Microbial drug resistance最新文献

{"title":"High Frequency of Methicillin-Resistant and Multidrug-Resistant Strains of <i>Staphylococcus aureus</i> Colonizing Students in Okada, Edo State, Nigeria.","authors":"Maureen Uchechukwu Okwu, Augustine Obhioze Akpoka, Olley Mitsan, Osazee Ekundayo Izevbuwa, Anita Osamede, Jan Tkadlec","doi":"10.1089/mdr.2023.0001","DOIUrl":"10.1089/mdr.2023.0001","url":null,"abstract":"<p><p><i>Staphylococcus aureus</i> is one of the most common bacterial pathogens, often asymptomatically colonizing healthy people, but capable of causing fatal disease. The ability to treat <i>S. aureus</i> infections is limited by the rapid spread of multidrug-resistant strains. This study aimed to determine the prevalence of <i>S. aureus</i> carriage among students from Okada, Edo State, Nigeria, to analyze the antibiotic resistance patterns and molecular characteristics of <i>S. aureus</i> isolates. One hundred healthy students from Okada, Nigeria, were tested for nasal colonization by <i>S. aureus.</i> Isolates were identified using standard microbiological methods. The susceptibilities of the isolates to a panel of 22 antimicrobials were tested. <i>spa</i> and staphylococcal cassette chromosome <i>mec</i> typing were performed. The prevalence of <i>S. aureus</i> and methicillin-resistant <i>S. aureus</i> (MRSA) among the students was 23% and 6%, respectively. Of the six (26.1%; 6/23) MRSA isolates detected, CC88-MRSA-IVa (<i>n</i> = 2) and CC7-MRSA-V (<i>n</i> = 2) were the most frequent clones. The CC7-MRSA-V isolates were resistant to multiple antimicrobials. Overall, resistance to beta-lactams, tetracyclines, fluoroquinolones, and aminoglycosides was detected among the <i>S. aureus</i> and MRSA isolates. The high prevalence of MRSA and methicillin-susceptible isolates with resistance to multiple antimicrobial classes observed among the students is an alarming finding. This study indicated the circulation of resistant clones of <i>S. aureus</i> in Nigerian educational institutions and the community.</p>","PeriodicalId":18701,"journal":{"name":"Microbial drug resistance","volume":" ","pages":"516-522"},"PeriodicalIF":2.6,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10609436","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":"Detection of Antimicrobial Resistance and Biofilm Production Among <i>Staphylococcus pseudintermedius</i> from Canine Skin Lesions.","authors":"Sahar Nouri Gharajalar,&nbsp;Sadegh Tanhaee,&nbsp;Mahdieh Omidzadeh,&nbsp;Masoud Onsori","doi":"10.1089/mdr.2022.0257","DOIUrl":"https://doi.org/10.1089/mdr.2022.0257","url":null,"abstract":"<p><p><b><i>Aims:</i></b> <i>Staphylococcus pseudintermedius</i> is an opportunistic pathogen also indicated as one of the major causes of skin infections in dogs. This study aimed to identify <i>S. pseudintermedius</i> isolated from canine skin lesions, evaluate their antibiotic resistance profile and biofilm production ability. <b><i>Methodology:</i></b> Lesions from 50 rural dogs with different skin lesions were sampled after pyoderma diagnosis by private practices. Bacterial species determination was investigated and susceptibility to nine antimicrobials were determined by means of Kirby-Bauer assay. Then seven antibiotic resistance genes, including <i>mecA, blaZ, tetK, tetM, bla_SHV, bla_OXA-</i>₁, and <i>bla_TEM</i> were screened by PCR. Moreover, biofilm formation ability of the strains was determined using the microtiter plate assay along with the presence of <i>icaADBC</i> genes. <b><i>Results:</i></b> A total of 37 (74%) isolates were identified as <i>S. pseudintermedius.</i> All <i>S. pseudintermedius</i> isolates were resistant to multiple drugs. Resistance to penicillin, amoxicillin-clavulanic acid, and cefazolin were higher than other antimicrobials. All the beta-lactam-resistant isolates carried <i>blaZ</i>, whereas <i>mecA</i> was found in 6 (16.21%) of them. Among tetracycline-resistant strains, the frequency of <i>tetK</i> and <i>tetM</i> determinants were 19 (90.47%) and 21 (100%), respectively. Finally, most cefazolin-resistant strains 31 (91.89%) were positive for <i>blaTEM</i> gene. The rate of biofilm production ability among <i>S. pseudintermedius</i> isolates was 35 (94.59%). Furthermore, the presence of <i>icaA/D</i> genes was detected in 35 (100%) and 29 (82.85%) of <i>S. pseudintermedius</i> strains, respectively. <b><i>Conclusion:</i></b> The high rates of antimicrobial resistance and biofilm production ability among <i>S. pseudintermedius</i> isolates, emphasize the urgent need to use more effective infection control policies and guidelines for antimicrobial use.</p>","PeriodicalId":18701,"journal":{"name":"Microbial drug resistance","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49679701","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":"Treatment of Colistin Dependence-Developing <i>Acinetobacter baumannii</i> with Antibiotic Combinations at Subinhibitory Concentrations.","authors":"Jeongwoo Jo,&nbsp;Ji Young Lee,&nbsp;Hongbaek Cho,&nbsp;Kwan Soo Ko","doi":"10.1089/mdr.2022.0205","DOIUrl":"10.1089/mdr.2022.0205","url":null,"abstract":"<p><p>Recent studies have revealed that colistin dependence frequently develops in colistin-susceptible <i>Acinetobacter baumannii</i> isolates. Despite resistance in parental strains, colistin-dependent mutants showed increased susceptibility to several antibiotics, which suggests the possibility of developing strategies to eliminate multidrug-resistant (MDR) <i>A. baumannii</i>. We investigated <i>in vitro</i> and <i>in vivo</i> efficacy of combinations of colistin and other antibiotics using MDR <i>A. baumannii</i> strains H08-391, H06-855, and H09-94, which are colistin-susceptible but develops colistin dependence upon exposure to colistin. An <i>in vitro</i> time-killing assay, a checkerboard assay, and an antibiotic treatment assay using <i>Galleria mellonella</i> larvae were performed. Although a single treatment of colistin at a high concentration did not prevent colistin dependence, combinations of colistin with other antibiotics at subinhibitory concentrations, especially amikacin, eradicated the strains by inhibiting the development of colistin dependence, in the <i>in vitro</i> time-killing assay. Only 40% of <i>G. mellonella</i> larvae infected by <i>A. baumannii</i> survived with colistin treatment alone; however, all or most of them survived following treatment with the combination of colistin and other antibiotics (amikacin, ceftriaxone, and tetracycline). Our results suggest the possibility of the combination of colistin and amikacin or other antibiotics as one of therapeutic options against <i>A. baumannii</i> infections by eliminating colistin-dependent mutants.</p>","PeriodicalId":18701,"journal":{"name":"Microbial drug resistance","volume":" ","pages":"448-455"},"PeriodicalIF":2.6,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9698524","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":"<i>In Vitro</i> Activity of Cefiderocol Against Carbapenem-Resistant <i>Enterobacterales</i> and <i>Pseudomonas aeruginosa</i>.","authors":"Lucia Malisova, Iveta Vrbova, Katarina Pomorska, Vladislav Jakubu, Helena Zemlickova","doi":"10.1089/mdr.2023.0090","DOIUrl":"10.1089/mdr.2023.0090","url":null,"abstract":"<p><p>The objective of this study was to assess the susceptibility of cefiderocol against multidrug-resistant carbapenemase-producing and nonproducing bacteria. The panel comprised 182 isolates of the order <i>Enterobacterales</i>, and 40 strains of <i>Pseudomonas aeruginosa</i>. Antimicrobial susceptibility testing has been performed using broth microdilution method