Infectious diseases now最新文献

{"title":"Dalbavancin for prosthetic joint infections: Empirical treatment","authors":"R. Mairesse ,&nbsp;L. Gautie ,&nbsp;M. Merouani ,&nbsp;A. Bouige ,&nbsp;C. Fourcade ,&nbsp;G. Krin ,&nbsp;P. Marlin ,&nbsp;G. Giordano ,&nbsp;S. Baklouti ,&nbsp;P. Gandia ,&nbsp;E. Bonnet","doi":"10.1016/j.idnow.2025.105035","DOIUrl":"10.1016/j.idnow.2025.105035","url":null,"abstract":"<div><h3>Objectives</h3><div>Bone and joint infections are complex and require a long course of antibiotics. Dalbavancin is a long half-life lipoglycopeptide, only indicated for skin and soft tissue infections. Studies on bone and joint diffusion are promising. The objective of this study was to evaluate the efficacy and safety of dalbavancin in combination with piperacillin-tazobactam for intra-operative treatment of knee or hip prosthetic joint infections.</div></div><div><h3>Patients and methods</h3><div>This retrospective and bicentric study was conducted between 2018 and 2022 and included 56 patients. The criteria used to diagnose prosthetic joint infections were those established in 2011 by the MusculoSkeletal Infection Society (MSIS), modified in 2013 at the International Consensus Meeting on Periprosthetic Joint Infections. The efficacy endpoint was the absence of relapse during the two-year follow-up period.</div></div><div><h3>Results</h3><div>Gram-positive cocci infections were the most common. All Gram-positive bacteria were susceptible to dalbavancin. The cure rate at two years was 91.5%. Only four patients experienced treatment failure. Few adverse events were reported, mainly digestive ones (diarrhea and pain).</div></div><div><h3>Conclusion</h3><div>This study provides data outside of the marketing authorization, while respecting the authorized dosage in a population of patients with clearly defined inclusion criteria and a two-year follow-up.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"55 2","pages":"Article 105035"},"PeriodicalIF":2.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143369647","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":"Intra-articular procedures and associated septic arthritis: A mini-review","authors":"François Vidal ,&nbsp;Michel Carles ,&nbsp;Johan Courjon","doi":"10.1016/j.idnow.2025.105023","DOIUrl":"10.1016/j.idnow.2025.105023","url":null,"abstract":"<div><div>Native joint septic arthritis (SA) is a severe, potentially life-threatening condition characterized by the invasion of synovial fluid and membrane by pathogens, most commonly bacteria. The rising frequency of intra-articular procedures such as joint aspirations and injections has led to increased concern regarding iatrogenic septic arthritis. This mini-review aims to summarize current understanding of the incidence, risk factors, bacterial etiology, and strategies for preventing SA associated with intra-articular procedures.</div><div>Recent studies report that while iatrogenic SA incidence remains low, ranging between 0.002% and 0.008% following injections, it is higher following arthroscopy (0.14%). Risk factors for iatrogenic SA mirror those of hematogenous SA, comprising older age, male gender, comorbidities such as diabetes mellitus, and systemic corticosteroid therapy. <em>Staphylococcus aureus</em> remains the most frequently implicated pathogen, followed by coagulase-negative staphylococci and streptococci. Preventive measures, including hand antisepsis, patient skin disinfection, and the wearing of surgical masks, are essential to reducing the risk of SA during intra-articular procedures.</div><div>Despite low incidence, SA poses significant morbidity and mortality risks, underscoring the need for adherence to infection control protocols. This review highlights the importance of standardized preventive measures and further research into optimized aseptic techniques, the objective being to mitigate the risk of iatrogenic infections in clinical practice.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"55 1","pages":"Article 105023"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970513","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":"Distribution of beta-lactamase genes in Enterobacteriaceae from human clinical samples","authors":"Md.Kaisar Rahman,&nbsp;Babafela Awosile","doi":"10.1016/j.idnow.2024.105019","DOIUrl":"10.1016/j.idnow.2024.105019","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to explore the distribution of beta-lactamase genes in Enterobacteriaceae from human clinical samples.</div></div><div><h3>Methods</h3><div>We analyzed data from 83 countries through the Antimicrobial Testing Leadership and Surveillance program, spanning 2004 to 2021. We calculated the proportion of each β-lactamase gene across nine bacterial species and generated a heatmap for β-lactamase genes with a frequency of ≥ 1 % in at least one species.