European Journal of Clinical Microbiology & Infectious Diseases最新文献

{"title":"Genome-wide Screening of the Escherichia coli Keio Knockout Collection Identifies Genetic Determinants of Epetraborole Hypersusceptibility.","authors":"Anara Babayeva, Bekir Çöl","doi":"10.1007/s10096-025-05183-9","DOIUrl":"10.1007/s10096-025-05183-9","url":null,"abstract":"<p><strong>Purpose: </strong>The escalating threat of antibiotic resistance necessitates innovative strategies to enhance the efficacy of emerging antimicrobials. Epetraborole (EP) is a boron-containing antibiotic targeting leucyl-tRNA synthetase (LeuRS) and has attracted interest for its novel mechanism of action and potential to treat infections caused by multidrug-resistant (MDR) Gram-negative pathogens.</p><p><strong>Methods: </strong>To elucidate the genetic determinants of EP susceptibility, we conducted a genome-wide screen (GWS) of the Escherichia coli Keio knockout collection, which comprises ~4,000 single-gene deletion mutants. Mutants exhibiting increased susceptibility to epetraborole were identified and validated via complementation assays.</p><p><strong>Results: </strong>Disrupted genes included those involved in leucine biosynthesis (leuD), RNA turnover (rnb), tRNA modification (trmU), ubiquinone biosynthesis (ubiG), NAD salvage pathway (pncA), arginine transport (artJ), transcriptional regulator (yddM) and ribosome biogenesis (yhbY), suggesting that epetraborole's primary inhibition of LeuRS synergizes with defects in these pathways. Bioinformatic analyses (Omics Dashboard, DAVID, STRING) linked these genes to tRNA homeostasis, stress response networks, and central dogma processes, implicating tRNA dysregulation as a critical vulnerability under epetraborole-induced stress.</p><p><strong>Conclusion: </strong>This study identifies novel genetic contributors to epetraborole susceptibility and provides a framework for exploring adjuvant therapies or resistance mechanisms to enhance its clinical utility against MDR infections.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"2167-2182"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282953","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":"Next-generation sequencing of the tonsillar microbiome in severe acute tonsillitis: comparison with healthy controls and culture-based findings.","authors":"Camilla Andersen, Tine Sneibjerg Ebsen, Casper Aabrandt Thorup, Kasper Basse Reinholdt, Ann Marlene Gram Kjaerulff, Nichlas Udholm, Vesal Khalid, Adnan Madzak, Christophe Duez, Henrik Münch, Søren Pauli, Christian Sander Danstrup, Niels Krintel Petersen, Thomas Greve, Tejs Ehlers Klug","doi":"10.1007/s10096-025-05195-5","DOIUrl":"10.1007/s10096-025-05195-5","url":null,"abstract":"<p><strong>Purpose: </strong>Previous culture-based studies suggest three significant pathogens in acute tonsillitis (AT): Streptococcus pyogenes, Fusobacterium necrophorum, and Streptococcus dysgalactiae. Next-generation sequencing (NGS) provides further insights into the human microbiome and may pinpoint additional pathogens in bacterial infections. We aimed to investigate the tonsillar microbiome and identify pathogens associated with AT by applying NGS to tonsillar swabs from patients with severe AT, comparing the findings with both healthy controls and culture-based results.</p><p><strong>Methods: </strong>Full-length sequencing of the 16S rRNA gene (16S tNGS) was performed on tonsillar swabs from 64 AT patients and 55 controls, who were prospectively enrolled at two Danish Ear-Nose-Throat Departments between June 2016 and December 2019.</p><p><strong>Results: </strong>The mean number of detected bacteria was significantly higher in patients analysed with 16S tNGS (36) than with culture methods (6.5, p < 0.001). The alpha diversity was lower in patients compared to controls (p < 0.001) and beta diversity showed separation of the two groups (p = 0.001). S. pyogenes (p = 0.001) and Bifidobacteriaceae (p = 0.002) were significantly more abundant in patients compared to controls. The three suggested pathogens were detected more frequently using 16S tNGS compared to culture: S. pyogenes (38% vs. 27%, p = 0.26), F. necrophorum (19% vs. 11%, p = 0.32), and S. dysgalactiae (14% vs. 11%, p = 0.79).</p><p><strong>Conclusion: </strong>The tonsillar microbiome differed significantly between AT patients and healthy controls. Our findings confirm the role of S. pyogenes in AT, but did not identify additional likely pathogens. The addition of 16S tNGS to cultures increased the collective detection rate of three previously suggested pathogens from 48 to 70%.