Journal of Antimicrobial Chemotherapy最新文献

{"title":"Antipseudomonal cephalosporins versus piperacillin/tazobactam or carbapenems for the definitive antibiotic treatment of Pseudomonas aeruginosa bacteraemia: new kids on the ICU block?","authors":"Davide Fiore Bavaro, Giuseppe Accurso, Silvia Corcione, Antonio Vena, Michela Schenone, Lucia Diella, Teresa Fasciana, Maddalena Giannella, Daniele Roberto Giacobbe, Simone Mornese Pinna, Renato Pascale, Francesca Giovannenze, Nicholas Geremia, Andrea Marino, Pierluigi Viale, Francesco Giuseppe De Rosa, Matteo Bassetti, Michele Bartoletti","doi":"10.1093/jac/dkaf080","DOIUrl":"10.1093/jac/dkaf080","url":null,"abstract":"<p><strong>Background: </strong>Pseudomonas aeruginosa bloodstream infections (Pa-BSIs) are still a major cause of mortality in ICUs, posing many treatment uncertainties.</p><p><strong>Methods: </strong>This multicentre, retrospective study analysed data from 14 Italian hospitals, including all consecutive adults developing Pa-BSI in ICU during 2021-22 and treated with antibiotics for at least 48 h. The primary aim was to identify predictors of 30 day mortality using Cox regression. Results were adjusted with inverse probability of treatment weighting (IPTW) and for immortal time bias.</p><p><strong>Results: </strong>Overall, 170 patients were included. High-risk BSI (source: lung, intra-abdominal, CNS) occurred in 118 (69%) patients, and 54 (32%) had septic shock. In 37 (22%), 73 (43%), 12 (7%) and 48 (28%) the definitive backbone therapy was piperacillin/tazobactam, carbapenems, colistin or new antipseudomonal cephalosporins (ceftolozane/tazobactam, n = 20; ceftazidime/avibactam, n = 22; cefiderocol, n = 6), respectively. Moreover, 58 (34%) received a second drug as combination therapy. The incidence of 30 day all-cause mortality was 27.6% (47 patients). By Cox regression, Charlson comorbidity index, neutropenia, septic shock and high-risk BSI were independent predictors of 30 day mortality, while previous colonization by P. aeruginosa, use of antipseudomonal cephalosporins as definitive treatment, and combination therapy were shown to be protective. However, after IPTW adjustment, only the protective effect of antipseudomonal cephalosporins was confirmed (adjusted HR = 0.27, 95% CI = 0.10-0.69), but not for combination therapy. Hence, the treatment effect was calculated: antipseudomonal cephalosporins significantly reduced mortality risk [-17% (95% CI = -4% to -30%)], while combination therapy was beneficial only in the case of septic shock [-66% (95% CI = -44% to -88%].</p><p><strong>Conclusions: </strong>In ICU, antipseudomonal cephalosporins may be the preferred target therapy for the treatment of Pa-BSI; in addition, initial combination therapy may be protective in the case of septic shock.</p>","PeriodicalId":14969,"journal":{"name":"Journal of Antimicrobial Chemotherapy","volume":" ","pages":"1342-1353"},"PeriodicalIF":3.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First report of SME-carbapenemase-producing Serratia marcescens in France.","authors":"Manon Robert, Marion Leterrier-Plong, Leslie Bouard, Chloé Chantereau-Jansen, Laurent Dortet, Cécile Emeraud, Eve-Marie Takoudju","doi":"10.1093/jac/dkaf072","DOIUrl":"10.1093/jac/dkaf072","url":null,"abstract":"","PeriodicalId":14969,"journal":{"name":"Journal of Antimicrobial Chemotherapy","volume":" ","pages":"1457-1461"},"PeriodicalIF":3.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: Resistance profiles of carbapenemase-producing Enterobacterales in a large centre in England: are we already losing cefiderocol?","authors":"Christopher M Longshaw, Boudewijn L M Dejonge, Yoshinori Yamano","doi":"10.1093/jac/dkaf074","DOIUrl":"10.1093/jac/dkaf074","url":null,"abstract":"","PeriodicalId":14969,"journal":{"name":"Journal of Antimicrobial Chemotherapy","volume":" ","pages":"1465-1468"},"PeriodicalIF":3.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nature-inspired designing of KLR- and KLS-rich antimicrobial peptides: unleashing the antibiofilm potential of RbP12 against MDR S. aureus and P. aeruginosa.","authors":"Zeeshan Yaseen, Saiqa Aslam, Sidra Rahmat Ullah, Abdur Rahman, Muhammad Bilal Khan Niazi, Saadia Andleeb","doi":"10.1093/jac/dkaf079","DOIUrl":"10.1093/jac/dkaf079","url":null,"abstract":"<p><strong>Objectives: </strong>Biofilm formation is a mechanism exhibited by bacteria, making them 10-1000 times more resistant than planktonic cells. The aim was to collect the most suitable characteristics from already available antibiofilm peptides and design novel antibiofilm peptide sequences along with these characteristics altogether in one sequence.