Journal of Hospital Infection最新文献

{"title":"The role of a DEdicated Infectious Disease consultant within an antimicrobial stewardship programme towards better patient CARE (DE-IDCARE Project): results from a quasi-experimental, single-centre study","authors":"A. Oliva ,&nbsp;C. Leanza ,&nbsp;L. Martellone ,&nbsp;S. Covino ,&nbsp;C. Franchi ,&nbsp;F. Cancelli ,&nbsp;M. Carnevalini ,&nbsp;V. Coradini ,&nbsp;G. Magni ,&nbsp;A. Coppola ,&nbsp;M. Augurusa ,&nbsp;G. Polito ,&nbsp;A. Mingoli ,&nbsp;F. Pugliese ,&nbsp;C.M. Mastroianni","doi":"10.1016/j.jhin.2025.10.029","DOIUrl":"10.1016/j.jhin.2025.10.029","url":null,"abstract":"<div><h3>Background</h3><div>The DE-IDCARE project aimed to evaluate the impact of dedicated infectious disease consultations (CIDs) compared with traditional on-demand ID consultations (CODs) within a structured antimicrobial stewardship programme (ASP).</div></div><div><h3>Methods</h3><div>A quasi-experimental, single-centre study included hospitalized patients in two high-risk settings (Emergency Surgery (ES) and post-neurosurgery intensive care units (NS-ICU)) receiving antimicrobial therapy during April–June 2023 (COD, pre-intervention, <em>N</em> = 117) and April–June 2024 (CID, post-intervention, <em>N</em> = 172). The CID model introduced tri-weekly systematic evaluations of all patients receiving antimicrobials. The intervention was assessed through 12 antimicrobial stewardship (AMS) indicators categorized into ID stewardship (ID-S), diagnostic stewardship (D-S) and therapeutic stewardship (T-S) and classified into optimal, nearly optimal, neutral, suboptimal and not optimal according to the difference in percentage between CID and COD. Antimicrobial consumption was analysed using the AWaRe classification and the DDD/100 days of hospitalization. New onset of multi-drug resistant (MDR) colonization as well as clinical outcomes were also evaluated.</div></div><div><h3>Results</h3><div>CID led to significant improvements in the majority of AMS indicators, especially antimicrobial discontinuation in cases without infection (+46%), 48–72 h re-evaluation of antimicrobial therapy (+36%) and appropriate duration of treatment (+21.1%). The use of Watch and Reserve antibiotics was reduced. New onset of MDR colonization was also reduced, while clinical outcomes were similar to COD.</div></div><div><h3>Conclusion</h3><div>The DE-IDCARE project underscores the potential of dedicated CIDs within a structured ASP, leading to optimization of antimicrobial prescriptions without significantly affecting patients' outcomes. These findings offer a strong rationale for the wider implementation of CID as a cornerstone of effective AMS strategies.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"168 ","pages":"Pages 35-47"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145490995","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":"Age- and sex-stratified trends in carbapenem-resistant Acinetobacter baumannii and Enterobacterales: insights from MuGSI (2012–2022)","authors":"Y. Takefuji","doi":"10.1016/j.jhin.2025.11.002","DOIUrl":"10.1016/j.jhin.2025.11.002","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"168 ","pages":"Pages 228-230"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145530989","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":"Uncovering a hidden threat from OXA-48-carbapenemase-producing Enterobacterales in a Scottish health board","authors":"O. Osgerby-Lacey ,&nbsp;D. Inverarity ,&nbsp;J. Welsh ,&nbsp;L. Guthrie ,&nbsp;N.J. Gadsby ,&nbsp;N. Henderson","doi":"10.1016/j.jhin.2025.11.017","DOIUrl":"10.1016/j.jhin.2025.11.017","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"168 ","pages":"Pages 231-232"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145642904","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":"Transmission pathways and genogroup contribution in Stenotrophomonas maltophilia dissemination: experience from a French university hospital","authors":"C. Sakr ,&nbsp;M. Danjean ,&nbsp;M. Darty-Mercier ,&nbsp;F. Cizeau ,&nbsp;D. Ducellier ,&nbsp;F. Fourreau ,&nbsp;S. Romano-Bertrand ,&nbsp;G. Royer ,&nbsp;P-L. Woerther ,&nbsp;J-W. Decousser","doi":"10.1016/j.jhin.2025.11.010","DOIUrl":"10.1016/j.jhin.2025.11.010","url":null,"abstract":"<div><h3>Background</h3><div><em>Stenotrophomonas maltophilia</em> is an environmental opportunistic pathogen that affects immunocompromised patients. Its genomic heterogeneity led to definition of the <em>S</em>. <em>maltophilia</em> complex, including different subpopulations (genogroups) with unknown respective dissemination potential. This study aimed to clarify the epidemiology and genogroup contribution of <em>S</em>. <em>maltophilia</em> in a hospital setting using a comprehensive whole genome sequencing (WGS) approach.</div></div><div><h3>Methods</h3><div>A prospective 16-month study was conducted in a 900-bed university hospital. In total, 204 strains from clinical and environmental samples underwent WGS. Core genome multi-locus sequence typing was performed to determine relatedness between strains, according to epidemiological data; allelic variation among clustered strains was analysed. Genogroups were identified from WGS, and their relative contribution among clustered and non-clustered strains was identified.</div></div><div><h3>Results</h3><div>Among the 189 non-duplicated genomes of human (<em>N</em>=156) and environmental (<em>N</em>=33) origin, 24 clusters (55 strains, two to six per cluster) were identified: four environmental, 16 human and four mixed. Temporal and/or geographical overlap was identified in 22 of 24 clusters. Although predominant among human strains, the main genogroups considered as human-adapted, such as genogroup 6, were not over-represented among clustered strains. Among clustered strains, up to six allelic variants were identified; six genes were involved in more than one allelic variant.</div></div><div><h3>Conclusion</h3><div>Although <em>S. maltophilia</em> is considered to have low cross-transmission potential, this longitudinal study highlighted some putative patient-to-patient cross-transmission events, without over-representation of some particular genogroups. Pending further larger studies, these results advocate for reinforcement of infection control around <em>S</em>. <em>maltophilia</em> carriers in high-risk settings.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"168 ","pages":"Pages 134-143"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582276","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":"Outbreak of Enterobacter kobei infections linked to a collagen-based adhesion barrier following lumbar disc surgery: an epidemiological and molecular study","authors":"M.T. Işik ,&nbsp;Y. Cezaroğlu ,&nbsp;F. Tomakin ,&nbsp;M. Büyüktepe","doi":"10.1016/j.jhin.2025.10.030","DOIUrl":"10.1016/j.jhin.2025.10.030","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative infections following spinal surgery are typically caused by skin flora or hospital-acquired pathogens. This article reports a novel outbreak of <em>Enterobacter kobei</em> infections linked to a collagen-based adhesion barrier.</div></div><div><h3>Aim</h3><div>To identify the source of increased surgical site infections in lumbar disc herniation (LDH) procedures, and to describe the outbreak investigation and containment measures implemented.</div></div><div><h3>Methods</h3><div>A multi-disciplinary outbreak team conducted epidemiological, environmental and microbiological investigations at a secondary care hospital in Turkey. Molecular typing using pulsed-field gel electrophoresis (PFGE) was employed to assess the clonal relationships of the isolates.</div></div><div><h3>Findings</h3><div>Between 19^th May and 9^th June 2023, 10 of 12 patients who underwent LDH surgery developed surgical site infections. Environmental cultures tested negative. <em>Enterobacter cloacae</em> was isolated from wound, blood and collagen-based adhesion barrier samples. Isolates sent to the National Public Health Laboratory were identified as <em>E. kobei</em>. PFGE analysis revealed two distinct but clonally related groups. The outbreak was contained following a nationwide recall of the adhesion barrier.</div></div><div><h3>Conclusion</h3><div>This incident marks the first reported outbreak of <em>E. kobei</em> associated with a surgical adhesion barrier. This highlights the need for vigilant infection control and careful monitoring of non-sterilized surgical materials to prevent similar events in the future.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"168 ","pages":"Pages 114-120"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514476","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":"Risk factors and colistin resistance in multi-drug-resistant Pseudomonas aeruginosa: insights from a urology and kidney transplant ward","authors":"M.D. Almeida ,&nbsp;B. Parada ,&nbsp;S.M. Johansson ,&nbsp;P. Valada ,&nbsp;J. Pereira ,&nbsp;R. Leal ,&nbsp;C. Chaves ,&nbsp;J. Frade ,&nbsp;A.R. Rebelo ,&nbsp;T. Gonçalves ,&nbsp;G.J. Da Silva ,&nbsp;R.S. Hendriksen ,&nbsp;C. Nogueira","doi":"10.1016/j.jhin.2025.09.017","DOIUrl":"10.1016/j.jhin.2025.09.017","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"168 ","pages":"Pages 225-227"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276604","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":"Molecular epidemiology of a nationwide Pseudomonas aeruginosa outbreak in Norway reveals multiple distinct clusters, including high-risk clone ST244","authors":"T. Pedersen ,&nbsp;A. Hesselberg Løvestad ,&nbsp;A. Ingebretsen ,&nbsp;D.H. Skutlaberg ,&nbsp;C.G. Ås ,&nbsp;A. Blomfeldt","doi":"10.1016/j.jhin.2025.11.004","DOIUrl":"10.1016/j.jhin.2025.11.004","url":null,"abstract":"<div><h3>Background</h3><div>A nationwide collection of <em>Pseudomonas aeruginosa</em> bacteraemia isolates was assembled during a wild-type <em>P. aeruginosa</em> ST3875 outbreak affecting approximately 400 patients across 40 hospitals in Norway in 2021–2022.