OBJECTIVE: The aim of this study was to collect data about pediatric Gram-negative @entity281 ( @entity281 ) to determine the factors that influence @entity6371 ( @entity6371 ), clinical course and outcome of @entity1 affected by Gram-negative @entity295 . METHODS: In this observational, prospective, multicenter study we collected cases of pediatric Gram-negative @entity281 during a 2-year period. We analyzed epidemiological, microbiological and clinical factors that associated with acquisition of @entity6371 infections and outcome. RESULTS: One-hundred and thirty-five @entity281 episodes were analyzed. Median age of @entity1 was 0.5  years (IQR 0.1-6.17, range 0-17  years). Predominant bacteria were Enterobacteriaceae (68.3  %), and Pseudomonas spp. (17.9  %). Multidrug resistance was detected in 45/134 cases (33.6  %), with the highest rates in @entity526 , Enterobacter and Pseudomonas spp. Acquisition of @entity6371 pathogens was significantly associated with prior @entity8509 treatment, older age, admission to hemato-oncology unit, polymicrobial infections, higher rate of development of @entity326 , and @entity881 . All-cause mortality was 17.9  %. Presence of @entity326 at presentation and parenteral nutrition were associated with higher mortality. Pseudomonas spp., and Enterobacter spp. BSIs had the highest rate of mortality. Inappropriate empiric antibiotic therapy was more frequent in @entity6371 @entity1 , although not significantly associated with poor outcome. CONCLUSION: Rates of @entity6371 and mortality in @entity1 with Gram-negative @entity281 remain high in our settings. Empiric broad-spectrum antibiotics and combination therapy could be recommended, especially in @entity1 with @entity5 , @entity1 admitted to the PICU, and for cases with @entity326 , who have higher mortality risk.

Factors influencing antimicrobial resistance and outcome of Gram-negative @entity281 in XXXX .

@entity1 :: ('9606', 'Species') :: ['children', 'patients'] @entity295 :: ('MESH:D018805', 'Disease') :: ['sepsis'] @entity6371 :: ('MESH:D018088', 'Disease') :: ['multidrug resistance', 'MDR'] @entity326 :: ('MESH:D012772', 'Disease') :: ['septic shock'] @entity5 :: ('MESH:D009369', 'Disease') :: ['malignant diseases'] @entity281 :: ('MESH:D007239', 'Disease') :: ['bloodstream infections', 'BSI'] @entity881 :: ('MESH:D009102', 'Disease') :: ['multiple organ failures'] @entity8509 :: ('D002511', 'Chemical') :: ['cephalosporin'] @entity526 :: ('562', 'Species') :: ['Escherichia coli']
@entity1 :: (9606,Species) :: ['children']
