{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T14:58:57Z","timestamp":1790261937892,"version":"4.1.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T00:00:00Z","timestamp":1744848000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["1U01AI110466-01A1"],"award-info":[{"award-number":["1U01AI110466-01A1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Gates Foundation","doi-asserted-by":"publisher","award":["OPP1017641"],"award-info":[{"award-number":["OPP1017641"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Gates Foundation","doi-asserted-by":"publisher","award":["OPP1017579"],"award-info":[{"award-number":["OPP1017579"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Gates Foundation","doi-asserted-by":"publisher","award":["OPP1017641"],"award-info":[{"award-number":["OPP1017641"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001321","name":"National Research Foundation of South Africa","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001321","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Drakenstein Child Health Study"},{"name":"L\u2019Or\u00e9al-UNESCO For Women in Science"},{"name":"Australian National Health and Medical Research Council"},{"name":"Investigator Grant","award":["APP1174455"],"award-info":[{"award-number":["APP1174455"]}]},{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lower respiratory tract infections (LRTIs) in infants are caused by viral and bacterial infections. We investigated associations between LRTI and nasopharyngeal (NP) viruses and bacteria in South African infants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a birth cohort, LRTI cases were identified prospectively and age-matched with controls. NP swabs were tested using polymerase chain reaction and 16S RNA gene sequencing. We calculated adjusted conditional odds ratios (aORs) and used mixed-effects models to identify differentially abundant taxa and explore viral\u2013bacterial interactions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 888 case-control samples were tested. Respiratory syncytial virus (RSV) (aOR, 5.69 [95% confidence interval, 3.03\u201310.69]), human rhinovirus (HRV) (1.47 [1.03\u20132.09]), parainfluenza virus (3.46 [1.64\u20137.26]), adenovirus (1.99 [1.08\u20133.68]), enterovirus (2.32 [1.20\u20134.46]), Haemophilus influenzae (1.72 [1.25\u20132.37]), Klebsiella pneumoniae (2.66 [1.59\u20134.46]), and high-density Streptococcus pneumoniae (1.53 [1.01\u20132.32]) were associated with LRTI. LRTI was associated with decreased relative abundance of Dolosigranulum (q = .001), Corynebacterium (q = .091), and Neisseria (q = .004). In samples positive for RSV, Staphylococcus and Alloprevotella relative abundance was higher in controls compared to cases. In samples positive for parainfluenza virus or HRV, Haemophilus relative abundance was higher in cases. Detection of cytomegalovirus (CMV) in controls was associated with reduced Corynebacterium, Dolosigranulum, and Staphylococcus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The associations between bacteria, viruses and LRTIs are similar to those from high-income countries. Haemophilus is a major bacterial driver of LRTIs, acting synergistically with viruses. Dolosigranulum and Corynebacterium may reduce LRTI risk, while Staphylococcus may reduce the risk of RSV-related LRTIs. CMV is associated with dysbiotic nasopharyngeal microbiota.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaf184","type":"journal-article","created":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T08:27:47Z","timestamp":1744100867000},"page":"e668-e679","source":"Crossref","is-referenced-by-count":11,"title":["Nasopharyngeal Microbiota in South African Infants With Lower Respiratory Tract Infection: A Nested Case-Control Study of the Drakenstein Child Health Study"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2175-3776","authenticated-orcid":false,"given":"Shantelle","family":"Claassen-Weitz","sequence":"first","affiliation":[{"name":"Division of Medical Microbiology, Department of Pathology, Faculty of Health Sciences, University of Cape Town , Cape Town ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao","family":"Xia","sequence":"additional","affiliation":[{"name":"Marshall Centre, Division of Infection and Immunity, School of Biomedical Sciences, University of Western Australia , Perth ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"Hannan","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town , Stellenbosch ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2762-9944","authenticated-orcid":false,"given":"Sugnet","family":"Gardner-Lubbe","sequence":"additional","affiliation":[{"name":"Department of Statistics and Actuarial Science, Faculty of Economic and Management Sciences, Stellenbosch University , Stellenbosch ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3598-7576","authenticated-orcid":false,"given":"Kilaza S","family":"Mwaikono","sequence":"additional","affiliation":[{"name":"Computational Biology Group and H3ABioNet, Department of Integrative Biomedical Sciences, University of Cape Town , Cape Town ,","place":["South Africa"]},{"name":"Department of