Clinical Microbiology and Infection最新文献

{"title":"Re: 'Decoding community-acquired pneumonia' by Fally et al.","authors":"Josselin Le Bel, Clara Flateau, Sarah Tubiana, Yann-Erick Claessens, Xavier Duval","doi":"10.1016/j.cmi.2025.02.031","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.02.031","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy of 16S rDNA PCR, Multiplex PCR and Metagenomic Next-Generation Sequencing in Periprosthetic Joint Infections: A Systematic Review and Meta-Analysis.","authors":"Flaminia Olearo, Said El Zein, Portillo M Eugenia, Antonia Zapf, Holger Rohde, Elie F Berbari, Marjan Wouthuyzen-Bakker","doi":"10.1016/j.cmi.2025.02.022","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.02.022","url":null,"abstract":"<p><strong>Background: </strong>The diagnostic accuracy of 16S rDNA PCR, multiplex PCR (mPCR), and metagenomic next-generation sequencing (mNGS) in periprosthetic joint infections (PJIs) remains unclear.</p><p><strong>Objectives: </strong>To evaluate the diagnostic accuracy of 16S rDNA PCR, mPCR, and mNGS in PJI.</p><p><strong>Data sources: </strong>PubMed and EMBASE (January 1, 2000-March 1, 2024), with no language restrictions.</p><p><strong>Study eligibility criteria: </strong>Studies containing sufficient data to construct a 2×2 contingency table allowing for sensitivity and specificity calculation were considered.</p><p><strong>Participants: </strong>Adults (≥18 years) with PJI and appropriate control groups.</p><p><strong>Tests: </strong>16S rDNA PCR, mPCR, and mNGS.</p><p><strong>Reference standard: </strong>Diagnosis required adherence to Musculoskeletal Infection Society, Infectious Diseases Society of America (IDSA), International Consensus Meeting, European Bone and Joint Infection Society criteria. Studies employing alternative author-defined criteria were included only if they did not rely solely on positive cultures to define PJI.</p><p><strong>Assessment of risk of bias: </strong>QUADAS-2 was used.</p><p><strong>Methods of data synthesis: </strong>A bivariate model calculated pooled diagnostic odds ratios (DORs), sensitivities, and specificities, each with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Seventy-nine studies were included, comprising 3,940 PJI cases and 4,700 uninfected controls. Pooled sensitivity/specificity were 80.0% (95% CI: 75.4-84.3%)/94.0% (95% CI: 91-96%) for 16S rDNA PCR; 62.2% (52.5-70.9%)/96.2% (93.2-97.9%) for mPCR; and 88.6% (83.3-92.4%)/93.2% (89.5-95.6%) for mNGS. Notably, mNGS had the highest DOR (105.9; 95% CI: 60-186.9). A sensitivity analysis excluding lower-quality studies resulted in increased DORs for all methods.</p><p><strong>Discussion: </strong>These molecular techniques display strong diagnostic accuracy for identifying PJI. Although mNGS yielded the highest DOR, numerous technical and practical challenges preclude its routine use for PJI diagnosis. Significant heterogeneity across studies warrants cautious interpretation and underscores the need for future comparative research.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Antimicrobial stewardship: recommendations to support implementation of the 2024 UNGA Political Declaration on Antimicrobial Resistance.","authors":"F Medioli, N Peiffer-Smadja, L Catteau, R Murri, J A Schouten, K Thursky, M G J de Boer, D Ashiru-Oredope","doi":"10.1016/j.cmi.2025.02.024","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.02.024","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating infection risk associated with Staphylococcus aureus nasal carriage in blood donors: a prospective multicentre study in Denmark.","authors":"Khoa Manh Dinh, Kathrine Agergård Kaspersen, Jens Kjærgaard Boldsen, Svend Ellermann-Eriksen, Sisse Rye Ostrowski, Bitten Aagaard, Henrik Hjalgrim, Ole Birger Pedersen, Lise Tornvig Erikstrup, Christian Erikstrup","doi":"10.1016/j.cmi.2025.02.021","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.02.021","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether Staphylococcus aureus nasal carriage influences susceptibility to community-acquired S. aureus-associated infection and any other bacterial infection risk in healthy individuals.</p><p><strong>Methods: </strong>This prospective cohort study included blood donors aged 18-70 years between 2014-2021 in Denmark. A nasal swab cultivated for S. aureus defined carriage type (exposure) and infection endpoints were redeemed antibacterial prescriptions or ICD-10 diagnoses from national registers. Adjusted incidence rate ratio (IRR) was estimated using Poisson regression for prescriptions while Cox regression estimated hazard ratio for diagnoses.