European Journal of Clinical Microbiology & Infectious Diseases最新文献

{"title":"3-Hydroxybenzoic acid inhibits the virulence attributes and disrupts biofilm production in clinical isolates of Acinetobacter baumannii.","authors":"Naji Naseef Pathoor, Pitchaipillai Sankar Ganesh, Abdul R Anshad, Rajesh Kanna Gopal, Esaki Muthu Ponmalar, Suvaiyarasan Suvaithenamudhan, Parthiban Rudrapathy, Esaki M Shankar","doi":"10.1007/s10096-024-05009-0","DOIUrl":"10.1007/s10096-024-05009-0","url":null,"abstract":"<p><strong>Purpose: </strong>Acinetobacter baumannii (A. baumannii) is an emerging global public health threat owing to its ability to form biofilms. Here, we evaluated 3-hydroxybenzoic acid (3-HBA), a promising organic compound, for its ability to disrupt biofilm formation and virulence attributes in clinical isolates of A. baumannii.</p><p><strong>Materials and methods: </strong>The effect of 3-HBA on A. baumannii was assessed by determining the minimum inhibitory concentration (MIC) and certain other in vitro investigations viz., extracellular polymeric substance (EPS) estimation, crystal violet staining assay, motility assay, and the hydrogen peroxide (H₂O₂) assay to examine its impact on bacterial virulence. Biofilm formation was also evaluated at the air-liquid interface. In situ visualization investigations were employed to confirm biofilm dispersion at the lowest effective concentration. The cytotoxic effects of 3-HBA on MCF-7 cells were investigated using the MTT assay.</p><p><strong>Results: </strong>At a sub-inhibitory concentration of 0.078 mg/mL, 3-HBA reduced biofilm formation in A. baumannii LSAB-04 and A. baumannii LSAB-06 by 61.22% and 59.21%, respectively, and decreased EPS production by 64% in LSAB-04 and 58.31% in LSAB-06. Microscopic examination confirmed significant biofilm dispersion. 3-HBA also significantly impaired swarming motility and increased their sensitivity to H₂O₂. The MTT assay showed a dose-dependent decrease in MCF-7 cell viability (43.67%) at a concentration of 0.078 mg/mL.</p><p><strong>Conclusion: </strong>Our findings underscore the likely role of 3-HBA as a promising A. baumannii biofilm-disrupting agent. Further, by downplaying against the virulence factors of A. baumannii, 3-HBA could be a compelling alternative to conventional antibiotics that however requires to be investigated.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"653-669"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909403","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}

{"title":"Chikungunya virus and armed forces: relevance and vaccine prospects.","authors":"Jonas Schmidt-Chanasit, Ralf Matthias Hagen, Hagen Frickmann","doi":"10.1007/s10096-024-05028-x","DOIUrl":"10.1007/s10096-024-05028-x","url":null,"abstract":"","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":"44 3","pages":"763-764"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11880158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540636","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}

{"title":"Artificial intelligence in antimicrobial stewardship: a systematic review and meta-analysis of predictive performance and diagnostic accuracy.","authors":"Flavia Pennisi, Antonio Pinto, Giovanni Emanuele Ricciardi, Carlo Signorelli, Vincenza Gianfredi","doi":"10.1007/s10096-024-05027-y","DOIUrl":"10.1007/s10096-024-05027-y","url":null,"abstract":"<p><p>The increasing threat of antimicrobial resistance has prompted a need for more effective antimicrobial stewardship programs (AMS). Artificial intelligence (AI) and machine learning (ML) tools have emerged as potential solutions to enhance decision-making and improve patient outcomes in AMS. This systematic review and meta-analysis aims to evaluate the impact of AI in AMS and to assess its predictive performance and diagnostic accuracy. We conducted a comprehensive literature search across PubMed/MEDLINE, Scopus, EMBASE, and Web of Science to identify studies published up to July 2024. Studies included were observational, cohort, or retrospective, focusing on the application of AI/ML in AMS. The outcomes assessed were the area under the curve (AUC), accuracy, sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV). We calculated the mean pooled effect size (ES) and its 95% confidence interval (CI) using a random-effects model. The risk of bias was assessed using the QUADAS-AI tool, and the protocol was registered in PROSPERO. Out of 3,458 retrieved articles, 80 studies met the inclusion criteria. Our meta-analysis demonstrated that ML models exhibited strong predictive performance and diagnostic accuracy, with the following results: AUC [ES: 72.28 (70.42-74.14)], accuracy [ES: 74.97 (73.35-76.58)], sensitivity [ES: 76.89; (71.90-81.89)], specificity [ES: 73.77; (67.87-79.67)], NPV [ES:79.92 (76.54-83.31)], and PPV [ES: 69.41 (60.19-78.63)] across various AMS settings. AI and ML tools offer promising enhancements due to their strong predictive performance. The integration of AI into AMS could lead to more precise antimicrobial prescribing, reduced antimicrobial resistance, and better resource utilization.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"463-513"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930965","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}

{"title":"First recorded food-borne outbreak of gastroenteritis caused by enteroinvasive Escherichia coli serotype O8:H19 in Thailand.","authors":"Kazuhisa Okada, Amonrattana Roobthaisong, Atchareeya Nakkarach, Suthida Muangnoicharoen Hearn, Adirek Saenharn, Lalada Naksen, Pawinee Doung-Ngern, Pilailuk Akkapaiboon Okada, Tetsuya Iida","doi":"10.1007/s10096-024-05024-1","DOIUrl":"10.1007/s10096-024-05024-1","url":null,"abstract":"<p><p>An enteroinvasive Escherichia coli (EIEC) outbreak affecting 154 individuals was identified among attendees at a wedding in Loei Province, Thailand. The median time to symptom onset was 18 h (range: 7-72 h). The epidemiological evidence suggested that larb-neua-dib (spicy minced raw beef salad) was the probable source of the outbreak. The O8:H19 isolates identified in this study closely resemble the O8:H19 strains from the United States and the United Kingdom, but not the O96:H19 strains from Europe. This is the first EIEC outbreak documented in Thailand. Complexities in identifying EIEC contribute to its underreporting.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"733-737"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11880058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881505","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}

{"title":"Genome-based development and clinical evaluation of a customized LAMP panel to rapidly detect, quantify, and determine antibiotic sensitivity of Escherichia coli in native urine samples from urological patients.","authors":"Moritz Fritzenwanker, Marcel O Grabitz, Vera Negwer, Oliver Schwengers, Borros Arneth, Trinad Chakraborty, Can Imirzalioglu, Florian Wagenlehner","doi":"10.1007/s10096-024-05030-3","DOIUrl":"10.1007/s10096-024-05030-3","url":null,"abstract":"<p><strong>Purpose: </strong>We designed and tested a point of care test panel to detect E.coli and antibiotic susceptibility in urine samples from patients at the point of care in the urological department. The aim of this approach is to facilitate choosing an appropriate antibiotic for urinary tract infections (UTI) at first presentation in the context of increasing antibiotic resistance in uropathogens worldwide.</p><p><strong>Methods: </strong>We analyzed 162 E.coli isolates from samples from a university urological department to determine phenotypic and genotypic resistance data. With this data we created customized LAMP (loop-mediated isothermal amplification) panels for a commercial machine with which to detect and possibly quantify E.coli and six antibiotic resistance determinants. In a second step we tested these panel(s) for diagnostic accuracy on 1596 urine samples and compared with routine microbiological culture.</p><p><strong>Results: </strong>E.coli was detected with 95.4% sensitivity and 96.1% specificity. Dynamics of the LAMP amplification could be used to gauge bacterial loads in the samples. Antibiotic sensitivity was detected with good negative (sensitive) predictive values: ampicillin 92.8%, ampicillin/sulbactam 96.4%, cefuroxime 92.8%, cefotaxime 97.8%, trimethoprim/sulfamethoxazole 96.5%, ciprofloxacin 96.8%.</p><p><strong>Conclusion: </strong>The LAMP panel provided E.coli detection and sensitivity information within one hour and thus could principally guide initial antibiotic therapy upon patients presenting with UTI. The panel helps to select initial adequate antibiotic therapy as well as providing diagnostic stewardship. Follow up investigations will expand the test system to other uropathogens.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"703-715"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11880174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946629","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}

{"title":"Clinical characteristics of suspected cases of human mpox (monkeypox) in Katako-Kombe, Democratic Republic of the Congo 2023: challenges and key responses.","authors":"Etongola Papy Steve Mbelambela, Akemo Jean Paul Wandja, Antonio Fredelindo Villanueva, Ndjongandeke Daniel Olamba, Lohohola Omba, Sifa Marie Joelle Muchanga","doi":"10.1007/s10096-024-05022-3","DOIUrl":"10.1007/s10096-024-05022-3","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to describe the clinical and epidemiologic characteristics of suspected cases of human mpox in one of the most affected health zones, Katako-Kombe, Sankuru Province, in the Democratic Republic of the Congo. Also, to identify key challenges to prevent and improve the health of the affected community.</p><p><strong>Methods: </strong>Between January 26, 2023 and November 30, 2023, the DRC reported its highest incidence of mpox cases,with a total of 12,569 suspected cases in 156 health zones from 22 of the 26 country's provinces. The Katako-Kombe Health Zone registered 369 suspected cases and 17 deaths, making it one of the hotspots of the outbreak.</p><p><strong>Results: </strong>Ten villages and centres were affected, with an attack rate (AT) of 2.15‰ and a case fatality rate (CFR) of 4.6%. Epi-curves showed an increase in clinical cases from January to May 2023, followed by a decrease until August 2023 and a resurgence of cases in September 2023, with a reproduction rate of 1.29. Furthermore, the occurrence of complications appeared to increase the CFR with 7 (14%), 11 (18.03%), and 9 (23.68%) for encephalitis, anemia, and pulmonary complications, respectively.</p><p><strong>Conclusions: </strong>AT, CFR, and transmission rate appeared to be lower in the current epidemic than in previous outbreaks and in Clade I. Critically, delayed medical care increases the incidence of complications and CFR. Therefore, mpox requires early diagnosis and prompt public health response. Including the possibility of mpox in the differential diagnosis of patients presenting with a vesicular or pustular rash is suggested.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"609-617"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871751","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}

{"title":"Ciprofloxacin-susceptible but levofloxacin-resistant Pseudomonas aeruginosa clinical strains with Vitek^®2: which mechanism involved and consequences in case of fluoroquinolone treatment?","authors":"Manon Robert, Louise Ruffier d'Epenoux, Axelle Paquin, David Boutoille, Aurélie Guillouzouic, Stéphane Corvec","doi":"10.1007/s10096-024-05006-3","DOIUrl":"10.1007/s10096-024-05006-3","url":null,"abstract":"<p><strong>Purpose: </strong>Pseudomonas aeruginosa clinical strains isolated harbored sometimes an atypical phenotype using the automated Vitek2^®: ciprofloxacin-susceptibility but levofloxacin-resistance according to 2019 CA-SFM criteria. The aims of this study are to investigate the resistance mechanism(s) involved and to identify the consequences on fluoroquinolone treatment.</p><p><strong>Methods: </strong>Strain resistance profile, patient's data were recovered and reviewed from the database. Minimum inhibitory concentrations of levofloxacin, ciprofloxacin, moxifloxacin and delafloxacin were determined by using a concentration gradient strip. gyrA, gyrB, parC, parE and mexR genes were PCR amplified and sequenced. A PFGE analysis was performed for strains, recovered in a short period of time from the same patient.</p><p><strong>Results: </strong>46 strains were studied. A couple of seldom mutations were detected in gyrA, gyrB, parC and parE genes. Phenotypically, most of the strains (91%) were resistant to ticarcillin/ clavulanic acid combination and aztreonam suggesting a MexAB-OprM efflux-pump overexpression. mexR sequencing demonstrated either a deletion, a mutation or a premature stop codon appearance leading to amino acid substitution for 75% of the strains. Interestingly, four patients presented successively a fully fluoroquinolone susceptible isolate, thereafter a ciprofloxacin-susceptible but levofloxacin-resistant isolate (discordant phenotype) and finally a fluoroquinolone-resistant isolate. Molecular typing of these strains highlighted a strong relatedness between those isolates.</p><p><strong>Conclusion: </strong>The phenotype detected by the automate Vitek2^® is linked to a likely efflux-pump overexpression mechanism and not fluoroquinolone-target mutation. Regarding this discordant phenotype, an alert should be provided to clinicians concerning the high risk of selecting a fluoroquinolone-resistant mutant.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"549-558"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863625","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}

{"title":"In vitro activity of cefepime-tazobactam against oxyimino cephalosporin-resistant clinical isolates of E. coli: exploring a potential carbapenem-sparing strategy.","authors":"Rimjhim Kanaujia, Satinder Kaur, Manisha Biswal, Pallab Ray, Navneet Sharma, Archana Angrup","doi":"10.1007/s10096-024-05033-0","DOIUrl":"10.1007/s10096-024-05033-0","url":null,"abstract":"<p><p>Cefepime-tazobactam (FEP-TAZ) consists of cefepime combined with tazobactam, a penicillanic acid-sulfone recognized as an established beta-lactamase inhibitor. This study aims to investigate the in-vitro effectiveness of FEP-TAZ against cefepime-resistant clinical isolates of Escherichia coli (E. coli). A total of 105 E. coli clinical isolates characterized by cefepime-resistant/susceptible dose-dependent and carbapenem-sensitive profiles were tested for susceptibility by broth microdilution (BMD) method against cefepime and FEP-TAZ (tazobactam at a fixed concentration of 4 mg/L). Minimum inhibitory concentration (MIC) values for cefepime were determined using the Clinical and Laboratory Standards Institute (CLSI) broth microdilution method (M100-2022). Simultaneously, we also performed Disk-diffusion (DD) to observe the concordance between BMD and DD. FEP-TAZ exhibited inhibitory efficacy against 83.8% of E. coli isolates, markedly reducing the geometric mean from 20.4 to 1.9. Comparative analysis with DD revealed concordance with MIC for all isolates except four isolates. FEP-TAZ demonstrated potent activity against E.coli. This may be used as a carbapenem-sparing agent for the treatment of serious infections caused by cefepime-resistant Gram-negative bacilli. Furthermore, in settings where BMD implementation poses challenges, the pragmatic application of DD proves to be a viable alternative.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"753-757"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921044","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}

{"title":"Fatal dengue virus infection in an unvaccinated traveler.","authors":"Jonathan Steinke, Veronica Di Cristanziano, Jan-Hendrik Naendrup, Dániel Cadar, Martin Gabriel, Roger Grosser, Noëlle Sieg, Lisa Altenrath, Jesko Welters, Alexander Simonis, Rosanne Sprute, Jorge Garcia Borrega, Gertrud Steger, Jonas Schmidt-Chanasit, Alexander Shimabukuro-Vornhagen, Henning Gruell","doi":"10.1007/s10096-024-05021-4","DOIUrl":"10.1007/s10096-024-05021-4","url":null,"abstract":"<p><p>Dengue is an increasing threat to individuals living in or visiting endemic countries. Effective vaccines have become available, but their use in travelers is typically only recommended to individuals with documented prior infection. We present a fatal case of severe dengue in an unvaccinated traveler without known prior dengue virus infection but longitudinal serologic and molecular evidence for secondary infection. In the context of this case and vaccination guidance for travelers, we discuss pre-vaccination screening, potential implications for travelers to regions with ongoing outbreaks, and emphasize the importance of serostatus-independent vaccines.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"747-752"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11880070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893040","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}

{"title":"The in vitro synergistic and antibiofilm activity of Ceftazidime/avibactam against Achromobacter species recovered from respiratory samples of cystic fibrosis patients.","authors":"Emel Mataracı-Kara, Damla Damar-Çelik, Berna Özbek-Çelik","doi":"10.1007/s10096-024-05017-0","DOIUrl":"10.1007/s10096-024-05017-0","url":null,"abstract":"<p><strong>Purpose: </strong>Achromobacter spp. may form biofilm in patients' respiratory tracts and cause serious infections. This research examined the bactericidal and synergistic effects of ceftazidime/avibactam (CZA) alone and in combination with different antibiotics against Achromobacter spp.</p><p><strong>Methods: </strong>MICs of 52 Achromobacter spp. were determined by broth microdilution. In-vitro time-kill curve experiments assessed CZA's bactericidal and synergistic properties alone and in combination with other antibiotics. Moreover, the antibiofilm activity of CZA alone or in combination with the antibiotics was assessed with using microplate method.</p><p><strong>Results: </strong>Based on MIC₉₀ values, CZA exhibited four times greater in-vitro activity against tested strains than ceftazidime. The most effective agent was meropenem, with a 92% susceptibility level on the tested strains. On the other hand, ciprofloxacin was found to be bactericidal at both 1 × and 4xMIC concentrations. CZA, chloramphenicol and meropenem were observed to have bactericidal effects alone at 4xMIC concentrations against the tested isolates. CZA + CS and CZA + MEM showed synergy in three out of five and two out of five strains tested at 1xMIC, respectively. Furthermore, the pairing of CZA with colistin, CZA with meropenem and CZA with ciprofloxacin exhibited a synergistic impact at 4xMIC. Moreover, combination therapy CZA with the tested antibiotics showed reduced biofilm formation in a concentration-dependent manner at 24 h.</p><p><strong>Conclusion: </strong>The outcomes of this research also suggest that CZA plus colistin, meropenem, or ciprofloxacin were more productive against Achromobacter strains. To our knowledge, this is the first article to evaluate the synergistic and antibiofilm activities of CZA alone or in combination with different agents against Achromobacter species.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"587-596"},"PeriodicalIF":3.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863643","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}