Science and Laboratory Technology, Dar es Salaam Institute of Technology , Dar es Salaam ,","place":["Tanzania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Harris Mounaud","sequence":"additional","affiliation":[{"name":"J. Craig Venter Institute , Rockville, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0425-9840","authenticated-orcid":false,"given":"William C","family":"Nierman","sequence":"additional","affiliation":[{"name":"J. Craig Venter Institute , Rockville, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3433-6106","authenticated-orcid":false,"given":"Lesley","family":"Workman","sequence":"additional","affiliation":[{"name":"South African Medical Research Council Unit on Child and Adolescent Health, University of Cape Town , Cape Town ,","place":["South Africa"]},{"name":"Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town , Cape Town ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix S","family":"Dube","sequence":"additional","affiliation":[{"name":"Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town , Cape Town ,","place":["South Africa"]},{"name":"Department of Molecular and Cell Biology, Faculty of Sciences, University of Cape Town , Cape Town ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7688-7344","authenticated-orcid":false,"given":"Samantha","family":"Africa","sequence":"additional","affiliation":[{"name":"Division of Medical Microbiology, Department of Pathology, Faculty of Health Sciences, University of Cape Town , Cape Town ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5177-7416","authenticated-orcid":false,"given":"Fadheela","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of Medical Microbiology, Department of Pathology, Faculty of Health Sciences, University of Cape Town , Cape Town ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Allen","sequence":"additional","affiliation":[{"name":"Division of Medical Microbiology, Department of Pathology, Faculty of Health Sciences, University of Cape Town , Cape Town ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lemese","family":"Ah Tow Edries","sequence":"additional","affiliation":[{"name":"Division of Medical Microbiology, Department of Pathology, Faculty of Health Sciences, University of Cape Town , Cape Town ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather J","family":"Zar","sequence":"additional","affiliation":[{"name":"South African Medical Research Council Unit on Child and Adolescent Health, University of Cape Town , Cape Town ,","place":["South Africa"]},{"name":"Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town , Cape Town ,","place":["South Africa"]},{"name":"Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital , Cape Town ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1366-4805","authenticated-orcid":false,"given":"Mark P","family":"Nicol","sequence":"additional","affiliation":[{"name":"Division of Medical Microbiology, Department of Pathology, Faculty of Health Sciences, University of Cape Town , Cape Town ,","place":["South Africa"]},{"name":"Marshall Centre, Division of Infection and Immunity, School of Biomedical Sciences, University of Western Australia , Perth ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,4,17]]},"reference":[{"key":"2026071700214625500_ciaf184-B1","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/S1473-3099(19)30410-4","article-title":"Quantifying risks and interventions that have affected the burden of lower respiratory infections among children younger than 5 years: an analysis for the Global Burden of Disease Study 2017","volume":"20","author":"GBD 2017 Lower Respiratory Infections Collaborators","year":"2020","journal-title":"Lancet Infect Dis"},{"key":"2026071700214625500_ciaf184-B2","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1016\/S1473-3099(18)30310-4","article-title":"Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory infections in 195 countries, 1990\u20132016: a systematic analysis for the Global Burden of Disease Study 2016","volume":"18","author":"GBD 2016 Lower Respiratory Infections Collaborators","year":"2018","journal-title":"Lancet Infect Dis"},{"key":"2026071700214625500_ciaf184-B3","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1146\/annurev-micro-091014-104209","article-title":"Mechanisms of bacterial colonization of the respiratory tract","volume":"69","author":"Siegel","year":"2015","journal-title":"Annu Rev Microbiol"},{"key":"2026071700214625500_ciaf184-B4","doi-asserted-by":"crossref","first-page":"e1005633","DOI":"10.1371\/journal.ppat.1005633","article-title":"Commensal-pathogen interactions along the human nasal passages","volume":"12","author":"Brugger","year":"2016","journal-title":"PLoS Pathog"},{"key":"2026071700214625500_ciaf184-B5","doi-asserted-by":"crossref","first-page":"1104","DOI":"10.1164\/rccm.201602-0220OC","article-title":"Nasopharyngeal microbiota, host transcriptome, and disease severity in children with respiratory syncytial virus infection","volume":"194","author":"de Steenhuijsen Piters","year":"2016","journal-title":"Am J Respir Crit Care Med"},{"key":"2026071700214625500_ciaf184-B6","doi-asserted-by":"crossref","first-page":"e0116380","DOI":"10.1371\/journal.pone.0116380","article-title":"Risk