</div></div><div><h3>Aim</h3><div>To investigate the molecular epidemiology of <em>P. aeruginosa</em> in Norway through a multi-centre retrospective study.</div></div><div><h3>Methods</h3><div>All available isolates collected over 18 months were retrieved from 20 microbiology laboratories, and underwent whole-genome sequencing at five university hospitals. Metadata, including demographics, sampling dates and locations, were collated. Phylogenetic and comparative genomic analyses were performed to identify sequence types (STs), clusters, resistance determinants, and virulence factors.</div></div><div><h3>Findings</h3><div>This study included 376 unique patients with <em>P. aeruginosa</em> bacteraemia from 33 hospitals (69% male; median age 76 years), representing &gt;90% of the national catchment area. Incidence varied regionally (5.1–16.3 per 100,000). The ST was resolved for 362 isolates, revealing 164 distinct types. Global high-risk and epidemic clones (e.g. ST233, ST244, ST277, ST298, ST308) comprised 30% of the collection. None of the isolates carried carbapenemases or extended-spectrum β-lactamases. Aside from the ST3875 outbreak clone (<em>N</em>=56), nine unrecognized phylogenetic clusters (two to 20 cases each) spanning multiple hospitals and regions were identified, including a widespread ST244 cluster harbouring a novel genomic island with putative virulence determinants, indicating a selective advantage for dissemination.</div></div><div><h3>Conclusions</h3><div>This comprehensive genomic surveillance study uncovered multiple unexpected clusters of <em>P. aeruginosa</em> bacteraemia isolates in Norway, along with widespread presence of susceptible epidemic clones. Routine multi-level surveillance integrating sequencing with epidemiological data could enable earlier recognition of emerging high-risk clones and outbreaks, thereby strengthening infection prevention efforts.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"168 ","pages":"Pages 70-79"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145574552","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":"Colonization status and risk factors for infection by carbapenem-resistant Gram-negative bacteria in intensive care units in Colombia","authors":"C. Espitia-Acero ,&nbsp;J.C. García-Betancur ,&nbsp;E. De La Cadena ,&nbsp;C.J. Pallares ,&nbsp;N. Restrepo-Arbeláez ,&nbsp;E. Patiño-Guevara ,&nbsp;M. Coy ,&nbsp;M.V. Villegas","doi":"10.1016/j.jhin.2025.11.003","DOIUrl":"10.1016/j.jhin.2025.11.003","url":null,"abstract":"<div><h3>Background</h3><div>Carbapenem-resistant Gram-negative bacteria (CRGNB) are increasing globally, leading to high mortality, extended hospital stays, and higher costs. Colombia is a hotspot for carbapenem resistance, but intensive care unit (ICU) surveillance for CRGNB is limited.</div></div><div><h3>Aim</h3><div>To assess the association between colonization by carbapenem-resistant organisms (CROs) on ICU admission and subsequent infection, along with other risk factors.</div></div><div><h3>Methods</h3><div>A multicentre prospective cohort study was conducted in two Colombian hospitals with high carbapenem resistance. CRO colonization status was determined upon ICU admission, and statistical analyses were performed to assess relations with infection development.</div></div><div><h3>Findings</h3><div>In general, 18.5% (82/442) of ICU patients were colonized by at least one CRO, with only six acquiring colonization during ICU stay. <em>Pseudomonas</em> spp. (70/106) and <em>Klebsiella</em> spp. (10/106) were the most common species; 28.3% of isolates harboured carbapenemase genes, mainly <em>bla</em>_KPC and <em>bla</em>_NDM. Bivariate analysis showed that readmission to the ICU (relative risk: 4.7; confidence interval 95%: 1.51–14.57) and the use of antibiotics in the last 30 days prior ICU admission (6.4; 1.76–23.13) were related to the development to bacterial infection, independently of the previous colonization status.</div></div><div><h3>Conclusion</h3><div>Identifying CRO colonization status, particularly in patients with risk factors and/or with frequent hospital transit, is crucial for effective infection control within the ICU.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"168 ","pages":"Pages 183-190"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145530994","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":"Across time and space: phylogenetic analysis of carbapenem-resistant Acinetobacter baumannii in a network of general and convalescent hospitals","authors":"E.T.L. Lui ,&nbsp;C. Li ,&nbsp;A.L.H. Lee ,&nbsp;D.N. Sapugahawatte ,&nbsp;W.S. Lee ,&nbsp;G.C.S. Chiu ,&nbsp;I.Y.Y. Cheung ,&nbsp;V.C.Y. Chow ,&nbsp;M. Ip","doi":"10.1016/j.jhin.2025.11.001","DOIUrl":"10.1016/j.jhin.2025.11.