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"2263-2273"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483673","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":"Rash associated with antibiotic administration in patients with infectious mononucleosis: a systematic review and meta-analysis.","authors":"Christos Vrysis, Angeliki Katsarou, Theodore Lytras, Konstantinos Katsikas, Matthew E Falagas","doi":"10.1007/s10096-025-05189-3","DOIUrl":"10.1007/s10096-025-05189-3","url":null,"abstract":"","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"2183-2196"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282954","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":"Emergence of ceftazidime-avibactam resistance in clinical Klebsiella pneumoniae during therapy.","authors":"Siquan Shen, Xiren Deng, Lu Guo, Li Yang, Hua Yu, Fupin Hu, Xiangning Huang","doi":"10.1007/s10096-025-05180-y","DOIUrl":"10.1007/s10096-025-05180-y","url":null,"abstract":"<p><strong>Background: </strong>The emergence of ceftazidime-avibactam resistance in Klebsiella pneumoniae poses a significant public health threat, driven by mutations in the bla . This study investigates the evolution of KPC variants (KPC-33, KPC-84, KPC-190) during therapy, highlighting their impact on resistance profiles and treatment challenges. Understanding these mechanisms is critical for guiding clinical interventions.</p><p><strong>Methods: </strong>Four K. pneumoniae strains were isolated from a patient undergoing ceftazidime-avibactam therapy. Antimicrobial susceptibility testing and bioinformatics tools were used to characterize genetic mutations and their phenotypic effects. Whole genome sequencing, cloning, and enzymatic kinetic assays were performed to analyze resistance mechanisms.</p><p><strong>Results: </strong>The study identified mutations in the Ω-loop and 240-loop of KPC-2, leading to reduced avibactam affinity and increased ceftazidime hydrolysis. KPC-33 restored carbapenem susceptibility, while KPC-84 and KPC-190 conferred dual resistance. Enzymatic assays confirmed altered kinetic parameters, correlating with clinical resistance patterns.</p><p><strong>Conclusions: </strong>KPC variants exhibit complex evolutionary pathways under antibiotic pressure, complicating treatment. Enhanced surveillance and optimized dosing regimens, including higher avibactam concentrations, are recommended to mitigate resistance. This study underscores the need for global monitoring of KPC variants to inform therapeutic strategies.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"2197-2206"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293563","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":"Comparison of Meltpro Myco Assay with MALDI-TOF Mass Spectrometry for rapid and accurate detection of clinical Mycobacterium Species.","authors":"Kehao Peng, Liuyue Xu, Xuezhi Wang, Jianming Hong, Gengchen Zhang, Yuchuan Zhao, Yinong Ye, Zengqi Huang, Jinmei Zhang, Yuchun Huang, Zhiqiao Wu, Xiaolin Yu, Yanqin Song, Shihao Chen, Yongping Wang, Yuhui Chen, Huizhong Wu, Xiaoyu Lai, Meiling Yu, Jingjing Liang, Wenjing Wei","doi":"10.1007/s10096-025-05171-z","DOIUrl":"10.1007/s10096-025-05171-z","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to compare the performance of the MeltPro Myco assay with that of MALDI-TOF mass spectrometry for detecting nontuberculous mycobacteria (NTMs) from clinical isolates and samples.</p><p><strong>Method: </strong>A total of 308 suspected NTM isolates from sputum or BALF samples of patients with pulmonary diseases were retrospectively analyzed. DNA sequencing was used as the gold standard method. An additional 164 clinical samples from patients with pulmonary diseases were used to assess the suitability of the MeltPro Myco assay for clinical use.</p><p><strong>Result: </strong>The results indicated that for NTM identification, the MeltPro Myco assay and MALDI-TOF had sensitivities of 99.3% and 97.2% and specificities of 90.9% and 100%.The MeltPro Myco assay achievies a sensitivity and specificity of 79.4% and 95.2% for the detection of NTM in clinical samples.</p><p><strong>Conclusion: </strong>Given its rapidity, straightforward operation, high accuracy, cost-effectiveness, and good reproducibility, the MeltPro Myco assay can be a valuable tool for timely screening of lung disease caused by NTM and has the potential to improve the diagnosis and prevention of NTM pulmonary disease in highly endemic areas.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"2033-2045"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141637","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":"Antibiotic-related dysbiosis of gut microbiota in healthy volunteers: a comparative study of ceftazidime-avibactam, piperacillin-tazobactam, and ceftriaxone.","authors":"Guohang Huang, Lili Cai, Jinlin Guo, Ruyi Zhu, Lina Zhu","doi":"10.1007/s10096-025-05184-8","DOIUrl":"10.1007/s10096-025-05184-8","url":null,"abstract":"<p><p>The administration of antibiotics can induce gut microbiota dysbiosis leading to Clostridium difficile infection and has been linked to conditions such as irritable bowel syndrome and metabolic syndrome. However, the specific effects of different antibiotics on the gut microbiota composition remain poorly characterized, particularly in human studies. A previous