrosive esophagitis are likely to develop strictures. It is crucial to avoid strictures and to prevent malnutrition.

Pseudomonas aeruginosa is one of the main opportunistic pathogen agents that cause increased morbidity and mortality in the hospital environment, mainly in surgical and intensive care units.The purpose of this study was to analyze the resistance profiles of P. aeruginosa strains isolated from patients hospitalized in surgical wards in Regional Institute of Gastroenterology and Hepatology, Cluj -Napoca.Methods & Materials: We conducted a retrospective study during January-December 2014. Isolation of P. aeruginosa strains was performed on selective media for Gram-negative. Identification of strains was done both by conventional methods and by automated methods using Vitek ® 2 Compact. Antibiotic susceptibility testing was done using the Vitek ® 2Compact, but also by Kirby-Bauer method. Interpretation susceptibility was performed according to the CLSI standard.Results: They were analyzed 259 isolates from 244 patients hospitalized in surgical wards, 50.8% male, respectively 49.2% women. These strains were isolated from different pathological products: lower tract respirator (75), pus (65), peritoneal fluid (26), urine (18), central venous catheter insertion (17), blood (13), faeces (9), bile (8) and other secretions (13). Patients were aged between 19 and 98 years, with a median value of 60.5 years. Most patients were immunosuppressed by malignancy, pancreatitis, gastric and duodenal ulcers, peritonitis, gallstones, and others. Clinical outcome was infaust, registering death in 49.6% of patients.P. aeruginosa strains showed the following levels of antibiotic resistance, respectively, 86.1% to ticarcillin, 62.1% to piperacillin, while resistance to the penicillins combined with beta-lactamase inhibitors, ticarcillin with clavulanic acid and piperacillin with tazobactam was 75.1%, respectively 51.8%. Resistance to antipseudomonal cephalosporins was 61.8% to ceftazidime and 48.8% to cefepime, while the level of resistance to carbapenems was 68.7% to imipenem and 69.8% to meropenem. Resistance to aminoglycosides was 76.6% to gentamicin, 65.4% to tobramycin and 75.6% to amikacin. 66.4% of strains showed cross-resistance to fluoroquinolones (ciprofloxacin, levofloxacin, moxifloxacin, norfloxacin), while resistance to colistin was only 0.6%. Conclusion:The studied strains showed high levels of resistance to all classes of antibiotics, colistin remains often the only therapeutic option. Judicious administration of antibiotics in combination with nosocomial infection control measures need to be introduced in hospitals to prevent the circulation of these multidrugresistant strains.

Pseudomonas aeruginosa is one of the main opportunistic pathogen agents that cause increased morbidity and mortality in the hospital environment, mainly in surgical and intensive care units.The purpose of this study was to analyze the resistance profiles of P. aeruginosa strains isolated from patients hospitalized in surgical wards in Regional Institute of Gastroenterology and Hepatology, Cluj -Napoca.Methods & Materials: We conducted a retrospective study during January-December 2014. Isolation of P. aeruginosa strains was performed on selective media for Gram-negative. Identification of strains was done both by conventional methods and by automated methods using Vitek ® 2 Compact. Antibiotic susceptibility testing was done using the Vitek ® 2Compact, but also by Kirby-Bauer method. Interpretation susceptibility was performed according to the CLSI standard.Results: They were analyzed 259 isolates from 244 patients hospitalized in surgical wards, 50.8% male, respectively 49.2% women. These strains were isolated from different pathological products: lower tract respirator (75), pus (65), peritoneal fluid (26), urine (18), central venous catheter insertion (17), blood (13), faeces (9), bile (8) and other secretions (13). Patients were aged between 19 and 98 years, with a median value of 60.5 years. Most patients were immunosuppressed by malignancy, pancreatitis, gastric and duodenal ulcers, peritonitis, gallstones, and others. Clinical outcome was infaust, registering death in 49.6% of patients.P. aeruginosa strains showed the following levels of antibiotic resistance, respectively, 86.1% to ticarcillin, 62.1% to piperacillin, while resistance to the penicillins combined with beta-lactamase inhibitors, ticarcillin with clavulanic acid and piperacillin with tazobactam was 75.1%, respectively 51.8%. Resistance to antipseudomonal cephalosporins was 61.8% to ceftazidime and 48.8% to cefepime, while the level of resistance to carbapenems was 68.7% to imipenem and 69.8% to meropenem. Resistance to aminoglycosides was 76.6% to gentamicin, 65.4% to tobramycin and 75.6% to amikacin. 66.4% of strains showed cross-resistance to fluoroquinolones (ciprofloxacin, levofloxacin, moxifloxacin, norfloxacin), while resistance to colistin was only 0.6%. Conclusion:The studied strains showed high levels of resistance to all classes of antibiotics, colistin remains often the only therapeutic option. Judicious administration of antibiotics in combination with nosocomial infection control measures need to be introduced in hospitals to prevent the circulation of these multidrugresistant strains.