## 5 Conclusions  
The frequency of _Enterococcus_ spp. isolated from hospitalized patients decreased during the first two years of the COVID-19 pandemic. The nature of the positive biological samples, identified enterococcal species, and antibiotic resistance are different in the hospitals from the same geographical and administrative region of Romania, which is associated with the distinctive profiles of the departments and local medical practice routines. The main resistance challenges are MDR and VRE, mainly in _E. facetium_ isolates from blood stream infections. The development of local antibiotic stewardship programmes needs to consider the AMRE surveillance and the risk of transferring germs from one hospital to another or to the community. Development of the bacterial identification techniques is necessary for the improvement of the etiologic diagnosis of hospitalized infection. The use of molecular investigations and the identification of the resistance genes are required for earlier microbiological diagnosis and appropriate therapeutic decisions. Conceptualization, G.G., M.A., D.T. and A.-V.I. ; methodology, G.G., A.-V.I. and D.T. ; software, E.-A.Z., A.-V.I. and G.T. ; validation, N.-M.M., E.-A.Z. and M.A. ; formal analysis, E.-A.Z., N-M.M. and L.-D.P. ; investigation, L.-D.P., N.-M.M., A.-V.I. and M.A. ; resources, G.G., D.T. and A.-V.I; data curation, E.-A.Z., N.-M.M. and M.A. ; writing--original draft preparation, A.-V.I. and D.T. ; writing--review and editing, M.A. and G.G. ; visualization, M.A., G.G., G.T. and N.-M.M. ; supervision, G.G., D.T. and M.A. All authors have read and agreed to the published version of the manuscript. This research received no external funding. The study did not require ethical approval. The consent was given as our retrospective study used laboratory management which regularly collected data from the databases. Not applicable. The authors acknowledge the research staff of \"Dunarea de Jose\" University\" Galati for the financial support for the publishing of our study. The authors declare no conflict of interest. Figure A2: Distribution of types of microorganisms. Figure A3: The distribution of _Enterococcus_ spp. \begin{tabular}{c c c c c c c c} \hline \hline
**Genera** & \multicolumn{2}{c}{**2019**} & \multicolumn{2}{c}{**No—2020**} & \multicolumn{2}{c}{**No—2021**} & \multicolumn{2}{c}{**Total**} & \multicolumn{1}{c}{**\%**} \\ \hline
**GP Cocci** & **No** & **\%** & **No** & **\%** & **No** & **\%** & & \\ \hline _Staphylococcus_ spp. & 3701 & 67.9\% & 2128 & 77.6\% & 2926 & 80.71\% & 8755 & 32.8\% \\ _Streplexococcus_ spp. & 812 & 14.9\% & 330 & 12\% & 325 & 8.96\% & 1467 & 5.5\% \\ \(\beta\)-Hemolytic group & & & & & & & & \\ _Streprotococcus pneumoniae_ & 826 & 15.16\% & 225 & 8.2\% & 307 & 8.46\% & 1358 & 5.08\% \\ _Enterococcus_ spp. & 106 & 1.94\% & 57 & 2.08\% & 67 & 1.84\% & 230 & 0.86\% \\ Total & 5445 & 100\% & 2740 & 100\% & 3625 & 100\% & 11,810 & 44.24\% \\ \hline \multicolumn{6}{c}{GN rods} \\ \hline _Escherichia coli_ & 3325 & 54.6\% & 1691 & 46.4\% & 2301 & 46.4\% & 7317 & 27.4\% \\ _Klebsiella_ spp. & 1328 & 21.8\% & 1068 & 29.3\% & 1526 & 30.8\% & 3922 & 14.7\% \\ _Proteins_ spp. & 400 & 6.6\% & 220 & 6.03\% & 278 & 5.6\% & 898 & 3.4\% \\ _Enterobacter_ spp. & 210 & 3.45\% & 80 & 2.19\% & 78 & 1.57\% & 368 & 1.37\% \\ _Salmonella_ spp. & 91 & 1.5\% & 44 & 1.2\% & 74 & 1.5\% & 209 & 0.8\% \\ Alte Enterobacterales & 20 & 0.32\% & 9 & 0.24\% & 14 & 0.28\% & 43 & 0.16\% \\ _Pseudomonas_ spp. & 624 & 10.2\% & 437 & 9.52\% & 549 & 11\% & 1610 & 6.03\% \\ _Acinetobacter_ spp. & 88 & 1.4\% & 95 & 2.6\% & 139 & 2.8\% & 322 & 1.2\% \\ Total & 6086 & 100\% & 3644 & 100\% & 4959 & 100\% & 14,689 & 55.1\% \\ \hline Other bacteria & \multicolumn{2}{c}{63} & \multicolumn{2}{c}{78} & \multicolumn{2}{c}{48} & \multicolumn{2}{c}{189} & \multicolumn{1}{c}{0.7\%} \\ \hline Total & \multicolumn{2}{c}{11,594} & \multicolumn{2}{c}{6473} & \multicolumn{2}{c}{8632} & \multicolumn{2}{c}{26,699} & \multicolumn{1}{c}{100\%} \\ \hline \hline \end{tabular}   
Note: % annual frequency.