</div></div><div><h3>Results</h3><div>A total of 359 β-lactamase genes were identified, with the highest proportion found in <em>Klebsiella</em> spp. (61.84 %, n = 222), followed by <em>Escherichia<!--> <!-->coli</em> (47.63 %, n = 171), and <em>Proteus</em> spp. (20.61 %, n = 74). The ESBL gene <em>bla</em>_CTX-M−15 was most prevalent in <em>Klebsiella</em> spp. (62.39 %) and <em>E.<!--> <!-->coli</em> (53.16 %). The carbapenemase genes <em>bla</em>_NDM-1, <em>bla</em>_OXA-48, and <em>bla</em>_KPC-2 were notably higher in <em>Providencia</em> spp. (59.47 %), <em>Raoultella</em> spp. (45.45 %), and <em>Serratia</em> spp. (25.24 %), respectively.</div></div><div><h3>Conclusion</h3><div>Further surveillance and research are needed to investigate the diversity of β-lactamase genes across One Health interfaces.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"55 1","pages":"Article 105019"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881424","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":"Association between in-hospital weight change and 28-day mortality in adults with gram-negative rod bacteremia","authors":"Monika Iwasaki ,&nbsp;Kazuhiro Ishikawa ,&nbsp;Takaaki Isoya ,&nbsp;Emilie Louise Akiko Matsumoto-Takahashi ,&nbsp;Nobuyoshi Mori","doi":"10.1016/j.idnow.2024.105015","DOIUrl":"10.1016/j.idnow.2024.105015","url":null,"abstract":"<div><h3>Background</h3><div>Body weight and fluid balance are critical parameters in the monitoring of patient status, as low body weight and fluid overload are associated with increased mortality in sepsis cases. While body weight reflects nutritional and fluid status, fluid balance is a major indicator of clinical stability. However, limited research has comprehensively evaluated the combined impact of in-hospital weight change and fluid balance on mortality in bacteremia patients, especially those undergoing treatment outside of ICUs.</div></div><div><h3>Aim</h3><div>This study aimed to investigate the association between in-hospital weight change, fluid balance, and 28-day mortality in patients with gram-negative rod (GNR) bacteremia, the objective being to determine the potential usefulness of these parameters in prediction of patient outcomes.</div></div><div><h3>Methods</h3><div>A retrospective cohort study on GNR bacteremia inpatients was conducted from April 2017 to March 2023 at St. Luke’s International Hospital. Univariate analysis, using chi-square and t-tests, was followed by multivariate logistic regression analysis to explore the relationship between 28-day mortality and a number of variables, including in-hospital weight change, with significance level set at p &lt; 0.05.</div></div><div><h3>Results</h3><div>Among 255 patients (230 survivors, 25 non-survivors), mean age was 76.3 years among survivors and 82.4 years among non-survivors (p = 0.05). In the survivor group, 49.1 % were female, compared to 44.0 % of the non-survivors (p = 0.78). In-hospital weight gain was significantly higher in non-survivors (3.81 %) compared to survivors (−0.81 %, p &lt; 0.001). Non-survivors had higher positive daily fluid balance and lower daily total calorie intake (p &lt; 0.05). After adjusting for other variables (age, sex, baseline clinical status and nutritional intake), multivariate analysis showed weight gain to be associated with 28-day mortality (odds ratio 1.10, 95 % CI: 1.01–1.20, p = 0.04).</div></div><div><h3>Conclusion</h3><div>Potentially influenced by fluid overload, in-hospital weight gain is associated with 28-day mortality. As a non-invasive and simple parameter, body weight shows potential as a practical tool for predicting outcomes, especially when accompanied by fluid balance assessments. Further prospective studies are needed to understand the multiple interactions between weight, fluid, and calorie intake.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"55 1","pages":"Article 105015"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846616","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":"Epidemiological and bacteriological trends from 2013 to 2023 of carbapenemase-producing enterobacterales (CPE) in a French university hospital: A permanent risk of outbreak","authors":"Manon Robert ,&nbsp;Stéphane Corvec ,&nbsp;Anaïs Andreo ,&nbsp;Florence Le Gallou ,&nbsp;Géraldine Marquot ,&nbsp;Reynald Mangeant ,&nbsp;Céline Bourigault ,&nbsp;Didier Lepelletier","doi":"10.1016/j.idnow.2024.105021","DOIUrl":"10.1016/j.idnow.2024.105021","url":null,"abstract":"<div><h3>Aim</h3><div>The aim of this study was to describe the epidemiology and bacteriological trends of carbapenemase-producing Enterobacteriaceae (CPE) at Nantes University Hospital from 2013 to 2023.</div></div><div><h3>Methods</h3><div>Potential CPE carriers were prospectively detected, and their contacts were systematically screened for CPE digestive colonization. A retrospective study was conducted from 2013 to 2023 (on patient characteristics) and from 2016 to 2023 (on CPE characteristics). An outbreak was defined as at least one secondary case occurring among contact patients during the same hospitalization, in the same unit, and with the same staff.