factors for mortality from acute lower respiratory infections (ALRI) in children under five years of age in low and middle-income countries: a systematic review and meta-analysis of observational studies","volume":"10","author":"Sonego","year":"2015","journal-title":"PLoS One"},{"key":"2026071700214625500_ciaf184-B7","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1136\/thoraxjnl-2014-206242","article-title":"Investigating the early-life determinants of illness in Africa: the Drakenstein Child Health Study","volume":"70","author":"Zar","year":"2015","journal-title":"Thorax"},{"key":"2026071700214625500_ciaf184-B8","doi-asserted-by":"crossref","first-page":"e009111","DOI":"10.1136\/bmjopen-2015-009111","article-title":"Incidence of childhood pneumonia: facility-based surveillance estimate compared to measured incidence in a South African birth cohort study","volume":"5","author":"le Roux","year":"2015","journal-title":"BMJ Open"},{"key":"2026071700214625500_ciaf184-B9","author":"World Health Organization"},{"key":"2026071700214625500_ciaf184-B10","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1016\/S2213-2600(16)00096-5","article-title":"Aetiology of childhood pneumonia in a well vaccinated South African birth cohort: a nested case-control study of the Drakenstein Child Health Study","volume":"4","author":"Zar","year":"2016","journal-title":"Lancet Respir Med"},{"key":"2026071700214625500_ciaf184-B11","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.ijid.2022.04.043","article-title":"Klebsiella pneumoniae lower respiratory tract infection in a South African birth cohort: a longitudinal study","volume":"121","author":"Zar","year":"2022","journal-title":"Int J Infect Dis"},{"key":"2026071700214625500_ciaf184-B12","doi-asserted-by":"crossref","first-page":"S317","DOI":"10.1093\/cid\/cix100","article-title":"Density of upper respiratory colonization with Streptococcus pneumoniae and its role in the diagnosis of pneumococcal pneumonia among children aged &lt;5 years in the PERCH study","volume":"64","author":"Baggett","year":"2017","journal-title":"Clin Infect Dis"},{"key":"2026071700214625500_ciaf184-B13","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1186\/s12866-020-01795-7","article-title":"Optimizing 16S rRNA gene profile analysis from low biomass nasopharyngeal and induced sputum specimens","volume":"20","author":"Claassen-Weitz","year":"2020","journal-title":"BMC Microbiol"},{"key":"2026071700214625500_ciaf184-B14","author":"R Core Team"},{"key":"2026071700214625500_ciaf184-B15","author":"Oksanen"},{"key":"2026071700214625500_ciaf184-B16","doi-asserted-by":"crossref","first-page":"e1009442","DOI":"10.1371\/journal.pcbi.1009442","article-title":"Multivariable association discovery in population-scale meta-omics studies","volume":"17","author":"Mallick","year":"2021","journal-title":"PLoS Comput Biol"},{"key":"2026071700214625500_ciaf184-B17","doi-asserted-by":"publisher","DOI":"10.21105\/joss.03021","article-title":"Seaborn","author":"Waskom","year":"2017"},{"key":"2026071700214625500_ciaf184-B18","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/S2352-4642(22)00304-2","article-title":"Early childhood wheezing phenotypes and determinants in a South African birth cohort: longitudinal analysis of the Drakenstein Child Health Study","volume":"7","author":"McCready","year":"2023","journal-title":"Lancet Child Adolesc Health"},{"key":"2026071700214625500_ciaf184-B19","doi-asserted-by":"crossref","first-page":"e00245-10","DOI":"10.1128\/mBio.00245-10","article-title":"Microbial communities of the upper respiratory tract and otitis media in children","volume":"2","author":"Laufer","year":"2011","journal-title":"mBio"},{"key":"2026071700214625500_ciaf184-B20","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1016\/j.chom.2015.03.008","article-title":"The infant nasopharyngeal microbiome impacts severity of lower respiratory infection and risk of asthma development","volume":"17","author":"Teo","year":"2015","journal-title":"Cell Host Microbe"},{"key":"2026071700214625500_ciaf184-B21","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1038\/s41564-021-01043-2","article-title":"Early-life viral infections are associated with disadvantageous immune and microbiota profiles and recurrent respiratory infections","volume":"7","author":"de Steenhuijsen Piters","year":"2022","journal-title":"Nat Microbiol"},{"key":"2026071700214625500_ciaf184-B22","doi-asserted-by":"crossref","first-page":"e211","DOI":"10.1097\/INF.0000000000001607","article-title":"The nasopharyngeal microbiota of children with respiratory infections in Botswana","volume":"36","author":"Kelly","year":"2017","journal-title":"Pediatr Infect Dis J"},{"key":"2026071700214625500_ciaf184-B23","doi-asserted-by":"crossref","first-page":"804935","DOI":"10.3389\/fmicb.2021.804935","article-title":"Corynebacterium species inhibit Streptococcus pneumoniae colonization and infection of the mouse airway","volume":"12","author":"Horn","year":"2022","journal-title":"Front