Current Opinion in Infectious Diseases最新文献

Host-directed immunotherapy for viral infections. 病毒感染的宿主定向免疫疗法。

IF 3.6 3区医学

Current Opinion in Infectious Diseases Pub Date : 2025-08-01 Epub Date: 2025-05-21 DOI: 10.1097/QCO.0000000000001116

Donald C Vinh

引用次数: 0

The plumbing problem: rising antimicrobial resistance in building water systems. 管道问题：建筑供水系统中抗菌素耐药性上升。

IF 3.6 3区医学

Current Opinion in Infectious Diseases Pub Date : 2025-08-01 Epub Date: 2025-06-05 DOI: 10.1097/QCO.0000000000001119

Claire Hayward, Harriet Whiley, Nicholas J Ashbolt

{"title":"The plumbing problem: rising antimicrobial resistance in building water systems.","authors":"Claire Hayward, Harriet Whiley, Nicholas J Ashbolt","doi":"10.1097/QCO.0000000000001119","DOIUrl":"10.1097/QCO.0000000000001119","url":null,"abstract":"Purpose of review: This review examines the interplay between biological and anthropogenic factors in the development and persistence of antimicrobial resistance (AMR) within building plumbing systems, which is of particular concern in high risk setting such as healthcare facilities. The review highlights the role of biofilms and amoeba as reservoirs for AMR and explores how engineering and design decisions, governance structures, and cleaning protocols influence microbial resistance dynamics.Recent findings: Biofilms provide a protective environment that facilitates horizontal gene transfer and enhances bacterial resistance to disinfection. Amoeba-hosted bacteria can evade standard cleaning practices, further promoting AMR persistence. Emerging technologies, such as digital twin modelling, offer new opportunities to optimize risk mitigation strategies. However, more consideration is needed to be given to design or management decision that may have unintended consequences, such as unintended design outcomes, such as increased biofilm growth from tap mixers and low-flow fixtures, and ineffective cleaning protocols, which can inadvertently worsen AMR.Summary: Effectively managing AMR in plumbing systems requires a multidisciplinary approach that integrates microbiology, engineering, and policy. Data driven risk assessments can identify high-risk areas that may require design changes but also can enable targeted cleaning strategies, reducing reliance on widespread disinfection that may drive resistance. Future policies must consider system-wide implications to prevent unintended consequences. By addressing both biological and anthropogenic drivers, we can develop sustainable solutions to mitigate AMR risks in healthcare and beyond.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"347-353"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Genome-wide approaches to bacterial strain typing: a history and review of recent methodological advances. 细菌菌株分型的全基因组方法：最近方法进展的历史和回顾。

IF 3.6 3区医学

Current Opinion in Infectious Diseases Pub Date : 2025-08-01 Epub Date: 2025-06-12 DOI: 10.1097/QCO.0000000000001118

William C Shropshire, Blake M Hanson, Samuel A Shelburne

{"title":"Genome-wide approaches to bacterial strain typing: a history and review of recent methodological advances.","authors":"William C Shropshire, Blake M Hanson, Samuel A Shelburne","doi":"10.1097/QCO.0000000000001118","DOIUrl":"10.1097/QCO.0000000000001118","url":null,"abstract":"Purpose of review: Whole genome sequencing (WGS) has transformed bacterial strain typing, an essential tool for outbreak detection, antimicrobial resistance surveillance, and tracking clonal emergence across clinical, research, and public health settings. Herein, we will review recent advances in WGS-based bacterial strain typing methods for purposes of comparison and classification with a focus on improvements in variant identification, strain classification, and transmission assessment.Recent findings: Advances in sequencing technologies as well as variant calling methodologies and parameter optimization have enhanced the precision and accuracy of single nucleotide variant identification. Hierarchical clustering of gene-by-gene strain typing, combined with novel data management and classification strategies, has improved standardized pathogen typing schemes in an effort to streamline inter-laboratory comparison. Additionally, novel approaches to defining transmission thresholds now better account for species-specific traits, while progress in metagenomic sequencing enables strain identification and tracking within mixed microbial communities.Summary: Recent developments have enhanced the accuracy, portability, scalability, and standardization of bacterial typing methods, integrating variant calling and gene-by-gene approaches into unified genotyping systems. However, challenges still remain in nomenclature consistency, inter-laboratory variant calling compatibility, and capturing bacterial heterogeneity. Future work should focus on refining genotyping frameworks to enhance surveillance and optimize detection of pathogen transmission while accounting for microbial diversity across various environments.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"329-338"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Respiratory syncytial virus prevention in immunocompromised hosts: gaps and opportunities. 免疫功能低下宿主的呼吸道合胞病毒预防：差距和机遇。

IF 3.6 3区医学

Current Opinion in Infectious Diseases Pub Date : 2025-08-01 Epub Date: 2025-06-05 DOI: 10.1097/QCO.0000000000001124

Alastair Murray, Helen Y Chu

{"title":"Respiratory syncytial virus prevention in immunocompromised hosts: gaps and opportunities.","authors":"Alastair Murray, Helen Y Chu","doi":"10.1097/QCO.0000000000001124","DOIUrl":"10.1097/QCO.0000000000001124","url":null,"abstract":"Purpose of review: Respiratory syncytial virus (RSV) poses a significant threat to immunocompromised individuals, yet preventive strategies and treatments remain largely unstudied in this population. New vaccines, mAbs, and antiviral agents are becoming available, with implications for high-risk patients.Recent findings: RSV in immunocompromised individuals often leads to severe disease, prolonged illness, and treatment delays. Diagnostic challenges and the heterogeneity of immunosuppression complicate management. Recent advances include preF-based vaccines and monoclonal antibodies, though current recommendations exclude many immunocompromised patients. Early vaccine trials showed mixed immunogenicity results in this group and real-world effectiveness remains unclear. Antiviral agents are also under investigation, though efficacy data in immunocompromised hosts are limited. Infection prevention strategies remain critical in this high-risk group.Summary: Despite promising advances in RSV prevention and treatment, immunocompromised patients remain underrepresented in clinical research. Targeted studies are urgently needed to determine optimal strategies for this vulnerable group. Until then, clinicians must rely on limited evidence and institutional protocols to guide care.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"300-304"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

To proceed or delay? The dilemma of community-acquired respiratory viruses in adults and pediatrics before allogeneic stem cell transplantation and chimeric-antigen-receptor T-cell therapy. 继续还是推迟？同种异体干细胞移植和嵌合抗原受体t细胞治疗前成人和儿科社区获得性呼吸道病毒的困境

IF 3.6 3区医学

Current Opinion in Infectious Diseases Pub Date : 2025-08-01 Epub Date: 2025-06-05 DOI: 10.1097/QCO.0000000000001120

José Luis Piñana, Rodrigo Martino, Simone Cesaro, Dina Averbuch, Per Lujgman

{"title":"To proceed or delay? The dilemma of community-acquired respiratory viruses in adults and pediatrics before allogeneic stem cell transplantation and chimeric-antigen-receptor T-cell therapy.","authors":"José Luis Piñana, Rodrigo Martino, Simone Cesaro, Dina Averbuch, Per Lujgman","doi":"10.1097/QCO.0000000000001120","DOIUrl":"10.1097/QCO.0000000000001120","url":null,"abstract":"Purpose of review: This review explores the impact of community-acquired respiratory virus (CARV) infections on outcomes before proceeding with hematopoietic cell transplantation (HCT) and chimeric-antigen-receptor T-cell (CAR-T) therapy recipients and which conditions should be considered to delay or proceed with cell therapy. It aims to assess current practices, the risks associated with early CARV infections in cell therapy recipients, and potential modifications to reduce complications and improve clinical outcomes if delay is not an option.Recent findings: Studies have shown that pretransplant CARV infections, particularly those with symptomatic lower respiratory tract disease (LRTD), are linked to increased mortality and prolonged hospitalization after hematopoietic stem cell transplant. The timing of CARV infection regarding the transplant, the type of CARV, and the intensity of immunosuppressive conditioning, among others, are key factors influencing outcomes. Additionally, recent research highlights the potential benefits of delaying transplantation, optimizing immunosuppression, and reducing the duration of neutropenia and lymphopenia to mitigate the risk of severe infections.Summary: Key challenges include determining the optimal timing for transplant in CARV-positive patients, managing cell procedures, and minimizing risk factors to reduce the development of a severe course resulting in poor outcome. Current practices often prioritize timely transplant/CAR-T procedures but may need to be adjusted to account for CARV infections. Implementing strategies such as reduced-intensity conditioning, enhanced infection prevention measures, and antiviral therapy could significantly impact patient outcomes, particularly in preventing progression to LRTD and reducing the risk for fatal outcome.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"290-299"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The role of antibacterial prophylaxis in high-risk neutropenia: benefits, risks, and current perspectives. 抗菌预防在高危中性粒细胞减少症中的作用：益处、风险和当前观点。

IF 3.6 3区医学

Current Opinion in Infectious Diseases Pub Date : 2025-08-01 Epub Date: 2025-05-02 DOI: 10.1097/QCO.0000000000001114

Abby P Douglas, Erica Stohs, Malgorzata Mikulska

{"title":"The role of antibacterial prophylaxis in high-risk neutropenia: benefits, risks, and current perspectives.","authors":"Abby P Douglas, Erica Stohs, Malgorzata Mikulska","doi":"10.1097/QCO.0000000000001114","DOIUrl":"10.1097/QCO.0000000000001114","url":null,"abstract":"Purpose of review: To review the benefits, risks and specific considerations surrounding antibacterial prophylaxis (ABP) in adults with neutropenia, focusing primarily on high-risk patients with hematologic malignancies (HM) and/or hematopoietic cell transplantation (HCT).Recent findings: There has been an overall reduction in benefit of fluoroquinolone prophylaxis (FQP) observed in recent studies, with a lack of overall mortality benefit and less efficacy in reducing Gram-negative bloodstream infections (BSI) rates, which may be explained by increasing rates of fluoroquinolone resistance (both on center-level and patient-level) and improved early sepsis management. In the context of FQP, epidemiology of BSIs has changed with greater Gram-positive BSIs and resistant Gram-negative BSIs.Summary: ABP, most frequently FQP, has been introduced since the 1980s with the aim of reducing rates of infection and mortality. While older meta-analyses support its efficacy in reducing episodes of febrile neutropenia (FN), BSI and most importantly mortality, more recent data report lack of benefit on mortality, and negative impacts such as rising antimicrobial resistance, and in the broader literature, safety concerns for FQP. The role of ABP in neutropenia has been increasingly questioned and should be considered at a center-by-center and an individual-patient level.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"281-289"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Preventing respiratory viral transmission in healthcare settings. 在卫生保健环境中预防呼吸道病毒传播。

IF 3.6 3区医学

Current Opinion in Infectious Diseases Pub Date : 2025-08-01 Epub Date: 2025-05-02 DOI: 10.1097/QCO.0000000000001115

Marie-Céline Zanella, Chanu Rhee, Michael Klompas

{"title":"Preventing respiratory viral transmission in healthcare settings.","authors":"Marie-Céline Zanella, Chanu Rhee, Michael Klompas","doi":"10.1097/QCO.0000000000001115","DOIUrl":"10.1097/QCO.0000000000001115","url":null,"abstract":"Purpose of review: The COVID-19 pandemic catalyzed new insights into respiratory viral transmission mechanisms and prevention. We review the most practical and impactful measures to prevent SARS-CoV-2 and other nosocomial respiratory viral infections in healthcare.Recent findings: Nosocomial respiratory viral infection rates mirror viral activity levels in the surrounding community. During peak periods ∼15-20% of hospitalized patients with respiratory viral infections may have acquired their virus in the hospital. Nosocomial respiratory viral infections are associated with increased lengths-of-stay, risk of respiratory failure, and hospital death. Most procedures contribute minimally to aerosol production compared to labored breathing, coughing, and forced expiration. Masking for source control and exposure control both decrease transmission risk, respirators more so than masks. Likewise, vaccinating healthcare workers decreases transmission risk and is associated with lower patient mortality rates, particularly in long-term care facilities. Increasing air changes, ultraviolet irradiation, and portable HEPA filtration units may also decrease transmission rates but their marginal benefit relative to current healthcare ventilation standards has yet to be established.Summary: Practical strategies to prevent nosocomial respiratory viral infections include maximizing staff and patient influenza and SARS-CoV-2 vaccination rates and implementing routine masking during patient interactions when community incidence is high.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"339-346"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Urinary tract infections in immunocompromised patients. 免疫功能低下患者的尿路感染。

IF 3.6 3区医学

Current Opinion in Infectious Diseases Pub Date : 2025-08-01 Epub Date: 2025-06-09 DOI: 10.1097/QCO.0000000000001121

Cesar J Figueroa-Ortiz, Peter A Mead

{"title":"Urinary tract infections in immunocompromised patients.","authors":"Cesar J Figueroa-Ortiz, Peter A Mead","doi":"10.1097/QCO.0000000000001121","DOIUrl":"10.1097/QCO.0000000000001121","url":null,"abstract":"Purpose of review: Urinary tract infections (UTIs) are a major source of morbidity in immunocompromised patients, including transplant recipients, individuals with hematologic malignancies, people living with HIV, and those receiving immunosuppressive therapies. This review provides a synthesis of recent evidence, highlighting challenges in diagnosis, management, and antimicrobial resistance in these high-risk populations.Recent findings: Recent literature highlights the high burden of UTIs among immunocompromised patients. These infections are often caused by multidrug-resistant pathogens. Across these groups, common risk factors include immunosuppression, diabetes, urologic instrumentation, and catheterization. Diagnostic uncertainty - particularly distinguishing true infection from asymptomatic bacteriuria - frequently leads to overtreatment. Emerging stewardship tools, such as reflex urinalysis protocols and electronic phenotyping of antimicrobials (e.g. the use of the 'Acute Urinary Antibiotics' labelling), show promise for reducing inappropriate antibiotic use in outpatient settings.Summary: UTIs in immunocompromised patients are increasingly complex due to atypical presentations and resistant pathogens. Clinical care must prioritize accurate diagnosis, judicious use of antibiotics, and implementation of stewardship interventions. Further research is needed to validate risk-based diagnostic tools and expand outpatient stewardship infrastructure in transplant and oncology settings.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"322-328"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Latent tuberculosis screening and treatment in solid organ and hematopoietic stem cell transplant candidates and recipients. 实体器官和造血干细胞移植候选者和受者的潜伏性结核筛查和治疗。