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Carbapenem-resistant <em>Acinetobacter baumannii</em> (CRAB) is a major threat to public health and is a common cause of nosocomial outbreaks.</div></div><div><h3>Aim</h3><div>To describe the genetic epidemiology of CRAB from both clinical and hospital environments in a network of hospitals in Hong Kong.</div></div><div><h3>Methods</h3><div>A collection of 185 CRAB strains from patients (<em>N</em> = 143) and nosocomial environments (<em>N</em> = 42) from the period 2012 to 2024 underwent whole-genome sequencing to investigate the phylogenetic relatedness, virulence genes, antibiotic resistance genes and possible lineages of the strains that caused nosocomial outbreaks. Clinical information and antibiotic susceptibility test reports were retrieved from electronic medical records. Time and spatial distribution of the strains was assessed.</div></div><div><h3>Findings</h3><div>The dominant sequence type of CRAB was ST2, accounting for 137 of 185 isolates (74.1%). It was followed by ST195 (<em>N</em> = 17, 9.2%) and ST49 (<em>N</em> = 16, 8.6%). All isolates carried the nreB gene that enhances environmental survival. Carriage of virulence factor genes was grossly similar between environmental and human isolates. Significantly more environmental isolates carried antimicrobial resistant genes conferring resistance to sulbactam-durlobactam, aminoglycosides and macrolides. Dissemination of CRAB across time and space in the regional network of hospitals was observed.</div></div><div><h3>Conclusion</h3><div>ST2 was the commonest sequence type in CRAB across clinical and nosocomial environment isolates of the entire hospital network, linking sporadic cases and clusters across different hospitals spanning over 10 years.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"168 ","pages":"Pages 13-22"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145530983","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":"The need for speed: ultra-rapid high-resolution outbreak analysis in a front-line hospital microbiology laboratory","authors":"M. Bloomfield ,&nbsp;S. Bakker ,&nbsp;M. Burton ,&nbsp;K. Dyet ,&nbsp;A. Eustace ,&nbsp;S. Hutton ,&nbsp;J. Jeram ,&nbsp;D. Macartney-Coxson ,&nbsp;D.J. Winter ,&nbsp;R.T. White","doi":"10.1016/j.jhin.2025.11.020","DOIUrl":"10.1016/j.jhin.2025.11.020","url":null,"abstract":"<div><h3>Background</h3><div>Many hospital laboratories have the technical capacity to perform microbial whole-genome sequencing but lack bioinformatic expertise to analyse sequence data. Sending isolates to reference laboratories creates delays that can be highly detrimental to outbreak responses. The Wellington Regional Hospital laboratory, which lacks on-site bioinformaticians, implemented real-time nanopore-based genome sequencing that has detected several hospital outbreaks at an early stage. This has required off-site analysis, often taking weeks. Solu Genomics, a cloud-based automated bioinformatic platform, requires no bioinformatic or command-line expertise and accepts basecalled sequence files or genome assemblies.</div></div><div><h3>Aim</h3><div>The aim of this study was to use Solu to replicate the analysis of two prior neonatal unit outbreaks detected by on-site genome sequencing, as if they had occurred now, and compare the output to ‘manual’ bioinformatic analysis.</div></div><div><h3>Methods</h3><div>Surveillance isolates that had been sequenced up until the beginning of each outbreak were loaded into Solu to replicate the background genomic data available when each outbreak occurred. The 13 methicillin-resistant <em>Staphylococcus aureus</em> (MRSA) and seven <em>Klebsiella variicola</em> outbreak isolates were then uploaded.</div></div><div><h3>Findings</h3><div>Including upload time, each Solu analysis was completed in under 40 min. The phylogenetic trees generated showed distinct clustering of outbreak isolates, with overall tree topologies similar to the manual analyses. Median pairwise single-nucleotide variant distances were 12 (range: 4–27) and 6 (range: 1–11) for the MRSA and <em>K. variicola</em> outbreaks, respectively, versus 6 (range: 0–14) and 18 (range: 0–54) for the manual analyses.</div></div><div><h3>Conclusion</h3><div>Solu Genomics delivers high-resolution, actionable outbreak analysis for common hospital bacterial pathogens within minutes, transforming routine nanopore sequencing into infection prevention and control (IPC)-ready insights without on-site bioinformatics.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"168 ","pages":"Pages 48-57"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145656412","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}