</div></div><div><h3>Results</h3><div>All in all, 553 CPE-positive carriers were identified during the study period. Among them, 178 (32 %) were sporadic cases and 100 (18 %) were incidentally detected. Fifty-seven outbreaks were investigated comprising 305 (55 %) secondary cases. The most commonly identified CPE species in outbreaks were Klebsiella pneumonia OXA-48.</div></div><div><h3>Conclusion</h3><div>CPE detection in the hospital was associated mainly with epidemic spread involving a variable number of secondary cases. CPE patients detected incidentally (without specific infection control measures) several days after hospital admission, repatriates and patients with a history of hospitalization abroad are at high risk of in-hospital CPE spread. The number of outbreaks did not decrease during the study period, and more generally, the number of secondary cases tends in some uncontrolled situations to increase, particular when CPE- positive patients are transferred or rehospitalized.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"55 1","pages":"Article 105021"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907054","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":"Proposed macroscopic quality indicators of antimicrobial stewardship in primary care: An observational study","authors":"C. Slekovec ,&nbsp;E. Pouly ,&nbsp;L. Malinowski ,&nbsp;X. Bertrand","doi":"10.1016/j.idnow.2024.105013","DOIUrl":"10.1016/j.idnow.2024.105013","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this study was to evaluate the ability of two macroscopic quality indicators to guide antibiotic stewardship strategies.</div></div><div><h3>Methods</h3><div>Setting: Bourgogne-Franche-Comté region (eight departments).</div><div>Antibiotic reimbursement data, expressed in defined daily doses, were used to calculate two macroscopic quality indicators from 2015 to 2020. Urinary tract infection indicator: (fosfomycin + nitrofurantoin + pivmecillinam) / (ciprofloxacin + ofloxacin + norfloxacin) calculated in women aged 15 to 64. Indicator for ear, nose, throat and respiratory tract infections: (amoxicillin/ (amoxicillin-clavulanate + oral 3GC) calculated in children under 15 years of age.</div></div><div><h3>Results</h3><div>In 2020, global antibiotic consumption varied from 22.2 to 26.6 defined daily doses per 1000 inhabitants per day, depending on the department. The macroscopic quality indicators were lowest in the departments of Nièvre and Yonne. The scores for the urinary tract infection indicator were 0.55 and 0.74, respectively, while those for the ear, nose and throat and respiratory tract infection indicators were 1.85 and 2.12, respectively. Both scores continuously increased in all departments of the region during the survey, except in 2020 for the urinary tract infection indicator, due to a nitrofurantoin shortage.</div></div><div><h3>Conclusion</h3><div>Even in departments with low antibiotic consumption, our macroscopic quality indicators help to identify antibiotic stewardship targets for the most common community-based infections,. They are easy to calculate from quantitative data without requiring any information on diagnosis. Complementarily to other indicators, they provide messages specifically addressed to general practitioners regarding population, molecules and diagnostic elements.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"55 1","pages":"Article 105013"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravenous administration of antibiotics by prolonged and continuous infusion","authors":"Clément Ourghanlian ,&nbsp;Elise d’Huart ,&nbsp;Pascale Longuet ,&nbsp;Matthieu Boisson ,&nbsp;Fabrice Bruneel ,&nbsp;Delphine Cabelguenne ,&nbsp;Alexandre Charmillon ,&nbsp;Antoine Dupuis ,&nbsp;Pierre Fillatre ,&nbsp;Luc Foroni ,&nbsp;Lucie Germon ,&nbsp;Sylvain Goutelle ,&nbsp;Anne-Lise Lecapitaine ,&nbsp;Cyril Magnan ,&nbsp;Claire Roger ,&nbsp;Jean Vigneron ,&nbsp;Michel Wolff ,&nbsp;Remy Gauzit ,&nbsp;Sylvain Diamantis ,&nbsp;Marie-Charlotte Chopin","doi":"10.1016/j.idnow.2024.105018","DOIUrl":"10.1016/j.idnow.2024.105018","url":null,"abstract":"","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"55 1","pages":"Article 105018"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cholera outbreak in Mayotte (France): A retrospective description of 16 patients treated for hypovolemia in the ICU","authors":"Y. Boué ,&nbsp;M. Niang ,&nbsp;A. Lapostolle ,&nbsp;A. Chamouine ,&nbsp;T. Benoit Cattin ,&nbsp;M. Favre ,&nbsp;C. Rouard ,&nbsp;C. Mortier ,&nbsp;R. Piarroux ,&nbsp;J. Carvelli ,&nbsp;for the CHOLEMAY Study Group","doi":"10.1016/j.idnow.2024.105020","DOIUrl":"10.1016/j.idnow.2024.105020","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe the presentation and therapeutic management of severe cholera in Mayotte (France).