Next Article in Journal
Interaction of Temporin-L Analogues with the E. coli FtsZ Protein
Next Article in Special Issue
Climatic Alterations Influence Bacterial Growth, Biofilm Production and Antimicrobial Resistance Profiles in Aeromonas spp.
Previous Article in Journal
An Analysis of the Infections and Determination of Empiric Antibiotic Therapy in Cats and Dogs with Cancer-Associated Infections
Previous Article in Special Issue
Virulence Factors in Staphylococcus Associated with Small Ruminant Mastitis: Biofilm Production and Antimicrobial Resistance Genes
Article

Antibiotic Susceptibility, Virulome, and Clinical Outcomes in European Infants with Bloodstream Infections Caused by Enterobacterales

1
Paediatric Infectious Disease Research Group, Institute for Infection and Immunity, St George’s University of London, Cranmer Terrace, London SW17 0RE, UK
2
Department of Paediatrics, Vittore Buzzi Children Hospital, University of Milan, Via Lodovico Castelvetro 32, 20154 Milan, Italy
3
Paediatric Clinical Research Centre “Romeo and Enrica Invernizzi”, Department of Biosciences, University of Milan, Via Giovanni Battista Grassi 74, 20157 Milan, Italy
4
Clinical-Surgical, Diagnostic and Pediatric Sciences Department, Unit of Microbiology and Clinical Microbiology, University of Pavia, Corso Str. Nuova 65, 27100 Pavia, Italy
5
Institute of Infection and Immunity, St George’s University of London, Cranmer Terrace, London SW17 0RE, UK
6
School of Pharmacy, Queen’s University, 97 Lisburn Rd., Belfast BT9 7BL, UK
7
Pediatric Pharmacology and Pharmacometrics, University Children’s Hospital (UKBB), University Hospital Basel, Spitalstrasse 33, 4056 Basel, Switzerland
*
Author to whom correspondence should be addressed.
Academic Editors: Manuela Oliveira and Elisabete Silva
Received: 12 May 2021 / Revised: 6 June 2021 / Accepted: 8 June 2021 / Published: 11 June 2021
(This article belongs to the Special Issue Antimicrobial Resistance and Virulence - 2nd Volume)
Mortality in neonates with Gram-negative bloodstream infections has remained unacceptably high. Very few data are available on the impact of resistance profiles, virulence factors, appropriateness of empirical treatment and clinical characteristics on patients’ mortality. A survival analysis to investigate 28-day mortality probability and predictors was performed including (I) infants <90 days (II) with an available Enterobacterales blood isolate with (III) clinical, treatment and 28-day outcome data. Eighty-seven patients were included. Overall, 299 virulence genes were identified among all the pathogens. Escherichia coli had significantly more virulence genes identified compared with other species. A strong positive correlation between the number of resistance and virulence genes carried by each isolate was found. The cumulative probability of death obtained by the Kaplan-Meier survival analysis was 19.5%. In the descriptive analysis, early age at onset, gestational age at onset, culture positive for E. coli and number of classes of virulence genes carried by each isolate were significantly associated with mortality. By Cox multivariate regression, none of the investigated variables was significant. This pilot study has demonstrated the feasibility of investigating the association between neonatal sepsis mortality and the causative Enterobacterales isolates virulome. This relationship needs further exploration in larger studies, ideally including host immunopathological response, in order to develop a tailor-made therapeutic strategy. View Full-Text
Keywords: infant; newborn; bacteremia; Gram-negative bacteria; drug resistance; microbial; virulence factors; mortality infant; newborn; bacteremia; Gram-negative bacteria; drug resistance; microbial; virulence factors; mortality
Show Figures

Figure 1

MDPI and ACS Style

Folgori, L.; Di Carlo, D.; Comandatore, F.; Piazza, A.; Witney, A.A.; Bresesti, I.; Hsia, Y.; Laing, K.; Monahan, I.; Bielicki, J.; Alvaro, A.; Zuccotti, G.V.; Planche, T.; Heath, P.T.; Sharland, M. Antibiotic Susceptibility, Virulome, and Clinical Outcomes in European Infants with Bloodstream Infections Caused by Enterobacterales. Antibiotics 2021, 10, 706. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10060706

AMA Style

Folgori L, Di Carlo D, Comandatore F, Piazza A, Witney AA, Bresesti I, Hsia Y, Laing K, Monahan I, Bielicki J, Alvaro A, Zuccotti GV, Planche T, Heath PT, Sharland M. Antibiotic Susceptibility, Virulome, and Clinical Outcomes in European Infants with Bloodstream Infections Caused by Enterobacterales. Antibiotics. 2021; 10(6):706. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10060706

Chicago/Turabian Style

Folgori, Laura, Domenico Di Carlo, Francesco Comandatore, Aurora Piazza, Adam A. Witney, Ilia Bresesti, Yingfen Hsia, Kenneth Laing, Irene Monahan, Julia Bielicki, Alessandro Alvaro, Gian V. Zuccotti, Tim Planche, Paul T. Heath, and Mike Sharland. 2021. "Antibiotic Susceptibility, Virulome, and Clinical Outcomes in European Infants with Bloodstream Infections Caused by Enterobacterales" Antibiotics 10, no. 6: 706. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10060706

Find Other Styles
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop