{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T23:17:49Z","timestamp":1787699869399,"version":"build-2784847793"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Centers for Disease Control and Prevention Safety and Healthcare Epidemiology Prevention Research Development","award":["75D30121D12775"],"award-info":[{"award-number":["75D30121D12775"]}]},{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["K08HS028854"],"award-info":[{"award-number":["K08HS028854"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Respiratory illness is the most frequent reason for unnecessary antibiotic use among hospitalized adults. In randomized trials, procalcitonin and respiratory virus testing without guidance on test interpretation do not influence antibiotic decision-making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a pragmatic, randomized, controlled trial of antimicrobial stewardship-guided test interpretation versus usual care among hospitalized adults receiving antibiotics for suspected respiratory infection with either low procalcitonin or positive respiratory virus testing at 2 hospitals. The intervention involved a templated note in the electronic health record interpreting test results in terms of the post-test probability of bacterial pneumonia and antibiotic decision-making. When probability of bacterial pneumonia was low, discontinuation of antibiotic therapy was recommended. The primary outcome was in-hospital antibiotic days of therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between 1 November 2023 and 10 January 2025, 107 adults were enrolled, including 65% with low procalcitonin, 30% with positive respiratory virus testing, and 5% with both. The intervention decreased antibiotic use by an average of 4.1 in-hospital days of therapy (7.5 versus 11.6, P = .006). All respiratory antibiotics were discontinued within 5 days of initiation for 76% of intervention patients versus 49% with usual care (P = .004). Length of stay (5.5 days intervention versus 6.6 days usual care, P = .16) and 30-day readmission (7% intervention versus 19% usual care, P = .079) did not significantly differ between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this proof-of-concept study, antimicrobial stewardship-guided interpretation of laboratory tests for viral infection using a simple template safely decreased unnecessary antibiotic use for hospitalized adults with community-acquired respiratory illness.<\/jats:p>\n                    <jats:p>Clinical Trial Registration. NCT05976581.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciag126","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T12:55:36Z","timestamp":1771505736000},"page":"954-961","source":"Crossref","is-referenced-by-count":4,"title":["Using Probability of Community-Acquired Pneumonia to Tailor Antimicrobials Among Inpatients: A Pragmatic, Randomized Trial"],"prefix":"10.1093","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2442-0654","authenticated-orcid":false,"given":"Jonathan D","family":"Baghdadi","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Public Health, University of Maryland School of Medicine , Baltimore, Maryland ,","place":["USA"]},{"name":"University of Maryland Institute for Health Computing , North Bethesda, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2193-1560","authenticated-orcid":false,"given":"Anthony D","family":"Harris","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health, University of Maryland School of Medicine , Baltimore, Maryland ,","place":["USA"]},{"name":"University of Maryland Institute for Health Computing , North Bethesda, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2377-5971","authenticated-orcid":false,"given":"Lisa","family":"Pineles","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health, University of Maryland School of Medicine , Baltimore, Maryland ,","place":["USA"]},{"name":"University of Maryland Institute for Health Computing , North Bethesda, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4691-5743","authenticated-orcid":false,"given":"Shatha","family":"Al-Shanqeeti","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Maryland School of Medicine , Baltimore, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danica","family":"Palacio","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Penn Medicine , Philadelphia, Pennsylvania ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Drew W","family":"Charles","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease, Medical University of South Carolina , Charleston, South Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6644-6684","authenticated-orcid":false,"given":"Emily","family":"Heil","sequence":"additional","affiliation":[{"name":"University of Maryland School of Pharmacy , Baltimore, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6895-604X","authenticated-orcid":false,"given":"Kimberly C","family":"Claeys","sequence":"additional","affiliation":[{"name":"University of Maryland School of Pharmacy , Baltimore, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline T","family":"Bork","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention , Atlanta, Georgia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1332-2828","authenticated-orcid":false,"given":"Sarah","family":"Sommerkamp","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Maryland School of Medicine , Baltimore, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8301-4421","authenticated-orcid":false,"given":"R Gentry","family":"Wilkerson","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Maryland School of Medicine , Baltimore, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald","family":"Godwin","sequence":"additional","affiliation":[{"name":"University of Maryland Medical System , Linthicum, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5665-6998","authenticated-orcid":false,"given":"Mark E","family":"Sutherland","sequence":"additional","affiliation":[{"name":"Division of Critical Care, Departments of Emergency Medicine and Internal Medicine, University of Maryland School of Medicine , Baltimore, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J Kristie","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health, University of Maryland School of Medicine , Baltimore, Maryland ,","place":["USA"]},{"name":"Department of Pathology, University of Maryland School of Medicine , Baltimore, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2933-6208","authenticated-orcid":false,"given":"Daniel J","family":"Morgan","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health, University of Maryland School of Medicine , Baltimore, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"key":"2026070722325357500_ciag126-B1","doi-asserted-by":"crossref","first-page":"1438","DOI":"10.1001\/jama.2014.12923","article-title":"Prevalence of antimicrobial use in US acute care hospitals, May-September 2011","volume":"312","author":"Magill","year":"2014","journal-title":"JAMA"},{"key":"2026070722325357500_ciag126-B2","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1056\/NEJMoa1500245","article-title":"Community-acquired pneumonia requiring hospitalization among U.S. adults","volume":"373","author":"Jain","year":"2015","journal-title":"New Engl J Med"},{"key":"2026070722325357500_ciag126-B3","doi-asserted-by":"crossref","first-page":"107841","DOI":"10.1016\/j.ijid.2025.107841","article-title":"Comparing viral, bacterial and co-infections in community- acquired pneumonia, a retrospective cohort study","volume":"154","author":"Waldeck","year":"2025","journal-title":"Int J Infect Dis"},{"key":"2026070722325357500_ciag126-B4","doi-asserted-by":"crossref","first-page":"ofaa066","DOI":"10.1093\/ofid\/ofaa066","article-title":"Influenza and bacterial coinfection in adults with community-acquired pneumonia admitted to conventional wards: risk factors, clinical features, and outcomes","volume":"7","author":"Abelenda-Alonso","year":"2020","journal-title":"Open Forum Infect Dis"},{"key":"2026070722325357500_ciag126-B5","author":"Jones"},{"key":"2026070722325357500_ciag126-B6","doi-asserted-by":"crossref","first-page":"e45","DOI":"10.1164\/rccm.201908-1581ST","article-title":"Diagnosis and treatment of adults with community-acquired pneumonia. An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America","volume":"200","author":"Metlay","year":"2019","journal-title":"Am J Respir Crit Care Med"},{"key":"2026070722325357500_ciag126-B7","author":"Albarillo"},{"key":"2026070722325357500_ciag126-B8","doi-asserted-by":"crossref","first-page":"e137","DOI":"10.1017\/ash.2023.408","article-title":"Developing a diagnosis calculator to estimate the probability of bacterial pneumonia","volume":"3","author":"Baghdadi","year":"2023","journal-title":"Antimicrob Stewardship Healthcare Epidemiol"},{"issue":"12):","key":"2026070722325357500_ciag126-B9","doi-asserted-by":"crossref","first-page":"1462","DOI":"10.1017\/ice.2024.163","article-title":"Changes in use of multiplex respiratory panel testing during the COVID-19 pandemic","volume":"45","author":"Baghdadi","year":"2024","journal-title":"Infect Control Hosp Epidemiol"},{"key":"2026070722325357500_ciag126-B10","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/S2213-2600(17)30120-0","article-title":"Routine