# Evolution of Antimicrobial Resistance in Acinetobacter baumannii and Pseudomonas aeruginosa in Romania: A Narrative Review of Published Data (2001–2024)

## TL;DR

This paper reviews how antibiotic resistance in two dangerous bacteria has changed in Romania over 20 years.

## Contribution

The study provides a comprehensive narrative review of antimicrobial resistance trends in A. baumannii and P. aeruginosa in Romania from 2001 to 2024.

## Key findings

- There is temporal variability in resistance rates of A. baumannii and P. aeruginosa in Romania.
- Differences in resistance patterns were observed across distinct time periods.
- The study highlights the need for national surveillance and antimicrobial stewardship.

## Abstract

Antimicrobial resistance constitutes a major global public health challenge, with Romania among the European countries affected. Acinetobacter baumannii and Pseudomonas aeruginosa was designated by the World Health Organization (WHO) as priority pathogens, are frequently implicated in healthcare-associated infections (HAIs), including pneumonia, surgical site infections, urinary tract infections, and bacteremia. We have narratively synthesized surveillance studies published in different regions of Romania, encompassing date whit the period 2001–2024. A total of 13 studies reporting data on P. aeruginosa (2003–2024) and 15 studies on A. baumannii (2001–2024) were included. The strains were isolated from various pathological products, including urine, sputum, tracheobronchial aspirate, blood, bronchoalveolar lavage, pus, peritoneal fluid, and cerebrospinal fluid, from hospitalized patients in different clinical departments. This review evaluated long-term trends in antimicrobial resistance profiles of A. baumannii and P. aeruginosa strains circulating in various regions of Romania. The findings revealed both temporal variability in resistance rates within comparable intervals and differences across distinct time periods. These long-term trends underscore the need for sustained national surveillance systems, harmonized reporting practices, and reinforced antimicrobial stewardship programs.