Microbiol"},{"key":"2026071700214625500_ciaf184-B24","doi-asserted-by":"crossref","first-page":"e0180630","DOI":"10.1371\/journal.pone.0180630","article-title":"Nasopharyngeal microbiota in infants and changes during viral upper respiratory tract infection and acute otitis media","volume":"12","author":"Chonmaitree","year":"2017","journal-title":"PLoS One"},{"key":"2026071700214625500_ciaf184-B25","doi-asserted-by":"crossref","first-page":"51ra124","DOI":"10.1126\/scitranslmed.3003783","article-title":"Sinus microbiome diversity depletion and Corynebacterium tuberculostearicum enrichment mediates rhinosinusitis","volume":"4","author":"Abreu","year":"2012","journal-title":"Sci Transl Med"},{"key":"2026071700214625500_ciaf184-B26","doi-asserted-by":"crossref","first-page":"e1316","DOI":"10.1016\/S2214-109X(20)30251-5","article-title":"Early-life respiratory syncytial virus lower respiratory tract infection in a South African birth cohort: epidemiology and effect on lung health","volume":"8","author":"Zar","year":"2020","journal-title":"Lancet Glob Health"},{"key":"2026071700214625500_ciaf184-B27","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1016\/S0140-6736(19)30721-4","article-title":"Causes of severe pneumonia requiring hospital admission in children without HIV infection from Africa and Asia: the PERCH multi-country case-control study","volume":"394","author":"The Pneumonia Etiology Research for Child Health (PERCH) Study Group","year":"2019","journal-title":"Lancet"},{"key":"2026071700214625500_ciaf184-B28","doi-asserted-by":"crossref","first-page":"49","DOI":"10.5588\/ijtld.22.0428","article-title":"Cytomegalovirus viral load as predictor of the clinical course of hypoxic pneumonia in children","volume":"27","author":"Lakhan","year":"2023","journal-title":"Int J Tuberc Lung Dis"},{"key":"2026071700214625500_ciaf184-B29","doi-asserted-by":"crossref","first-page":"e909","DOI":"10.1016\/S2214-109X(20)30205-9","article-title":"Initial findings from a novel population-based child mortality surveillance approach: a descriptive study","volume":"8","author":"Taylor","year":"2020","journal-title":"Lancet Glob Health"},{"key":"2026071700214625500_ciaf184-B30","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1093\/infdis\/jiab481","article-title":"Nasopharyngeal codetection of Haemophilus influenzae and Streptococcus pneumoniae shapes respiratory syncytial virus disease outcomes in children","volume":"225","author":"Diaz-Diaz","year":"2022","journal-title":"J Infect Dis"},{"key":"2026071700214625500_ciaf184-B31","doi-asserted-by":"crossref","first-page":"eaba9301","DOI":"10.1126\/science.aba9301","article-title":"Neutrophilic inflammation in the respiratory mucosa predisposes to RSV infection","volume":"370","author":"Habibi","year":"2020","journal-title":"Science"},{"key":"2026071700214625500_ciaf184-B32","doi-asserted-by":"crossref","first-page":"112064","DOI":"10.1016\/j.celrep.2023.112064","article-title":"Staphylococcus aureus stimulates neutrophil itaconate production that suppresses the oxidative burst","volume":"42","author":"Tomlinson","year":"2023","journal-title":"Cell Rep"},{"key":"2026071700214625500_ciaf184-B33","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1186\/s40168-023-01563-5","article-title":"Succession and determinants of the early life nasopharyngeal microbiota in a South African birth cohort","volume":"11","author":"Claassen-Weitz","year":"2023","journal-title":"Microbiome"},{"key":"2026071700214625500_ciaf184-B34","doi-asserted-by":"crossref","first-page":"e1740","DOI":"10.1016\/S2214-109X(21)00407-1","article-title":"Cytomegalovirus acquisition in infancy and the risk of tuberculosis disease in childhood: a longitudinal birth cohort study in Cape Town, South Africa","volume":"9","author":"Martinez","year":"2021","journal-title":"Lancet Glob Health"},{"key":"2026071700214625500_ciaf184-B35","doi-asserted-by":"crossref","first-page":"e13658","DOI":"10.1111\/pai.13658","article-title":"Early-life cytomegalovirus infection is associated with gut microbiota perturbations and increased risk of atopy","volume":"33","author":"Sbihi","year":"2022","journal-title":"Pediatr Allergy Immunol"},{"key":"2026071700214625500_ciaf184-B36","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1093\/cid\/cis598","article-title":"Rapid molecular diagnosis of pulmonary tuberculosis in children using nasopharyngeal specimens","volume":"55","author":"Zar","year":"2012","journal-title":"Clin Infect Dis"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciaf184\/62944920\/ciaf184.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/81\/6\/e668\/62944920\/ciaf184.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/81\/6\/e668\/62944920\/ciaf184.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T04:21:57Z","timestamp":1784262117000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/81\/6\/e668\/8115313"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,17]]},"references-count":36,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,4,17]]},"published-print":{"date-parts":[[2026,2,4]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciaf184","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,12,15]]},"published":{"date-parts":[[2025,4,17]]}}}