</p><p><strong>Results: </strong>Of 8,738 included participants, 3,503 (40.5%) were carriers. During a median follow-up of 3.8 years (IQR: 2.4-5.1), 1,110 participants redeemed dicloxacillin/flucloxacillin and 1,412 redeemed topical fusidic acid prescriptions while 378 participants received hospital treatment for infections during 3.4 years (IQR: 1.9-4.6). Nasal carriers redeemed dicloxacillin and topical fusidic acid prescriptions more often than non-carriers (IRR 1.40 [95% CI: 1.24-1.58] and IRR 1.22 [1.10-1.36], respectively). Participants who redeemed one dicloxacillin prescription were six times more likely to redeem another within two years. Among these, carriers had a higher incidence of redeeming additional dicloxacillin prescriptions than non-carriers (absolute risk, 19.0% vs 12.9%, respectively; IRR 1.46 [1.17-1.84]). S. aureus nasal carriage was not associated with higher risk of redeeming other antibacterial prescriptions nor with risk of hospital-treated S. aureus and any other bacterial infections.</p><p><strong>Conclusion: </strong>In this study comprising healthy adults, nasal carriers with S. aureus exhibited an increased risk of redeemed dicloxacillin and topical fusidic acid prescriptions, but nasal carriage was not associated with any other types of bacterial infection. Findings suggest that nasal carriage elevates the burden of community-acquired S. aureus infections.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Transforming ESCMID in a time of climate change: a call for sustainable conferencing\" [Clin Microbiol Infect 30 (2024) 1347-1350].","authors":"Teun Bousema, Suzanne A V van Asten, Jordache Ramjith, Michael E J Buhl, Bieke Tack, Kate E Whitfield, Alexander W Friedrich, Anu Kantele","doi":"10.1016/j.cmi.2025.02.023","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.02.023","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Taking the patient pulse: Gauging outcomes important to patients for bloodstream infection trials.","authors":"Sarah B Doernberg, Heather A King","doi":"10.1016/j.cmi.2025.02.019","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.02.019","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality due to carbapenem-resistant Acinetobacter baumannii bacteraemia: a five-year cohort study in intensive care patients.","authors":"Stamatis Karakonstantis, Evangelos I Kritsotakis, Renatos-Nikolaos Tziolos, Loukia Vassilopoulou, Maria Loukaki, Despoina Kypraiou, Emmanouil C Petrakis, Alberto Tovil, Sophia Kokkini, Kyriaki Tryfinopoulou, Petros Ioannou, Εumorfia Kondili, Diamantis P Kofteridis","doi":"10.1016/j.cmi.2025.02.018","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.02.018","url":null,"abstract":"<p><strong>Objectives: </strong>Carbapenem-resistant Acinetobacter baumannii (CRAB) has emerged as a major and difficult-to-treat nosocomial pathogen. This study estimated the mortality associated with CRAB bacteraemia in patients receiving treatment in the intensive care unit. A susceptible-infection counterfactual framework was applied to reflect the potential benefit of improved antimicrobial therapy.</p><p><strong>Methods: </strong>A five-year (2019-2023) cohort study was conducted in a tertiary-care referral hospital in Greece. Competing risks survival analysis methods were applied to estimate excess in-hospital mortality due to CRAB bacteraemia by comparing patients infected by CRAB to those infected by other more susceptible Gram-negative bacteria (GNB).</p><p><strong>Results: </strong>The cohort comprised 400 intensive care patients with GNB bacteraemia (median age 70 years, 65% male). CRAB was the most common pathogen (43%), followed by K. pneumoniae (12%), E. coli (11%), and P. aeruginosa (10%). Patients with CRAB bacteraemia experienced significantly higher in-hospital mortality at 14 days (35% vs. 21%), 28 days (53% vs. 30%) and overall (74% vs. 52%) compared to patients with other GNB bacteraemia. Multivariable competing-risks regression confirmed that CRAB bacteraemia was independently associated with increased risk of 28-day inpatient death (cause-specific hazard ratio [csHR] 1.80, 95% CI 1.28-2.54; sub-distribution hazard ratio [sHR] 1.84, 95% CI 1.28-2.62), simultaneously lowering the probability of discharge alive (csHR 0.68, 95% CI 0.38-1.21; sHR 0.52, 95% CI 0.30-0.91). Estimation of the attributable fraction suggested that effective antimicrobial management may result in a relative decrease in the risk of in-hospital mortality by 44% (95% CI 22%-61%) in CRAB bacteraemia patients.