{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T17:23:27Z","timestamp":1791393807926,"version":"4.3.3"},"reference-count":56,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,6,11]],"date-time":"2021-06-11T00:00:00Z","timestamp":1623369600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Penta Foundation","award":["na"],"award-info":[{"award-number":["na"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>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\u2019 mortality. A survival analysis to investigate 28-day mortality probability and predictors was performed including (I) infants &lt;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\u00a0coli 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.<\/jats:p>","DOI":"10.3390\/antibiotics10060706","type":"journal-article","created":{"date-parts":[[2021,6,11]],"date-time":"2021-06-11T12:44:37Z","timestamp":1623415477000},"page":"706","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Antibiotic Susceptibility, Virulome, and Clinical Outcomes in European Infants with Bloodstream Infections Caused by Enterobacterales"],"prefix":"10.3390","volume":"10","author":[{"given":"Laura","family":"Folgori","sequence":"first","affiliation":[{"name":"Paediatric Infectious Disease Research Group, Institute for Infection and Immunity, St George\u2019s University of London, Cranmer Terrace, London SW17 0RE, UK"},{"name":"Department of Paediatrics, Vittore Buzzi Children Hospital, University of Milan, Via Lodovico Castelvetro 32, 20154 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Di Carlo","sequence":"additional","affiliation":[{"name":"Paediatric Clinical Research Centre \u201cRomeo and Enrica Invernizzi\u201d, Department of Biosciences, University of Milan, Via Giovanni Battista Grassi 74, 20157 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Comandatore","sequence":"additional","affiliation":[{"name":"Paediatric Clinical Research Centre \u201cRomeo and Enrica Invernizzi\u201d, Department of Biosciences, University of Milan, Via Giovanni Battista Grassi 74, 20157 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurora","family":"Piazza","sequence":"additional","affiliation":[{"name":"Clinical-Surgical, Diagnostic and Pediatric Sciences Department, Unit of Microbiology and Clinical Microbiology, University of Pavia, Corso Str. Nuova 65, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam A.","family":"Witney","sequence":"additional","affiliation":[{"name":"Institute of Infection and Immunity, St George\u2019s University of London, Cranmer Terrace, London SW17 0RE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6812-7556","authenticated-orcid":false,"given":"Ilia","family":"Bresesti","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Vittore Buzzi Children Hospital, University of Milan, Via Lodovico Castelvetro 32, 20154 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7955-852X","authenticated-orcid":false,"given":"Yingfen","family":"Hsia","sequence":"additional","affiliation":[{"name":"Paediatric Infectious Disease Research Group, Institute for Infection and Immunity, St George\u2019s University of London, Cranmer Terrace, London SW17 0RE, UK"},{"name":"School of Pharmacy, Queen\u2019s University, 97 Lisburn Rd., Belfast BT9 7BL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1883-3433","authenticated-orcid":false,"given":"Kenneth","family":"Laing","sequence":"additional","affiliation":[{"name":"Institute of Infection and Immunity, St George\u2019s University of London, Cranmer Terrace, London SW17 0RE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Monahan","sequence":"additional","affiliation":[{"name":"Institute of Infection and Immunity, St George\u2019s University of London, Cranmer Terrace, London SW17 0RE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Bielicki","sequence":"additional","affiliation":[{"name":"Paediatric Infectious Disease Research Group, Institute for Infection and Immunity, St George\u2019s University of London, Cranmer Terrace, London SW17 0RE, UK"},{"name":"Pediatric Pharmacology and Pharmacometrics, University Children\u2019s Hospital (UKBB), University Hospital Basel, Spitalstrasse 33, 4056 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Alvaro","sequence":"additional","affiliation":[{"name":"Paediatric Clinical Research Centre \u201cRomeo and Enrica Invernizzi\u201d, Department of Biosciences, University of Milan, Via Giovanni Battista Grassi 74, 20157 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2795-9874","authenticated-orcid":false,"given":"Gian Vincenzo","family":"Zuccotti","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Vittore Buzzi Children Hospital, University of Milan, Via Lodovico Castelvetro 32, 20154 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Planche","sequence":"additional","affiliation":[{"name":"Institute of Infection and Immunity, St George\u2019s University of London, Cranmer Terrace, London SW17 0RE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul T.","family":"Heath","sequence":"additional","affiliation":[{"name":"Paediatric Infectious Disease Research Group, Institute for Infection and Immunity, St George\u2019s University of London, Cranmer Terrace, London SW17 0RE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike","family":"Sharland","sequence":"additional","affiliation":[{"name":"Paediatric Infectious Disease Research Group, Institute for Infection and Immunity, St George\u2019s University of London, Cranmer Terrace, London SW17 0RE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,6,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Ballot, D.E., Bandini, R., Nana, T., Bosman, N., Thomas, T., Davies, V.A., Cooper, P.A., Mer, M., and Lipman, J. 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