{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T14:37:02Z","timestamp":1790087822413,"version":"4.0.1"},"reference-count":38,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["MicrobiologyOpen"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                    poses a significant therapeutic challenge in pediatric patients with cystic fibrosis (CF) due to increasing multidrug resistance (MDR) and carbapenem resistance, underscoring the need for surveillance to guide treatment strategies. In this study, sputum and throat swab samples were collected from inpatient and outpatient CF children with pulmonary infection at the Children's Medical Center in Tehran, Iran. Isolates were identified using standard culture and biochemical methods, followed by antimicrobial susceptibility testing. Carbapenemase production was assessed phenotypically and by molecular detection of resistance genes, and genetic diversity was also evaluated using Random Amplified Polymorphic DNA (RAPD)\u2013polymerase chain reaction (PCR). A total of 117\n                    <jats:italic>P. aeruginosa<\/jats:italic>\n                    isolates were recovered (prevalence 17.41%), of which 94.9% were nonsusceptible to at least one antimicrobial agent. Carbapenem\u2010resistant\n                    <jats:italic>P. aeruginosa<\/jats:italic>\n                    (CRPA) and MDR isolates accounted for 24.8% and 23.1% of isolates, respectively. Carbapenemase gene coexistence was significantly associated with MDR (\n                    <jats:italic>\u03c1<\/jats:italic>\n                    \u2009=\u20090.227,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.014) and CRPA (\n                    <jats:italic>\u03c1<\/jats:italic>\n                    \u2009=\u20090.314,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.001). Metallo\u2010\u03b2\u2010lactamase production was detected in 13.7% of isolates, while\n                    <jats:italic>blaVIM<\/jats:italic>\n                    was the most frequently identified carbapenemase gene (59%). RAPD\u2013PCR demonstrated marked genetic heterogeneity, grouping isolates into 24 distinct clusters. Overall, the substantial burden of MDR and CRPA identified at this tertiary pediatric center highlights an urgent need for stricter antimicrobial stewardship, enhanced infection control measures, and ongoing surveillance to mitigate resistance spread and preserve therapeutic effectiveness in this vulnerable population. These findings warrant multicenter investigation to determine whether similar patterns exist across other Iranian pediatric CF facilities.\n                  <\/jats:p>","DOI":"10.1002\/mbo3.70217","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T04:50:20Z","timestamp":1769662220000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Burden of Antimicrobial\u2010Resistant\n                    <i>Pseudomonas aeruginosa<\/i>\n                    Isolates in Children With Cystic Fibrosis: Molecular Characterization and Genotyping Analysis"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1122-4523","authenticated-orcid":false,"given":"Erfaneh","family":"Jafari","sequence":"first","affiliation":[{"name":"Pediatric Infectious Diseases Research Center (PIDRC) Tehran University of Medical Sciences (TUMS) Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babak","family":"Pourakbari","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Research Center (PIDRC) Tehran University of Medical Sciences (TUMS) Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Reza","family":"Asadi Karam","sequence":"additional","affiliation":[{"name":"Department of Molecular Biology Pasteur Institute of Iran Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Azizian","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Research Center (PIDRC) Tehran University of Medical Sciences (TUMS) Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Reza","family":"Modaresi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics School of Medicine Tehran University of Medical Sciences (TUMS) Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Setareh","family":"Mamishi","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Research Center (PIDRC) Tehran University of Medical Sciences (TUMS) Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S298838"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjresp-2024-002456"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics14060539"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/gels8120760"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2024.01.005"},{"key":"e_1_2_13_7_1","volume-title":"Antimicrobial Resistance Threats in the United States, 2021\u20132022","author":"CDC","year":"2024"},{"key":"e_1_2_13_8_1","volume-title":"Cystic Fibrosis Foundation Patient Registry Highlights","author":"CF\u2010Foundation","year":"2023"},{"key":"e_1_2_13_9_1","volume-title":"Performance Standards for Antimicrobial Susceptibility Testing","author":"CLSI","year":"2024"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.00766-22"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2024.1374466"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/5831139"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.micpath.2023.106325"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/pathogens10121638"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00284-022-03048-4"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.3390\/tropicalmed8040205"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.00173-22"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2023.04.011"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2019.02048"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmni.2022.101059"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-031-08491-1_13"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40121-025-01175-6"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2021.665759"},{"key":"e_1_2_13_24_1","first-page":"2954","volume-title":"Clinical Microbiology Procedures Handbook","author":"Leber A. 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