IF 3.6 3区医学

Current Opinion in Infectious Diseases Pub Date : 2025-08-01 Epub Date: 2025-06-04 DOI: 10.1097/QCO.0000000000001117

Sonya Krishnan, Robin Avery, Veronica Dioverti, Jeffrey A Tornheim

{"title":"Latent tuberculosis screening and treatment in solid organ and hematopoietic stem cell transplant candidates and recipients.","authors":"Sonya Krishnan, Robin Avery, Veronica Dioverti, Jeffrey A Tornheim","doi":"10.1097/QCO.0000000000001117","DOIUrl":"10.1097/QCO.0000000000001117","url":null,"abstract":"Purpose of review: Tuberculosis disease (TBD) has high mortality in transplant recipients. This review evaluates the current evidence for latent tuberculosis infection (LTBI) screening and treatment in solid organ transplant (SOT) and hematopoietic stem cell transplant recipients (HCST).Recent findings: Untreated LTBI still poses a significant risk in transplant recipients, with reactivation to TBD leading to high mortality rates. Currently available methods to test for LTBI (interferon-gamma release assays and tuberculin skin tests) can have low predictive value for determining who will progress from LTBI to TBD in transplant. Tuberculosis preventive therapy (TPT) is recommended for those with a positive LTBI screening test. Evidence indicates that short-course, rifamycin-based TPT regimens are associated with less hepatoxicity and improved treatment completion compared to isoniazid. In the transplant population, however, drug-drug interactions limit their use, so isoniazid preventive therapy remains the preferred regimen. Several recent studies have evaluated moxifloxacin as a potential TPT regimen in transplant, but this regimen has not yet been incorporated into guidelines. The timing of LTBI treatment can differ for SOT versus HSCT.Summary: While comprehensive LTBI screening and TPT are critical for reducing the risk of TBD, future research should aim to optimize LTBI diagnostic tools and therapeutic regimens to enhance the efficacy of LTBI diagnostics and minimize TPT side effects and drug-drug interactions in the transplant population.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"305-312"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Chronic meningitis: diagnostic and therapeutic challenges. 慢性脑膜炎：诊断和治疗的挑战。

IF 3.6 3区医学

Current Opinion in Infectious Diseases Pub Date : 2025-06-01 Epub Date: 2025-04-04 DOI: 10.1097/QCO.0000000000001107

Matthew Smyth, Monica Diaz, Deanna Saylor

{"title":"Chronic meningitis: diagnostic and therapeutic challenges.","authors":"Matthew Smyth, Monica Diaz, Deanna Saylor","doi":"10.1097/QCO.0000000000001107","DOIUrl":"10.1097/QCO.0000000000001107","url":null,"abstract":"Purpose of review: We review recent advances in diagnosis and treatment of chronic meningitis, focusing on tuberculous meningitis (TBM), cryptococcal meningitis (CM), syphilitic meningitis, neuroborreliosis, and recurrent chronic meningitis. Noninfectious causes and unique challenges faced in resource-limited settings are also considered.Recent findings: Novel biomarkers are being identified that may be useful for the diagnosis of TBM [i.e. monokine induced by interferon-γ (MIG), plasminogen binding proteins] and syphilitic meningitis (i.e. CXCL13, neurofilament light protein, etc.) but require more validation. Much progress has been made regarding diagnosis and treatment of CM, with a new semiquantitative lateral flow assay showing high diagnostic and prognostic utility and clinical trials demonstrating that regimens of oral lipid nanocrystal formulation and a single dose of liposomal formulation of amphotericin B maintain clinical efficacy with improved side effect profiles. An ongoing clinical trial of ceftriaxone for treatment of syphilitic meningitis and early stage studies of linezolid for TBM treatment may also lead to changes in recommended treatment regimens for these conditions in the near future.Summary: Diagnosis and management of chronic meningitis remains a significant challenge, and further research is needed to improve our diagnostic and therapeutic armamentariums. However, emergence of potential new biomarkers for diagnosis and disease course is cause for optimism.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"252-260"},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0