according to the European Committee on Antimicrobial Susceptibility Testing recommendations. Mass spectrometry matrix-assisted laser desorption/ionization-time of flight mass spectrometry and carbapenemase-producing test were used to verify the presence of carbapenemases in clinical isolates. The genetic expression of single carbapenemases (<i>bla</i>_KPC, <i>bla</i>_OXA-48, <i>bla</i>_NDM, <i>bla</i>_VIM, <i>bla</i>_IMP, <i>bla</i>_GES) was determined by real-time polymerase chain reaction. Cefiderocol exhibited a good activity against the majority of strains tested in this study. Altogether, growth of 81.9% (<i>n</i> = 149) strains of the order <i>Enterobacterales</i> and 77.5% (<i>n</i> = 31) of <i>P. aeruginosa</i> isolates were inhibited at minimal inhibitory concentration (MIC) ≤2 mg/L. Values MIC₅₀/MIC₉₀ were 0.5/8 mg/L for enterobacteria, and 1/8 mg/L for <i>P. aeruginosa</i>. One isolate (<i>Klebsiella pneumoniae</i>) harboring two carbapenemases (<i>bla</i>_OXA-48, <i>bla</i>_NDM) had cefiderocol MIC 0.5 mg/L. In enterobacteria resistant to cefiderocol, <i>bla</i>_NDM carbapenemase prevailed (43.3%, <i>n</i> = 29), followed by <i>bla</i>_OXA-48 (31.3%, <i>n</i> = 21) and <i>bla</i>_KPC (4.5%, <i>n</i> = 3). <i>bla</i>_IMP (<i>n</i> = 8) and <i>bl</i>a_VIM (<i>n</i> = 1) metallo-β-lactamases dominated in cefiderocol-resistant <i>P. aeruginosa</i> (<i>n</i> = 9) isolates. Very good susceptibility (100%) to this drug showed <i>bla</i>_GES-positive strains of <i>P. aeruginosa</i> (<i>n</i> = 8) and isolates resistant to meropenem without confirmed carbapenemase gene (<i>n</i> = 10). In this study, cefiderocol demonstrated potent activity against important nosocomial pathogens, therefore, therapeutic options of this drug against multidrug-resistant bacteria should be considered.</p>","PeriodicalId":18701,"journal":{"name":"Microbial drug resistance","volume":" ","pages":"485-491"},"PeriodicalIF":2.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10611972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10115359","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":"<i>Klebsiella quasipneumoniae</i> subsp. <i>similipneumoniae</i> ST1859 O5:KL35 from Soil: First Report of <i>qnrE1</i> in the Environment.","authors":"Ralf Lopes,&nbsp;João Pedro Rueda Furlan,&nbsp;Micaela Santana Ramos,&nbsp;Lucas David Rodrigues Dos Santos,&nbsp;Rafael da Silva Rosa,&nbsp;Eliana Guedes Stehling","doi":"10.1089/mdr.2023.0075","DOIUrl":"10.1089/mdr.2023.0075","url":null,"abstract":"<p><p>A <i>Klebsiella quasipneumoniae</i> subsp. <i>similipneumoniae</i> strain, named S915, belonging to the ST1859 O5:KL35, and harboring the plasmid-mediated quinolone resistance <i>qnrE1</i> gene, was isolated from a soil sample cultivated with lettuce in Brazil. The core genome multilocus sequence typing analysis revealed that S915 strain was most related to a clinical strain of Brazil. Comparative genomic analysis showed that ST1859 O5:KL35 strains have been circulating in clinical settings and are closely related to multidrug resistance and multimetal tolerance. Strain S915 presented a plasmid contig co-harboring the <i>qnrE1</i> gene and tellurite tolerance operon. The region harboring the <i>qnrE1</i> gene (IS<i>Ecp1</i>-<i>qnrE1</i>-<i>araJ</i>-<i>ahp</i>) shared high similarity with others from infected humans, ready-to-eat dish, and food-producing animals in Brazil. This is the first report of the plasmid-mediated <i>qnrE1</i> gene in the environment. Our findings evidence the initial dissemination of the <i>qnrE1</i> gene in the environment by the introduction of a clinical strain, which may be spread to different sectors, representing a One Health challenge.</p>","PeriodicalId":18701,"journal":{"name":"Microbial drug resistance","volume":" ","pages":"492-496"},"PeriodicalIF":2.6,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10143781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Message from the Editor-in-Chief.","authors":"","doi":"10.1089/mdr.2023.29007.igb","DOIUrl":"10.1089/mdr.2023.29007.igb","url":null,"abstract":"","PeriodicalId":18701,"journal":{"name":"Microbial drug resistance","volume":"29 10","pages":"443"},"PeriodicalIF":2.6,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41205263","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":"Prevalence of <i>fosA3</i> Gene in Fosfomycin-Resistant <i>Proteus mirabilis</i> in the Autonomous Community of Madrid (Spain) and Characterization of Two Positive Strains.","authors":"Cristina Loras,&nbsp;María Pérez-Vázquez,&nbsp;Andrea González Prieto,&nbsp;Jesús Oteo-Iglesias,&nbsp;Juan-Ignacio Alós","doi":"10.1089/mdr.2022.0269","DOIUrl":"10.1089/mdr.2022.0269","url":null,"abstract":"<p><p>Plasmid-mediated resistance to fosfomycin has been seldom described in <i>Proteus mirabilis</i>. We report two strains harboring <i>fosA3</i> gene. Whole-genome sequencing revealed a plasmid that encoded <i>fosA3</i> gene flanked by two insertion sequence (IS)<i>26</i> mobile elements. Both strains also produced the <i>bla</i>_CTX-M-65 gene that was located in the same plasmid. The sequence detected was IS1182-<i>bla</i>_CTX-M-65-orf1-orf2-IS26-IS26-<i>fosA</i>3-orf1-orf2-orf3-IS26. The importance of this transposon lies in its ability to spread in <i>Enterobacterales</i>, therefore, epidemiological surveillance should be carried out.</p>","PeriodicalId":18701,"journal":{"name":"Microbial drug resistance","volume":" ","pages":"444-447"},"PeriodicalIF":2.6,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9250966","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":"Colonization of Residents and Staff of an Italian Long-Term Care Facility and an Adjacent Acute Care Hospital Geriatrics Unit by Multidrug-Resistant Bacteria.","authors":"Maria Teresa Nitti,&nbsp;Ferisa Sleghel,&nbsp;Malgorzata Kaczor,&nbsp;Richard Aschbacher,&nbsp;Elena Moroder,&nbsp;Angela Maria Di Pierro,&nbsp;Francesca Piscopiello,&nbsp;Melissa Spalla,&nbsp;Aurora Piazza,&nbsp;Roberta Migliavacca,&nbsp;Elisabetta Pagani","doi":"10.1089/mdr.2023.0019","DOIUrl":"10.1089/mdr.2023.0019","url":null,"abstract":"<p><p>In 2022, we undertook a point prevalence screening study for <i>Enterobacterales</i> with extended-spectrum β-lactamases (ESBLs), high-level AmpC cephalosporinases and carbapenemases, and also methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) and vancomycin-resistant enterococci (VRE) in a long-term care facility (LTCF) and the associated acute-care hospital Geriatrics unit in Bolzano, Northern Italy. Urine samples and rectal, inguinal, oropharyngeal, and nasal swabs were plated on selective agar plates. Metadata of the patients, including demographic data, were collected, and risk factors for colonization were determined. ESBL, AmpC, carbapenemase, and quinolone resistance genes were investigated by the HybriSpot 12 PCR AUTO System. The following colonization percentages by multidrug-resistant (MDR) bacteria have been found in LTCF residents: all MDR organisms, 59.5%; ESBL producers, 46.0% (mainly CTX-M-type enzymes); carbapenemase producers, 1.1% (one <i>Klebsiella pneumoniae</i> with KPC-type); MRSA, 4.5%; VRE, 6.7%. Colonization by MDR bacteria was 18.9% for LTCF staff and 45.0% for Geriatrics unit patients. Peripheral vascular disease, the presence of any medical device, cancer, and a Katz Index of 0 were significant risk factors for colonization of LTCF residents by MDR bacteria in univariate and/or multivariate regression analysis. To conclude, the ongoing widespread diffusion of MDR bacteria in the LTCF suggests that efforts should be strengthened on MDR screening, implementation of infection control strategies, and antibiotic stewardship programs targeting the unique aspects of LTCFs. ClinicalTrials.gov ID: 0530250-BZ Reg01 30/08/2022.