</p><p><strong>Methods: </strong>Antibiofilm peptides were collected from AMP database (APD3), and sequence analysis was performed to derive the most suitable features. An artificial design approach, modified database filtering technology, was chosen to design novel peptide sequences, and their activity was predicted by machine-learning prediction models. Antibacterial and antibiofilm potential of the selected peptide sequence (arginine-based peptide 12; RbP12) was assessed against Staphylococcus aureus P10 and Pseudomonas aeruginosa PA64.</p><p><strong>Results: </strong>A total of 34 peptides were designed, of which 22 were arginine based and 12 were serine based. All the designed peptides were predicted to have antibiofilm properties. RbP12 was found to inhibit the growth of S. aureus P10 completely at an MIC of 85 mg/L, while the percentage inhibition of P. aeruginosa PA64 was calculated to be 32.1%. Significant inhibition of biofilms by RbP12 was observed in the case of both S. aureus P10 and P. aeruginosa PA64. An MTT assay showed no significant cytotoxicity by RbP12 with 96% cell viability.</p><p><strong>Conclusions: </strong>RbP12 was found to have higher antibacterial and antibiofilm activity against S. aureus P10 compared with P. aeruginosa PA64. With 96% cell viability, usage of RbP12 on human skin is totally safe. Based on these results, the aim is to develop self-assembled peptide hydrogels for wound healing in future work.</p>","PeriodicalId":14969,"journal":{"name":"Journal of Antimicrobial Chemotherapy","volume":" ","pages":"1331-1341"},"PeriodicalIF":3.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: Resistance profiles of carbapenemase-producing Enterobacterales in a large centre in England: are we already losing cefiderocol?","authors":"Timothy M Rawson, Maxwell Al-Hassan, Ilona Brzeska-Trafny, Anna Morkowska, Elita Jauneikaite, Razan Saman, Hugo Donaldson, Frances Davies","doi":"10.1093/jac/dkaf060","DOIUrl":"10.1093/jac/dkaf060","url":null,"abstract":"","PeriodicalId":14969,"journal":{"name":"Journal of Antimicrobial Chemotherapy","volume":" ","pages":"1462-1464"},"PeriodicalIF":3.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The synergistic effect of the combination of polymyxin B and rifampicin in a murine neutropenic thigh infection model with E. coli and K. pneumoniae.","authors":"Sanne Van Den Berg, Sebastiaan D T Sassen, William Couet, Sandrine Marchand, Heleen Van Der Spek, Marian T Ten Kate, Joseph Meletiadis, Anouk E Muller","doi":"10.1093/jac/dkaf056","DOIUrl":"10.1093/jac/dkaf056","url":null,"abstract":"<p><strong>Background: </strong>Antibiotic combination therapy is increasingly used to treat MDR pathogens. In vitro studies suggest that the polymyxin B/rifampicin combination might be synergistic. Therefore, the pharmacodynamics of rifampicin as monotherapy and combined with polymyxin B were studied in Escherichia coli- and Klebsiella pneumoniae-infected mice.</p><p><strong>Methods: </strong>The rifampicin pharmacokinetics (oral doses 0.5-64 mg/kg) in murine plasma were studied to estimate the exposures to rifampicin. These exposures were subsequently correlated with the antibacterial effect in a sigmoid maximum-effect model. The minimum exposures needed for a static, 1 log10 and 2 log10 kill effect in two E. coli and two K. pneumoniae strains were determined for monotherapy and the combination. The pharmacodynamic interactions between polymyxin B and rifampicin were assessed using Loewe additivity and Bliss independence in both an E. coli and a K. pneumoniae strain.</p><p><strong>Results: </strong>Rifampicin monotherapy resulted in a static effect in E. coli but not against K. pneumoniae. When combined with polymyxin B, rifampicin fAUC/MIC needed for stasis, 1 log10 and 2 log10 kill effect decreased with increasing polymyxin B exposures for all strains. Synergy was confirmed in Loewe additivity (interaction indices 0.11-0.51 for E. coli and 0.04-0.19 for K. pneumoniae) and Bliss independence (267% and 863%). Maximal killing (>2 log10 kill) in combination therapy was found at rifampicin/polymyxin B fAUC/MIC of 0.68/32.56 for E. coli and 0.169/16.28 for K. pneumoniae.</p><p><strong>Conclusions: </strong>These in vivo studies confirmed that there is a clear synergistic effect between polymyxin B and rifampicin, which was stronger for the K. pneumoniae strain than for the E. coli strain.</p>","PeriodicalId":14969,"journal":{"name":"Journal of Antimicrobial Chemotherapy","volume":" ","pages":"1248-1255"},"PeriodicalIF":3.