published phase I study explored the role of a colon-targeted adsorbent DAV132 to mitigate the effects of antibiotics-related dysbiosis on the gut microbiota in healthy individuals. Using the publicly available dataset from this publication PRJNA922086, we evaluated the impacts of a 5-day intravenous treatment with two broad-spectrum beta-lactam/beta-lactamase inhibitor antibiotics ceftazidime-avibactam, piperacillin-tazobactam and a third-generation cephalosporin ceftriaxone on the diversity, composition, and bacterial interactions at days 1, 6, and 37 post-administration. All three antibiotics significantly altered beta diversity of the gut microbiota by day 6, with ceftriaxone exhibiting the most prolonged effects. Changes in the composition of the gut microbiota were more similar between the ceftazidime-avibactam and piperacillin-tazobactam groups, and distinct from those observed in the ceftriaxone group. Consistent with beta diversity changes, bacterial interaction networks revealed greater and longer-lasting disruptions of bacterial interaction in the gut microbiota in the ceftriaxone group compared to the other two antibiotics. These findings highlight distinct patterns of microbiota disruption following ceftriaxone, ceftazidime-avibactam, and piperacillin-tazobactam treatments and underscore the importance of antibiotic selection in minimizing gut dysbiosis.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"2151-2158"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274479","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":"Development of a real-time multiple cross displacement amplification assay for rapid and highly sensitive detection of Streptococcus pyogenes.","authors":"Yiqin Zhang, Xinbei Jia, Lijuan Ma, Lin Zhou, Fei Xiao, Xiaolan Huang, Juan Zhou, Yi Wang, Jun Tai","doi":"10.1007/s10096-025-05186-6","DOIUrl":"10.1007/s10096-025-05186-6","url":null,"abstract":"<p><p>The aim of this study was to develop a method based on multiple cross displacement amplification (MCDA) and real-time fluorescence technique for rapid, highly sensitive and specific detection of Streptococcus pyogenes (Group A Streptococcus, GAS). A set of 10 primers targeting the speB gene of GAS was designed for the MCDA reaction. According to the principle of real-time MCDA detection, the core primer was further modified with a restriction endonuclease recognition sequence, a fluorophore, and a quencher. The optimal reaction temperature for the assay was determined based on the performance of the MCDA amplification products. The detection limit was evaluated using tenfold serial dilutions of GAS genomic DNA templates. To assess specificity, the assay was tested using genomic DNA from 3 GAS strains and 29 non-GAS strains. To evaluate clinical application of the GAS real-time MCDA assay, 56 clinical samples were analyzed and compared with the lateral flow biosensors (LFB) method and PCR. The GAS real-time MCDA method was performed using a fluorescence instrument at 63℃ for 40 min. The method demonstrated high sensitivity, with a detection limit of 50 fg, and showed no cross-reactivity with other pathogens. The GAS real-time MCDA assay described here offers a new and valuable diagnostic tool for the reliable and rapid detection of GAS.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"2139-2150"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257654","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":"β-lactam antibiotics vs vancomycin in treating methicillin-sensitive staphylococcus aureus bloodstream infections: a meta-analysis of clinical outcomes.","authors":"Guoliang Yu, Yonghai Lou, Lingfang He, Zhitao Wang, Yu Ren","doi":"10.1007/s10096-025-05164-y","DOIUrl":"10.1007/s10096-025-05164-y","url":null,"abstract":"<p><strong>Background: </strong>This meta-analysis systematically reviews and compares the efficacy of β-lactam antibiotics and vancomycin in the treatment of methicillin-sensitive Staphylococcus aureus (MSSA) bloodstream infections, with the aim of providing evidence-based recommendations for clinical decision-making.</p><p><strong>Methods: </strong>This systematic review and meta-analysis followed the PRISMA 2020 guidelines and was registered with PROSPERO. Two independent reviewers conducted comprehensive literature searches across multiple databases, specifically targeting Randomized Controlled Trial (RCT) and non-RCT comparing β-lactam antibiotics and vancomycin in treating MSSA bloodstream infections. Outcomes analyzed included mortality within 30 days and 90 days, defervescence time, bacterial clearance time, and treatment duration.</p><p><strong>Results: </strong>Seven retrospective cohort studies involving a total of 6957 patients were included. The pooled results indicated no significant difference in 30-day and 90-day mortality or treatment duration between the two antibiotics regimens. However, β-lactam antibiotics demonstrated a faster action, with significantly shorter times for fever reduction and bacterial clearance compared to vancomycin.</p><p><strong>Conclusions: </strong>This study found that β-lactam antibiotics are more efficacious than vancomycin in treating MSSA bloodstream infections. Although clinical outcomes such as mortality and treatment duration were similar between the groups, the faster clinical response observed with β-lactam antibiotics supports their preferential use in cases of MSSA infection. Since all included studies were retrospective, the overall reliability of the evidence is affected. Future high-quality prospective studies are needed to further validate these findings.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"2019-2031"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186815","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":"Underutilization of nirmatrelvir/ritonavir in eligible COVID-19 patients.","authors":"Celia Fortea de Arpe, Reynaldo Homen, Adrian Valls-Carbó, Julia Barrado, Carolina Olmos-Mata, Juncal Pérez-Somarriba, Ana Muñoz-Gomez, Maria Jose Núñez-Orantos, Noemí Cabello-Clotet, Vicente Estrada","doi":"10.1007/s10096-025-05150-4","DOIUrl":"10.1007/s10096-025-05150-4","url":null,"abstract":"<p><p>Nirmatrelvir/ritonavir (NMV/r) might reduce the risk of hospitalization or death due to SARS-CoV2. Indirect data suggest that antiviral use among non-hospitalized patients is low. The aim of the study is to determine the number of patients admitted for COVID-19 who met the criteria to receive NMV/r prior to admission but did not receive it. We analyzed clinical data from electronic medical records of 132 patients who were hospitalized due to Covid-19 from August to November 2023. Among the 88 patients eligible for NMV/r before hospitalization, only 3.8% received it, even though 24.3% had previous contact with the healthcare system. Among those who were eligible for treatment, a potential drug interaction was identified in 80.6%; NMV/r was contraindicated in only ten cases (11.3%) due to a serious interaction, as it was deemed impossible to stop or alter it. Of the patients who did not receive treatment, three died from Covid-19, while there were no deaths in the treatment group. Our data confirm that many patients who could benefit from early treatment with NMV/r are not receiving it. This limited use may be linked to missed opportunities to prevent hospitalization and mortality from Covid-19.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"2283-2286"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282956","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":"Staphylococcus aureus vertebral osteomyelitis: a single-centre retrospective cohort study with focus on oral flucloxacillin follow-up.","authors":"Johan Wern, Bo Söderquist, Staffan Tevell","doi":"10.1007/s10096-025-05176-8","DOIUrl":"10.1007/s10096-025-05176-8","url":null,"abstract":"<p><strong>Background: </strong>International guidelines for Staphylococcus aureus vertebral osteomyelitis recommend 6 weeks of treatment, including oral follow-up using antibiotics with high bioavailability such as a fluoroquinolone/rifampicin combination. Oral flucloxacillin is not recommended due to low bioavailability and scarce evidence. However, flucloxacillin as oral follow-up treatment is common practice in Sweden based on favourable clinical experience, good tolerability, few interactions, and low ecological impact. Our aim was to review a single-centre experience of S. aureus vertebral osteomyelitis, with focus on flucloxacillin treatment.</p><p><strong>Methods: </strong>A single-centre retrospective cohort of patients with Staphylococcus aureus vertebral osteomyelitis (n = 40) was identified between 2010 and 2016. Patients were further stratified by antibiotic treatment strategy with focus on oral flucloxacillin therapy (n = 24). Primary outcomes were relapse or death within 12 months of treatment initiation, and antibiotic-related adverse effects during treatment.</p><p><strong>Results: </strong>Methicillin-susceptible S. aureus (MSSA) caused 38 of the infections (95%), and five patients (13%) died, all in-hospital. Flucloxacillin was used for at least 75% of the oral treatment duration in 24 patients (60%). Median antibiotic treatment duration among these patients was 125.5 days (IQR 95-182), 109 days (IQR 76-149) of which comprised oral antibiotics. There were two relapses and two deaths among the patients treated predominantly with flucloxacillin, resulting in a composite clinical cure rate of 83% (20 of 24).</p><p><strong>Conclusions: </strong>Prolonged oral flucloxacillin administration could be a potential treatment option for MSSA vertebral osteomyelitis. A prospective study of optimal treatment duration and dosing strategies for flucloxacillin in vertebral osteomyelitis is warranted.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"2077-2084"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157407","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}