Diagnostic microbiology and infectious disease最新文献

{"title":"Anti-NMDA receptor encephalitis following SARS-CoV-2 infection in children","authors":"Li-Ping Huang ,&nbsp;Chyuan’an Lai ,&nbsp;Qing Kang ,&nbsp;Xiang-Dong Zeng","doi":"10.1016/j.diagmicrobio.2025.117028","DOIUrl":"10.1016/j.diagmicrobio.2025.117028","url":null,"abstract":"<div><h3>Background</h3><div>The purpose of this study was to report the phenomenon of anti-N-methyl-<span>d</span>-aspartate (anti-NMDA) receptor encephalitis following novel coronavirus disease 2019 (COVID-19), to minimize misdiagnoses of this as post-COVID-19 syndrome, and to promote early identification, enabling these patients to benefit from early immunotherapy.</div></div><div><h3>Methods</h3><div>The study included three pediatric patients with anti-NMDA receptor encephalitis following COVID-19, treated at our hospital from July to September 2023. We collected and analyzed the clinical data from these patients, including background information, clinical presentations, laboratory examination results, imaging results, electrophysiological results, treatment, and prognosis.</div></div><div><h3>Results</h3><div>Three patients presented with varying degrees of nonspecific symptoms, including recurrent dizziness, headache, and/or sleep disturbance, after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, initially considered as post-COVID-19 syndrome. After 2 months, 3 months, and 5 months, they developed seizures, speech disturbance, motor abnormalities, mood abnormalities, and other neuropsychiatric symptoms, with elevated cerebrospinal fluid monocytes, positive cerebrospinal fluid SARS-CoV-2-IgG, and anti-NMDAR-IgG. They were diagnosed with anti-NMDA receptor encephalitis following novel coronavirus disease. They were treated with intravenous immunoglobulin and corticosteroids, and each made a general recovery.</div></div><div><h3>Conclusion</h3><div>SARS-CoV-2 virus infection may be a trigger for the development of anti-NMDAR encephalitis. When neurological symptoms (even some nonspecific symptoms) are present following SARS-CoV-2 virus infection, neuroantibody assays are warranted to enable such patients to reap the potential benefits of early immunotherapy treatment.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"113 4","pages":"Article 117028"},"PeriodicalIF":1.8,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cedecea infections in humans - A narrative review","authors":"Sofia Maraki ,&nbsp;Viktoria Eirini Mavromanolaki ,&nbsp;Evangelia Iliaki-Giannakoudaki ,&nbsp;Anna Kasimati","doi":"10.1016/j.diagmicrobio.2025.117026","DOIUrl":"10.1016/j.diagmicrobio.2025.117026","url":null,"abstract":"<div><h3>Background</h3><div><em>Cedecea</em> species are Gram-negative, facultative anaerobic, non-sporulating, catalase-positive, oxidase-negative and motile rod shaped bacteria belonging to <em>Enterobacteriaceae</em> family. Members of the genus <em>Cedecea</em> are rarely reported to cause human infections. These infections primarily occur in immunocompromised patients with severe underlying medical conditions. The objective of this review was to collect and evaluate all published documented cases of <em>Cedecea</em> spp. human infections.</div></div><div><h3>Methods</h3><div>We searched PubMed and Scopus databases for articles providing data related to the epidemiology, clinical features and microbiology of <em>Cedecea</em> human infections.</div></div><div><h3>Results</h3><div>A total of 49 studies involving 50 patients with <em>Cedecea i</em>nfections were regarded as eligible for inclusion in our review. The mean patient age was 53.3 years and most (72 %) were male. Comorbidities were common in 88 % of the patients. The most common types of infection were bacteremia, respiratory tract infections, soft tissue infections and urinary tract infections, and more than half of them were healthcare-associated. <em>C. lapagei</em> was the predominant species, followed by <em>C. davisae</em> and <em>C. neteri</em>. High rates of resistance were recorded for ampicillin (47.6 %), gentamicin (38.1 %), amoxicillin-clavulanate, cephalothin, and ceftazidime (33.3 %) each. Ciprofloxacin was the most frequently used antibiotic, followed by meropenem. The median treatment duration was 14 days. The outcome was favorable for the majority of the patients (87.8 %). The mortality rate attributed to the infection was 10.2 %.</div></div><div><h3>Conclusions</h3><div>Physicians should be aware of this rare pathogen that exhibits resistance to many antibiotics, so they can tailor antimicrobial treatment based on susceptibility testing results to optimize outcome.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"113 4","pages":"Article 117026"},"PeriodicalIF":1.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144749036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of false-negative diagnostics of Listeria monocytogenes due to weak phospholipase activity","authors":"Lauren V. Alteio ,&nbsp;Ariane Pietzka ,&nbsp;Laura van den Höövel ,&nbsp;Patrick Mikuni-Mester","doi":"10.1016/j.diagmicrobio.2025.117024","DOIUrl":"10.1016/j.diagmicrobio.2025.117024","url":null,"abstract":"<div><div>We investigated an atypical <em>Listeria monocytogenes</em> strain isolated from the food processing environment, which may evade widely used diagnostic approaches. After species confirmation using PCR and MALDI-TOF, enzyme analysis revealed reduced phospholipase activity, indicating a link between its activity and the white appearance of atypical strains on chromogenic agar. While no mutation was detected in the phospholipase C gene, comparative genomics revealed a distinct seven base pair insertion in the <em>prfA</em> gene, resulting in gene truncation. These results highlight the risk of false negatives in current diagnostics and a need for improved detection methods to ensure food safety.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"113 4","pages":"Article 117024"},"PeriodicalIF":1.8,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accidental needle inoculation of bacillus Calmette-Guerin vaccine in medical worker – TBC arthritis","authors":"Sladjana Matic ,&nbsp;Valerija Teodosic ,&nbsp;Slavisa Zagorac","doi":"10.1016/j.diagmicrobio.2025.117006","DOIUrl":"10.1016/j.diagmicrobio.2025.117006","url":null,"abstract":"<div><div>Despite the increase of mycobacterial infection, the incidence of tuberculous hand infection remains extremely low. We report a case of a 51-old pediatric nurse, who inadvertently inoculated her index finger via needlestick, while performing BCG immunization of the baby. Two days after the event, painful swelling and erythema of the distal interphalangeal joint region of the index finger appeared. Further diagnostic confirmed rare case of mycobacterial finger joint infection. It is important that hospital stuff should be informed about the possibility of BCG accident transmission to reduce the incidents of percutaneous injuries.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"113 3","pages":"Article 117006"},"PeriodicalIF":1.8,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The aetiologic agents and resistance rates in community-acquired complicated intra-abdominal infections: Where are we locally?","authors":"Eren Ozturk ,&nbsp;Irem Akdemir ,&nbsp;Eray Ontas ,&nbsp;Gule Cinar ,&nbsp;Elif Mukime Saricaoglu ,&nbsp;Ezgi Gulten ,&nbsp;Siyar Ersoz ,&nbsp;Kemal Osman Memikoglu","doi":"10.1016/j.diagmicrobio.2025.117023","DOIUrl":"10.1016/j.diagmicrobio.2025.117023","url":null,"abstract":"<div><h3>Background</h3><div>Community-acquired complicated intra-abdominal infections (CA-cIAIs) are a significant global health concern, associated with considerable morbidity and mortality. In regions lacking local epidemiological data, obtaining intraoperative cultures is recommended to guide empirical antibiotic selection. This study aimed to describe the local microbiological profile and resistance patterns in CA-cIAIs.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed adult patients operated for CA-cIAIs at Ankara University Hospital between January 2018 and December 2023. Inclusion criteria included intraoperative or percutaneous drainage sampling and absence of recent hospitalization or abdominal procedures within three months.</div></div><div><h3>Results</h3><div>Among 124 surgical patients, cultures were collected from 80 (64.5 %), with 44 (70 %) yielding microbiological growth. A total of 69 pathogens were identified. The most frequent infection sources were cholecystitis (36 %), appendicitis (27 %), and colon perforation (20 %). <em>Escherichia coli</em> (46.4 %), <em>Klebsiella pneumoniae</em> (10.1 %), and <em>Enterococcus faecalis</em> (8.7 %) were the predominant organisms. Extended-spectrum beta-lactamase (ESBL) production was observed in 30.4 % of Gram-negative strains, with notable resistance to third-generation cephalosporins (40 %) and fluoroquinolones (33.3 %). Empirical antibiotics included piperacillin-tazobactam (77.2 %) and teicoplanin (47.7 %). However, their predictive values were low (PPV: 32.4 % and 38.1 %, respectively), with moderate concordance rates.</div></div><div><h3>Conclusions</h3><div><em>E. coli</em> remains the leading pathogen in CA-cIAIs, but rising resistance rates to key antibiotics pose challenges to empirical treatment. Although piperacillin-tazobactam and teicoplanin were the most commonly used empirical agents, their low PPV underscore the need for improved strategies to optimize empirical therapy. Our findings emphasize the importance of obtaining intraoperative cultures to enable timely de-escalation and appropriate antimicrobial stewardship</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"113 4","pages":"Article 117023"},"PeriodicalIF":1.8,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of the causative organisms in 17 cases of infected abdominal aortic aneurysms using ribosomal RNA gene sequencing analysis and genetic study on 10 cases of Helicobacter cinaedi","authors":"Risako Kakuta ,&nbsp;Takuya Shimizu ,&nbsp;Hisakazu Yano ,&nbsp;Tetsuo Watanabe ,&nbsp;Masumitsu Hatta ,&nbsp;Shinya Inomata ,&nbsp;Yuko Fujikawa ,&nbsp;Kazuhiro Nomura ,&nbsp;Tetsuji Aoygi ,&nbsp;Yukio Katori","doi":"10.1016/j.diagmicrobio.2025.117019","DOIUrl":"10.1016/j.diagmicrobio.2025.117019","url":null,"abstract":"<div><div>Infected abdominal aortic aneurysm (IAAA) is a life-threatening condition, often complicated by a high rate of culture-negative cases, which hampers appropriate antimicrobial selection. This study investigated the causative organisms in 17 patients who underwent surgery for IAAA at two institutions in Japan. Pathogens were identified through blood and tissue cultures, ribosomal RNA gene sequencing, and histopathological examination. In cases where <em>Helicobacter cinaedi</em> was detected, multilocus sequence typing (MLST) and genetic analyses for resistance to β-lactams, macrolides, and quinolones were conducted. Of the 17 cases, 11 (64.7%) were culture-negative, and <em>H. cinaedi</em> was identified in 8 (72.7%) of these through rRNA gene analysis. Including 2 culture-positive cases, <em>H. cinaedi</em> was found in 10 cases (58.8%) overall. All <em>H. cinaedi</em> cases harbored genetic mutations associated with macrolide resistance and amino acid substitutions linked to quinolone resistance, while no mutations related to β-lactam resistance were detected. These findings indicate that <em>H. cinaedi</em> is a predominant pathogen in culture-negative IAAA and suggest that β-lactam antibiotics are appropriate for treatment, whereas macrolides and quinolones should be avoided.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"113 3","pages":"Article 117019"},"PeriodicalIF":2.1,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144711250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of COVID-19 pandemic on toxinogenic Clostridioides difficile infections and correlation with multidrug-resistant bacterial infections","authors":"Luisa Torrini ,&nbsp;Fabiana Diaco ,&nbsp;Agnese Viscido ,&nbsp;Federica Sacco ,&nbsp;Germana Sfara ,&nbsp;Daniele Emanuele Compagnino ,&nbsp;Gianluca Puggioni ,&nbsp;Monica Coletti ,&nbsp;Guido Antonelli ,&nbsp;Giammarco Raponi","doi":"10.1016/j.diagmicrobio.2025.117014","DOIUrl":"10.1016/j.diagmicrobio.2025.117014","url":null,"abstract":"<div><div><em>Clostridioides difficile</em> infection (CDI) is one of the most common healthcare-associated infections, contributing to significant morbidity and mortality, particularly in hospitalized patients. Its incidence is influenced by infection control measures, antimicrobial stewardship, and hospital hygiene protocols. The Coronavirus disease 2019 (COVID-19) pandemic led to the widespread adoption of stringent infection prevention strategies. These measures may have influenced the incidence of CDI. At the university hospital Policlinico Umberto I in Rome, we conducted a retrospective analysis of CDI cases across three periods: preCOVID-19, COVID-19 and postCOVID-19. Our findings revealed a statistically significant decrease in CDI cases during the COVID-19 period compared to the preCOVID-19 period, as well as in the postCOVID-19 period compared to the COVID-19 period. Additionally, we explored the potential association between CDI and multidrug-resistant organisms (MDRO). Our findings indicate a reduction in MDRO infections among patients with CDI in the COVID-19 and postCOVID-19 periods compared to the preCOVID-19 period. These results highlight the potential impact of infection control strategies on CDI incidence and suggest a possible relationship between CDI and MDRO infection. Further research is needed to assess the long-term effects of these measures and their implications for future infection prevention strategies.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"113 3","pages":"Article 117014"},"PeriodicalIF":2.1,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The neurocysticercosis puzzle: A case of chronic cephalalgia and hydrocephalus","authors":"Víctor Antón-Berenguer ,&nbsp;Jorge Ligero-López ,&nbsp;Rafael Torres-Perea ,&nbsp;María Dolores Martín-Rodrigo ,&nbsp;Antonio Nicolás Ruiz-Benito ,&nbsp;Francisco Jesús Merino-Fernández ,&nbsp;José Miguel Rubio-Muñoz ,&nbsp;María Delmans Flores-Chávez","doi":"10.1016/j.diagmicrobio.2025.117020","DOIUrl":"10.1016/j.diagmicrobio.2025.117020","url":null,"abstract":"<div><div>Neurocysticercosis (NC) is the most common helminthic CNS infection, primarily affecting individuals from endemic regions. We present the case of a 33-year-old Peruvian woman, who had been residing in Spain for over a decade, who experienced recurrent episodes of severe headache, vertigo, and diplopia. Initial evaluations revealed tetraventricular hydrocephalus with unclear etiology. Over the course of a year, she underwent multiple hospitalizations, being diagnosed with retinal toxoplasmosis. Serological testing revealed <em>Taenia solium</em> IgG antibodies. Despite inconclusive neuroimaging, she was treated with albendazole and corticosteroids, leading to symptom improvement. However, mild headaches persisted. Years later, a CT scan revealed a calcified cysticercus in the fourth ventricle, confirming the diagnosis of ventricular NC. This case underscores the diagnostic challenges of NC, particularly in atypical presentations. A multidisciplinary approach combining serology, neuroimaging, epidemiological risk assessment and clinical history is crucial for early detection and management. Long-term follow-up is essential to monitor sequelae and ensure optimal outcomes.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"113 3","pages":"Article 117020"},"PeriodicalIF":2.1,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A challenging case of refractory infection following fish fin injury: Successful treatment through combined therapy","authors":"Yanqing Chen ,&nbsp;Shifu Mo ,&nbsp;Jianjian Li ,&nbsp;Huiting Zhong ,&nbsp;Chikit Chao ,&nbsp;Ting Liu ,&nbsp;Han Ma","doi":"10.1016/j.diagmicrobio.2025.117021","DOIUrl":"10.1016/j.diagmicrobio.2025.117021","url":null,"abstract":"<div><div>We report a case of refractory infection caused by Mycobacterium marinum and Mycobacterium shottsii following a fish fin injury. The diagnosis was confirmed by acid-fast bacilli staining and metagenomic next-generation sequencing. This case posed challenges in diagnosis and treatment due to the simultaneous infection by acute and chronic pathogens, uncommon skin and joint symptoms, and multiple lesions involving deep fascia and intermuscular spaces caused by special pathogens. Ultimately, resolution of the lesions without recurrence was achieved after the thorough surgical debridement and excision of the affected tissue in conjunction with dual antibiotic therapy. This success highlights that optimal outcomes require both the most thorough lesion clearance possible and adequate antibacterial therapy administered concurrently.</div><div>Notably, M. shottsii—previously undocumented as a human pathogen—was identified in this case, expanding the known spectrum of mycobacterial pathogens and highlighting a previously unrecognized zoonotic risk.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"113 3","pages":"Article 117021"},"PeriodicalIF":2.1,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144695245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical performance of the Abbott Alinity anti-HBc immunoassay and its association with FIB-4 score in risk stratification of liver fibrosis","authors":"Iheb Elkaibi,&nbsp;Sophie Laplanche,&nbsp;Salomon Ohana,&nbsp;Habiba Daikha","doi":"10.1016/j.diagmicrobio.2025.117018","DOIUrl":"10.1016/j.diagmicrobio.2025.117018","url":null,"abstract":"<div><h3>Background</h3><div>Hepatitis B virus (HBV) infection remains a major global health concern, especially in immunocompromised individuals due to the risk of viral reactivation. Anti- HBc antibodies serve as key markers of past or ongoing infection. This study evaluated the diagnostic performance of the Abbott Alinity anti-HBc assay and investigated the clinical significance of anti-HBc positivity, particularly in relation to liver fibrosis.</div></div><div><h3>Methods</h3><div>A retrospective, cross-sectional study was conducted on 10,377 serum samples tested for anti-HBc at Paris Saint Joseph Hospital between November 2022 and December 2023. The correlation between anti-HBc index values, HBsAg status, HBV DNA viral load, and fibrosis severity (via FIB-4 index) was analyzed across various patient populations, including immunocompromised and at-risk groups.</div></div><div><h3>Results</h3><div>Anti-HBc positivity was observed in 15.3 % of samples. Retesting had no impact on interpretation for samples with S/CO &gt; 2. Anti-HBc levels were significantly higher in HBsAg-positive and DNA HBV-positive samples. Immunocompromised patients showed lower anti-HBc indices. A higher FIB-4 index was associated with anti- HBc positivity, suggesting a potential link between past HBV infection and increased risk of advanced fibrosis. No correlation was found between anti-HBc levels and HBV DNA viral load or HBsAg index.</div></div><div><h3>Conclusion</h3><div>The Abbott Alinity anti-HBc assay demonstrates strong performance, with minimal need for retesting outside the gray zone. Anti-HBc positivity may serve as an independent risk factor for liver fibrosis, underlining its importance in HBV surveillance, especially in immunocompromised patients. Clinical guidelines may consider tailored retesting strategies and emphasize nucleic acid testing for comprehensive HBV evaluation.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"113 3","pages":"Article 117018"},"PeriodicalIF":2.1,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}