</p><p><strong>Conclusions: </strong>CRAB's detrimental role as a leading cause of increased inpatient mortality and prolongation of hospitalisation in intensive-care patients was demonstrated. These outcomes could improve substantially if more effective antimicrobial treatment becomes available. Nevertheless, considering CRAB is predominantly a hospital-acquired pathogen, efforts should always be directed towards preventing nosocomial transmission.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of Treponema pallidum DNA for diagnosis, resistance identification, and treatment outcome prediction in early syphilis among men who have sex with men.","authors":"Tzong-Yow Wu, Kuan-Yin Lin, Hsin-Yun Sun, Yu-Shan Huang, Wang-Da Liu, Li-Hsin Su, Wen-Chun Liu, Yi-Ching Su, Sui-Yuan Chang, Chien-Ching Hung","doi":"10.1016/j.cmi.2025.02.017","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.02.017","url":null,"abstract":"<p><strong>Objectives: </strong>We investigated the use of Treponema pallidum DNA (TP-DNA) for diagnosis, resistance identification, and treatment outcome prediction in early syphilis among men who have sex with men (MSM).</p><p><strong>Methods: </strong>MSM seeking care for sexually transmitted infections were prospectively enrolled from September 2021 to August 2024. Oral rinse, rectal swab, and urethral swab samples were tested for TP-DNA. Resistance-associated mutations (RAMs) to macrolides and tetracyclines were identified. Treatment responses were compared between syphilis cases with detected TP-DNA and those without.</p><p><strong>Results: </strong>Of 656 MSM enrolled, TP-DNA was most frequently detected in oral rinse samples (37.8% [193/510]), followed by rectal swab (20.2% [103/510]) and urethral swab samples (11.6%, 59/510) in clinic visits for early syphilis. TP-DNA was detected in 45.7% (233/510) of early syphilis cases and 0.7% (1/141) of cases without syphilis, resulting in a specificity of 99.3% (95%CI, 96.1-100%) and sensitivity 45.7% (95%CI, 41.3-50.1%). Secondary syphilis cases had the highest yield of TP-DNA detection (67.6% [117/173]), followed by primary (48.7% [19/39]) and early latent syphilis cases (32.6% [97/298]). The Ct values of TP-PCR in oral rinse samples were significantly lower in cases of higher rapid plasma reagin (RPR) titers (P<0.001). The rate of T. pallidum harbouring RAMs to macrolides was 58.9% (139/236), increasing over six-month intervals, from 32.4% (12/37) in 2021 to 77.8% (21/27) in 2023. Cases of detected TP-DNA had greater serologic responses to treatments than those without: 80.3% (159/198) vs 67.0% (156/233) at month 6 (P=0.002) and 84.1% (143/170) vs 70.3% (137/195) at month 12 (P=0.002).</p><p><strong>Conclusions: </strong>TP-PCR showed high specificity for the diagnosis of early syphilis, which correlated with RPR titers and treatment response, and lower Ct values in oral rinse samples correlated with higher RPR titers. The high prevalence of T. pallidum strains with RAMs to macrolides argues against using azithromycin to treat syphilis in Taiwan.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metagenomic analysis of microbial cell-free DNA from plasma of patients with suspected infections: performance and therapeutic impact in clinical routine.","authors":"Jan Esse, Johannes Träger, Philipp Steininger, Karl Bihlmaier, Julia Fürst, Zsofia Bardonicsek-Depnering, Nora Naumann-Bartsch, Patrick Morhart, Ixchel Castellanos, Stefan W Krause, Larissa Herbst, Richard Strauß, Martin Chada, Klaus Korn, Giuseppe Valenza, Daniel Teschner, Christian Bogdan, Jürgen Held","doi":"10.1016/j.cmi.2025.02.016","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.02.016","url":null,"abstract":"<p><strong>Objectives: </strong>The sensitivity of blood cultures (BC) is limited, especially when antimicrobial therapy already has been administered or when non-culturable pathogens are causing the disease. Metagenomic next-generation sequencing (mNGS) of cell-free DNA (cfDNA) from plasma has the potential to compensate for the disadvantages of BC diagnostics.