</div></div><div><h3>Patients and methods</h3><div>We carried out retrospective data collection. All patients treated in the intensive care unit (ICU) with a confirmed diagnosis of cholera by PCR were studied. Only patients treated for hypovolemia were included.</div></div><div><h3>Results</h3><div>Out of the 215 confirmed cases of cholera in Mayotte on July 12, 2024, 25 required treatment in the ICU (11.6 %). Among these cases, 16 were treated for hypovolemia (7.4 %), while five patients died of cholera before they could be admitted to hospital (lethality rate 2.3 %). No patient died in hospital.</div><div>Median patient age was 17 years (4–30) with a sex ratio of 1. Severe diarrhea was the rule with a median of one diarrheal stool every two hours. Clinical severity was characterized by sunken eyes and Glasgow Coma Scale (GCS) &lt; 14 (n = 16/16,100 %). Biological severity was determined by profound metabolic acidosis with venous pH &lt; 7.20 (n = 16/16, 100 %). Intravenous fluid therapy was aggressive with a median of 280 mL/kg (230–300) Ringer’s lactate solution during the first 48 h.</div></div><div><h3>Conclusions</h3><div>Cholera can be a life-threatening infection, with deaths occurring due to severe diarrhea and hypovolemia. From the onset of symptoms, which are sometimes fulminant, patients must be admitted to a care center as soon as possible. We will continue to collect data to create scores that will enable us to better recognize the most severe forms of the disease.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"55 1","pages":"Article 105020"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to: The new 2024 French guidelines for respiratory transmission prevention: Present-day limitations and the need to implement new standard precautions","authors":"Olivia Keita-Perse ,&nbsp;Sara Romano-Bertrand ,&nbsp;French Guidelines for Respiratory Transmission Prevention of the French Society for Hospital Hygiene","doi":"10.1016/j.idnow.2024.105017","DOIUrl":"10.1016/j.idnow.2024.105017","url":null,"abstract":"","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"55 1","pages":"Article 105017"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864264","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":"Estimating the number and incidence of carbapenemase-producing Enterobacterales infections in France in 2020: A capture-recapture study","authors":"Mélanie Colomb-Cotinat ,&nbsp;Amélie Jouzeau ,&nbsp;Gaëlle Pedrono ,&nbsp;Aurélie Chabaud ,&nbsp;Christian Martin ,&nbsp;Isabelle Poujol ,&nbsp;Sylvie Maugat ,&nbsp;Lory Dugravot ,&nbsp;Catherine Dumartin ,&nbsp;Anne Berger-Carbonne ,&nbsp;Loïc Simon ,&nbsp;Laurent Dortet","doi":"10.1016/j.idnow.2024.105016","DOIUrl":"10.1016/j.idnow.2024.105016","url":null,"abstract":"<div><h3>Objectives</h3><div>Even though France faces few severe infections due to carbapenem-producing Enterobacterales (CPE), inter-regional epidemic stages render their dissemination a cause for considerable concern. CPE reporting relies in France on three non-exhaustive monitoring systems (MS): an early-alert system, a nationwide passive surveillance system and the National Reference Centre. We aim to estimate the number and incidence of CPE-related infections in France in 2020 and to identify any overlap between the three systems to determine whether their continued use still serves a purpose.</div></div><div><h3>Methods</h3><div>Data on clinical CPE isolates in 2020 were extracted from the three MS databases. Screening samples were excluded. Datasets were manually merged, isolate by isolate, so as to identify in which system(s) each isolate was reported. A system-participant was defined as any declarant reporting at least one isolate in an MS. Using our matched dataset, we performed Bayesian model averaging for capture-recapture estimations.</div></div><div><h3>Results</h3><div>All in all, 1722 CPE isolates were reported through the monitoring systems in 2020. We estimated that the number of CPE infections was almost twice this number, corresponding to incidence of 0.031 CPE/1000 hospital-days [CI95% 0.015–0.057/1,000 hospital-days], with regional disparities taken into account. Among participating the laboratories, 86% were involved in only one of the systems. Among clinical CPE isolates, 56% were isolated from urine.</div></div><div><h3>Conclusion</h3><div>Regarding this rare infection, surveillance based only on passive surveillance from voluntary hospitals does not reflect actual epidemiology. We recommend maintaining the three monitoring systems and improving the participation of hospitals’ nationwide surveillance, the objective being to more accurately capture the real incidence of CPE infections.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"55 1","pages":"Article 105016"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}