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-resistance to 14-, 15- and 16-membered ring macrolides in Salmonella and Campylobacter.","authors":"Ruby Singh, Sampa Mukherjee, Lucas B Harrision, Patrick F McDermott, Beilei Ge, Jeffrey M Gilbert, Cong Li, Jean M Whichard, Gamola Z Fortenberry, Uday Dessai, Shaohua Zhao","doi":"10.1093/jac/dkaf094","DOIUrl":"10.1093/jac/dkaf094","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to gain a better understanding of how resistance determinants in Salmonella and Campylobacter contribute to 14-, 15- and 16-membered ring macrolide resistance phenotypes.</p><p><strong>Methods: </strong>A total of 126 azithromycin-resistant (AziR) and -susceptible (AziS) [Salmonella (n = 45) and Campylobacter (n = 81)] isolates were selected for antimicrobial susceptibility testing (AST) and WGS.</p><p><strong>Results: </strong>Seven functional macrolide resistance determinants, including erm(42), mef(C), mph(A), mph(E), mph(G), msr(E) and one point mutation (acrB_R717L) were previously identified in AziRSalmonella. These determinants resulted in an 8- and 16-fold 15-membered ring gamithromycin and azithromycin MIC50 increase, respectively, compared with AziS isolates, with a maximum MIC increase of up to 256. The same isolates also exhibited up to a 32-fold 14-membered ring erythromycin MIC50 increase. Salmonella with erm(42) or acrB_R717L showed up to 128-fold 16-membered ring macrolide tildipirosin MIC increase, compared with isolates that were susceptible or carrying other macrolide resistance genes. In Campylobacter, all AziR isolates had an MIC50 ranging from 32 to 4096 mg/L of the various membered ring macrolides, whereases all susceptible Campylobacter isolates had significantly lower MIC50 values, ranging from 0.25 to 4 mg/L. The MIC50 of the various ring macrolides for AziRCampylobacter isolates was 16- to 4096-fold higher when compared with AziSCampylobacter.</p><p><strong>Conclusions: </strong>Our study has revealed that the function of macrolide resistance genes in Salmonella can be associated with specific macrolide ring structures, whereas the single 23S rRNA mutation in Campylobacter results in significantly elevated MICs of all macrolides. for the various ring macrolides.</p>","PeriodicalId":14969,"journal":{"name":"Journal of Antimicrobial Chemotherapy","volume":" ","pages":"1445-1452"},"PeriodicalIF":3.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Population pharmacokinetics and exposure-response relationship of the antituberculosis drug BTZ-043.","authors":"Simon E Koele, Norbert Heinrich, Veronique R De Jager, Julia Dreisbach, Patrick P J Phillips, Petra Gross-Demel, Rodney Dawson, Kim Narunsky, Leticia M Wildner, Timothy D Mchugh, Lindsey H M Te Brake, Andreas H Diacon, Rob E Aarnoutse, Michael Hoelscher, Elin M Svensson","doi":"10.1093/jac/dkaf076","DOIUrl":"10.1093/jac/dkaf076","url":null,"abstract":"<p><strong>Introduction: </strong>BTZ-043 is a first-in-class benzothiazinone for the treatment of TB with demonstrated early bactericidal activity. BTZ-043 is metabolized into two major metabolites: M1 and M2. The aim of this study was to characterize the pharmacokinetics (PK) and early exposure-response (pharmacokinetic/pharmacodynamic, PK/PD) relationship for BTZ-043.</p><p><strong>Methods: </strong>A population PK/PD model for BTZ-043 and its metabolites was developed using data from a sequential Phase 1b/2a, randomized, controlled clinical trial in participants with pulmonary TB. BTZ-043 was administered in daily doses ranging from 250 to 1750 mg over 14 days. The decrease in bacterial load was determined by culture of sputum samples to quantify cfu on solid medium, and time to positivity in liquid medium.</p><p><strong>Results: </strong>In total, 77 participants received the experimental treatment. PK were best described by two-compartment disposition models for BTZ-043 and M2, and a one-compartment disposition model for M1. When given without food, the bioavailability was 54% (95% CI: 43%-65%) lower than with food. The decrease in bacterial load was described by a bilinear model with estimated node at 48 h. Participants in the highest dose group in Stage 2 (1000 mg) had a 2-fold faster decrease in mycobacterial load during the initial 2 days compared with participants in the lowest dose group (250 mg), driven by an Emax relationship to the BTZ-043total exposure (BTZ-043 + M2).</p><p><strong>Conclusions: </strong>We characterized the population PK/PD of BTZ-043 in trial participants with pulmonary TB. An exposure-response relationship was only apparent for the first 2 days on treatment, indicating the need for further dose-finding studies.</p>","PeriodicalId":14969,"journal":{"name":"Journal of Antimicrobial Chemotherapy","volume":" ","pages":"1315-1323"},"PeriodicalIF":3.