</p><p><strong>Methods: </strong>We conducted a retrospective study in patients with suspected infections over a period of 3 months. cfDNA from plasma was analysed by mNGS (Illumina NextSeq, 25 million reads per sample, read length 75 base pairs) and sequences were analysed with DISQVER®, a CE-IVDD-labelled software algorithm and curated database. The data were compared to findings obtained with simultaneously taken BC and other microbiological results (+/- 7 days).</p><p><strong>Results: </strong>DISQVER® analysis was performed on 190 samples from 147 patients (124 adult, 23 pediatric). The median time-to-result including transport was two days (IQR 2-3; range 2-8). DISQVER® detected 158 pathogens (103 bacteria, 49 viruses, four fungi, one parasite) in 80 plasma samples (positivity rate 42.1%). The median number of pathogens per positive sample was one (IQR 1-2; range 1-10). The most common bacteria were Enterobacterales (30.1%; 31/103), anaerobic bacteria (18.4%; 19/103) and Enterococcus spp. (15.5%; 16/103), the most frequent viruses were Epstein-Barr virus (28.6%; 14/49), human herpesvirus 6B (18.4%; 9/49) and human cytomegalovirus (18.4%; 9/49). Mycobacterium avium, Legionella pneumophila, Tropheryma whipplei, Rhizomucor pusillus and Leishmania infantum were detected in one sample each. Simultaneous BC were positive in only 10.2% (18/176) of the samples, but were mostly (68.2%; 120/176) collected under antibiotic therapy. DISQVER® analysis resulted in 24 treatment changes in 20 patients (13.6%; 20/147; 9 start/escalation, 10 stop/de-escalation, 2 catheter replacements, 3 other).</p><p><strong>Conclusions: </strong>DISQVER® significantly increased the detection rate of pathogens, led to the diagnosis of serious infections that otherwise would have been missed, and possibly improved the treatment of more than 10% of patients.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality and sequelae associated with regional use of intracranial devices among patients with pneumococcal meningitis; a nationwide, population-based cohort study.","authors":"Isabella L Platz, Malte M Tetens, Nanna S Andersen, Jacob Bodilsen, Ram B Dessau, Svend Ellermann-Eriksen, Jens K Møller, Lene Nielsen, Alex Christian Yde Nielsen, Kirstine K Søgaard, Christian Østergaard, Anne-Mette Lebech, Lars Haukali Omland, Niels Obel","doi":"10.1016/j.cmi.2025.02.015","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.02.015","url":null,"abstract":"<p><strong>Objectives: </strong>Intracranial devices may be used to treat or guide treatment of increased intracranial pressure in patients with pneumococcal meningitis. European guidelines do not recommend the routine use of intracranial devices in management of pneumococcal meningitis. However, in some countries, intracranial devices are used routinely, but the effect remains unknown. We aimed to examine whether mortality and sequelae were lower in patients with pneumococcal meningitis admitted to hospitals in regions in which intracranial devices were routinely used compared to regions not utilizing intracranial devices routinely in pneumococcal meningitis management.</p><p><strong>Methods: </strong>In a registry-based, nationwide, population-based cohort study we examined patients with pneumococcal meningitis (Denmark, 2004-2021). Patients were categorized according to whether the individual was admitted to hospitals in regions where intracranial devices were routinely (exposed patients, n=305 of whom 66 (22%) had an intracranial device) or not routinely used (non-exposed patients, n=333 of whom 4 (1%) had an intracranial devices). We used Cox-regression to calculate adjusted mortality rate ratios (aMRR) and hazard ratios of sequelae for the short-term and long-term periods (<6 or ≥6 months after study inclusion).</p><p><strong>Results: </strong>The short-term cumulative incidence of death was 22% among exposed patients and 22% among non-exposed patients. We found no association between mortality and routine use of intracranial devices in the region in which patients with pneumococcal meningitis were admitted (short-term aMRR (95% confidence interval [95%CI]): 0.9 [0.6-1.3], long-term aMRR [95%CI]: 1.0 [0.7-1.6]). Furthermore, our study did not demonstrate lower risks of diagnosis of epilepsy, hearing loss, diagnoses suggestive of brain damage, disability pension, or shorter length of stay in exposed compared with non-exposed patients with pneumococcal meningitis.</p><p><strong>Conclusions: </strong>The routine use of intracranial devices is not associated with lower mortality or morbidity among patients with pneumococcal meningitis.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}