</p>","PeriodicalId":18701,"journal":{"name":"Microbial drug resistance","volume":" ","pages":"477-484"},"PeriodicalIF":2.6,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9752705","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":"Biocides in the Hospital Environment: Application and Tolerance Development.","authors":"Catarina Geraldes,&nbsp;Luís Tavares,&nbsp;Solange Gil,&nbsp;Manuela Oliveira","doi":"10.1089/mdr.2023.0074","DOIUrl":"10.1089/mdr.2023.0074","url":null,"abstract":"<p><p>Hospital-acquired infections are a rising problem with consequences for patients, hospitals, and health care workers. Biocides can be employed to prevent these infections, contributing to eliminate or reduce microorganisms' concentrations at the hospital environment. These antimicrobials belong to several groups, each with distinct characteristics that need to be taken into account in their selection for specific applications. Moreover, their activity is influenced by many factors, such as compound concentration and the presence of organic matter. This article aims to review some of the chemical biocides available for hospital infection control, as well as the main factors that influence their efficacy and promote susceptibility decreases, with the purpose to contribute for reducing misusage and consequently for preventing the development of resistance to these antimicrobials.</p>","PeriodicalId":18701,"journal":{"name":"Microbial drug resistance","volume":" ","pages":"456-476"},"PeriodicalIF":2.6,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10467733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Epidemiological Characteristics of Carbapenem-Resistant <i>Klebsiella pneumoniae</i> Infections in a Tertiary Hospital in China.","authors":"Zhiwen Cui,&nbsp;Lirui Wang,&nbsp;Min Feng","doi":"10.1089/mdr.2022.0280","DOIUrl":"https://doi.org/10.1089/mdr.2022.0280","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Infections caused by carbapenem-resistant <i>Klebsiella pneumoniae</i> (CR-KP) are an important public health problem. This study aimed to evaluate the clinical characteristics of patients with CR-KP. <b><i>Methods:</i></b> A retrospective cohort study was conducted of all patients with CR-KP infection. A total of 615 patients with CR-KP infection were identified and 135 patients who did not meet the eligibility criteria were excluded. Clinical characteristics, antimicrobial regimens, and patient outcomes were analyzed. <b><i>Results:</i></b> The overall mortality rate of CR-KP infections was 37.3% and the mortality rate in patients with bloodstream infections was 66.2%. Survival analysis revealed that there were statistically significant differences between patients with bloodstream infections and those with pulmonary and drainage fluid infections. Logistics regression analysis showed that hemopathy, age >60 years, solid tumors, diabetes, septic shock, acute kidney injury, and stroke were independent predictors of 30-day mortality rate. The chi-square test showed that treatment with a combination of carbapenems, tigecycline, and polymyxin B was superior to treatment with carbapenems with polymyxin B, without tigecycline. <b><i>Conclusions:</i></b> CR-KP infections, especially bloodstream infections, have a high mortality rate. The outcome is strongly dependent on patients' clinical conditions. Antimicrobial regimens combining carbapenems, tigecycline, and polymyxin B might be a better choice.</p>","PeriodicalId":18701,"journal":{"name":"Microbial drug resistance","volume":"29 9","pages":"401-406"},"PeriodicalIF":2.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10515162","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}