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ceftazidime-avibactam plus aztreonam cocktail for the treatment of VIM-producing Pseudomonas aeruginosa infections: good enough to have another?","authors":"Manuel Pina-Sánchez, Marta Rua, Carla López-Causapé, Idoia Bilbao, Miquel Àngel Sastre-Femenia, Antonio Oliver, José Luis Del Pozo","doi":"10.1093/jac/dkaf083","DOIUrl":"10.1093/jac/dkaf083","url":null,"abstract":"<p><strong>Background: </strong>Few active antibiotic options are available to treat MBL-producing Pseudomonas aeruginosa infections, and some of these options are either poorly tolerated or have pharmacokinetic limitations. The use of aztreonam monotherapy for treating MBL-producing P. aeruginosa remains controversial due to the risk of selecting resistant mutants during treatment.</p><p><strong>Objectives: </strong>To describe the clinical outcomes of patients treated with ceftazidime-avibactam plus aztreonam for VIM-producing P. aeruginosa infections. The assessed outcomes include clinical success, clinical cure, all-cause mortality at day 28, combination therapy-associated adverse events, infection relapse and microbiological recurrence.</p><p><strong>Methods: </strong>This retrospective observational single-centre study was conducted at Clínica Universidad de Navarra, Pamplona, Spain. Eight patients with VIM-producing P. aeruginosa infections were included. Whole-genome sequencing of isolates was performed at Hospital Universitario Son Espases, Palma, Spain.</p><p><strong>Results: </strong>All isolates were susceptible to aztreonam and aztreonam-avibactam. No resistance mechanisms against these antibiotics were identified through whole-genome sequencing, except in one isolate that overexpressed the MexAB-OprM efflux pump. Clinical success and clinical cure were achieved in seven of eight patients, while all-cause mortality at day 28 was two of eight. Clinical cure was documented for five different infections and three distinct P. aeruginosa clones. No adverse events related to antibiotic therapy were reported, and no infection relapses occurred after treatment. Microbiological recurrence was observed in two cases.</p><p><strong>Conclusions: </strong>In our experience, patients with VIM-producing P. aeruginosa infections treated with ceftazidime-avibactam plus aztreonam mostly achieved clinical success. However, given the limited sample size, further research is required to validate these findings.</p>","PeriodicalId":14969,"journal":{"name":"Journal of Antimicrobial Chemotherapy","volume":" ","pages":"1371-1376"},"PeriodicalIF":3.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retrospective observational cohort study of oral azithromycin treatment for Legionnaires' disease.","authors":"Lorna Pairman, Yong Tai Beh, Hannah Maher, Sharon J Gardiner, Paul Chin, Jonathan Williman, Stephen T Chambers","doi":"10.1093/jac/dkaf081","DOIUrl":"10.1093/jac/dkaf081","url":null,"abstract":"<p><strong>Background: </strong>Legionnaires' disease (LD) is typically treated with macrolides, including the azalide azithromycin, or quinolones. In 2013, guidelines for empirical treatment of community-acquired pneumonia at Christchurch Hospital, New Zealand were changed to prioritize oral azithromycin over IV clarithromycin.</p><p><strong>Objectives: </strong>To determine whether the change in antimicrobial guidelines led to altered outcomes for patients subsequently confirmed to have LD.</p><p><strong>Methods: </strong>Patients with confirmed LD between 2010 and 2020 were identified from clinical and laboratory data. Hospital records were used to identify mortality, ICU admission, length of hospital stay, time to clinical stability, and time to first anti-Legionella treatment. Mean differences, risk ratios (RRs) and an interrupted time series with propensity adjustment were used to compare patient outcomes before and after the guideline change.</p><p><strong>Results: </strong>There were 323 patients included: 128 before and 195 after the change. Patient outcomes generally improved after the change including: mortality within 30 days (RR 0.4, 95% CI 0.2-0.8); ICU admission (RR 0.6, 95% CI 0.5-0.9); length of stay (difference -2.3 days, 95% CI -4.3 to -0.4); and time to clinical stability (difference -2.4 days, 95% CI -4.3 to -0.5). The interrupted time series analysis suggested improvements in patient outcomes may have occurred regardless of the guideline change.</p><p><strong>Conclusions: </strong>Outcomes for patients with LD were not worsened by the change in antimicrobial guidelines and may have improved. Overall rates of mortality were low. This result was reassuring given the harm that may result from unnecessary use of IV compared with oral antimicrobial agents.</p>","PeriodicalId":14969,"journal":{"name":"Journal of Antimicrobial Chemotherapy","volume":" ","pages":"1354-1361"},"PeriodicalIF":3.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}