{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T02:30:14Z","timestamp":1788489014267,"version":"build-2803163510"},"reference-count":43,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T00:00:00Z","timestamp":1691366400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Pediatric Infections Research Center, Research Institute for Children\u2019s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Objective: Carbapenem-resistant Enterobacteriaceae (CRE) infection is life-threatening, especially for immunocompromised children. The source tracking of CRE could prevent bacteremia during hospitalization. In this study, the intestinal colonization of CRE and their translocation to blood were investigated. Methods: Stool samples from immunocompromised pediatric patients were collected after admission, and secondary stool and blood samples were collected in case of fever. After CRE phonotypic detection, the OXA-48, NDM-1, VIM, IMP, and KPC genes were detected by PCR. Enterobacterial Repetitive Intergenic Consensus Polymerase Chain Reaction (ERIC-PCR) was used to determine the phylogenic relatedness of the blood and fecal isolates. Results: Bacteremia was recorded in 71.4% of the patients. Enterobacteriaceae spp. were recorded in 100% of the stool samples and 31% of the blood samples. The correlation between the length of stay (LOS), days of fever, chemotherapy regimens, and death rate was significant (p-value \u2264 0.05). OXA-48 was present in all CRE isolates in both the primary and the secondary stool samples and the blood samples. According to the phylogenetic data, 58.33% of the patients with bacteremia had identical blood and stool isolates. The death rate was 24.4% in children with CRE bacteremia. Conclusions: The primary intestinal colonization with CRE in immunocompromised pediatrics and their translocation to blood was established in this study. The implementation of infection control programs and the application of infection prevention strategies for immunocompromised children is necessary.<\/jats:p>","DOI":"10.3390\/tropicalmed8080402","type":"journal-article","created":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T06:38:48Z","timestamp":1691390328000},"page":"402","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Endogenous Bacteremia Caused by Intestinal Colonization of Carbapenem-Resistant Enterobacteriaceae (CRE) in Immunocompromised Children"],"prefix":"10.3390","volume":"8","author":[{"given":"Nasim","family":"Almasian Tehrani","sequence":"first","affiliation":[{"name":"Pediatric Infections Research Center, Research Institute for Children\u2019s Health, Shahid Beheshti University of Medical Sciences, Tehran 1546815514, Iran"},{"name":"Department of Microbiology and Microbial Biotechnology, Shahid Beheshti University, Tehran 1983969411, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7216-2530","authenticated-orcid":false,"given":"Leila","family":"Azimi","sequence":"additional","affiliation":[{"name":"Pediatric Infections Research Center, Research Institute for Children\u2019s Health, Shahid Beheshti University of Medical Sciences, Tehran 1546815514, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahnaz","family":"Armin","sequence":"additional","affiliation":[{"name":"Pediatric Infections Research Center, Research Institute for Children\u2019s Health, Shahid Beheshti University of Medical Sciences, Tehran 1546815514, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neda","family":"Soleimani","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Microbial Biotechnology, Shahid Beheshti University, Tehran 1983969411, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatemeh","family":"Fallah","sequence":"additional","affiliation":[{"name":"Pediatric Infections Research Center, Research Institute for Children\u2019s Health, Shahid Beheshti University of Medical Sciences, Tehran 1546815514, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdollah","family":"Karimi","sequence":"additional","affiliation":[{"name":"Pediatric Infections Research Center, Research Institute for Children\u2019s Health, Shahid Beheshti University of Medical Sciences, Tehran 1546815514, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bibi Shahin","family":"Shamsian","sequence":"additional","affiliation":[{"name":"Pediatric Congenital Hematologic Disorders Research Center, Research Institute for Children\u2019s Health, Shahid Beheshti University of Medical Sciences, Tehran 1546815514, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiva","family":"Nazari","sequence":"additional","affiliation":[{"name":"Pediatric Infections Research Center, Research Institute for Children\u2019s Health, Shahid Beheshti University of Medical Sciences, Tehran 1546815514, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7474-2515","authenticated-orcid":false,"given":"Masoud","family":"Alebouyeh","sequence":"additional","affiliation":[{"name":"Pediatric Infections Research Center, Research Institute for Children\u2019s Health, Shahid Beheshti University of Medical Sciences, Tehran 1546815514, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"64","DOI":"10.4066\/AMJ.2014.1926","article-title":"Carriage prevalence of carbapenem-resistant Enterobacteriaceae in stool samples: A surveillance study","volume":"7","author":"Rai","year":"2014","journal-title":"Australas. 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