molecular point-of-care testing for respiratory viruses in adults presenting to hospital with acute respiratory illness (ResPOC): a pragmatic, open-label, randomised controlled trial","volume":"5","author":"Brendish","year":"2017","journal-title":"Lancet Resp Med"},{"key":"2026070722325357500_ciag126-B11","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1186\/s12879-017-2784-z","article-title":"Multiplex PCR point of care testing versus routine, laboratory-based testing in the treatment of adults with respiratory tract infections: a quasi-randomised study assessing impact on length of stay and antimicrobial use","volume":"17","author":"Andrews","year":"2017","journal-title":"BMC Infect Dis"},{"key":"2026070722325357500_ciag126-B12","doi-asserted-by":"crossref","first-page":"ofz481","DOI":"10.1093\/ofid\/ofz481","article-title":"Rapid multiplex testing for upper respiratory pathogens in the emergency department: a randomized controlled trial","volume":"6","author":"May","year":"2019","journal-title":"Open Forum Infect Dis"},{"key":"2026070722325357500_ciag126-B13","doi-asserted-by":"crossref","first-page":"7098","DOI":"10.1038\/s41467-024-51547-8","article-title":"Multiplex real-time PCR in non-invasive respiratory samples to reduce antibiotic use in community-acquired pneumonia: a randomised trial","volume":"15","author":"Abelenda-Alonso","year":"2024","journal-title":"Nat Commun"},{"key":"2026070722325357500_ciag126-B14","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1016\/j.cmi.2023.07.031","article-title":"Point-of-care multiplex molecular diagnosis coupled with procalcitonin-guided algorithm for antibiotic stewardship in lower respiratory tract infection: a randomized controlled trial","volume":"29","author":"Velly","year":"2023","journal-title":"Clin Microbiol Infect"},{"key":"2026070722325357500_ciag126-B15","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/1471-2334-7-10","article-title":"Diagnostic and prognostic accuracy of clinical and laboratory parameters in community-acquired pneumonia","volume":"7","author":"M\u00fcller","year":"2007","journal-title":"BMC Infect Dis"},{"key":"2026070722325357500_ciag126-B16","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.annemergmed.2008.01.003","article-title":"Risk prediction with procalcitonin and clinical rules in community-acquired pneumonia","volume":"52","author":"Huang","year":"2008","journal-title":"Ann Emerg Med"},{"key":"2026070722325357500_ciag126-B17","doi-asserted-by":"crossref","first-page":"1692","DOI":"10.1093\/infdis\/jiv252","article-title":"Serum procalcitonin measurement and viral testing to guide antibiotic use for respiratory infections in hospitalized adults: a randomized controlled trial","volume":"212","author":"Branche","year":"2015","journal-title":"J Infect Dis"},{"key":"2026070722325357500_ciag126-B18","first-page":"Cd007498","article-title":"Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections","volume":"2012","author":"Schuetz","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"2026070722325357500_ciag126-B19","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1056\/NEJMoa1802670","article-title":"Procalcitonin-guided use of antibiotics for lower respiratory tract infection","volume":"379","author":"Huang","year":"2018","journal-title":"New Engl J Med"},{"key":"2026070722325357500_ciag126-B20","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1093\/cid\/ciz545","article-title":"Procalcitonin to distinguish viral from bacterial pneumonia: a systematic review and meta-analysis","volume":"70","author":"Kamat","year":"2020","journal-title":"Clin Infect Dis"},{"issue":"4):","key":"2026070722325357500_ciag126-B21","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1093\/labmed\/lmae108","article-title":"Diagnostic stewardship of procalcitonin testing by implementation of computer-based decision support","volume":"56","author":"Belfiore","year":"2025","journal-title":"Lab Med"},{"key":"2026070722325357500_ciag126-B22","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1017\/ice.2023.5","article-title":"Principles of diagnostic stewardship: a practical guide from the Society for Healthcare Epidemiology of America Diagnostic Stewardship Task Force","volume":"44","author":"Fabre","year":"2023","journal-title":"Infect Control Hosp Epidemiol"},{"key":"2026070722325357500_ciag126-B23","doi-asserted-by":"crossref","first-page":"1823","DOI":"10.1017\/ice.2023.72","article-title":"Diagnostic stewardship to support optimal use of multiplex molecular respiratory panels: a survey from the Society for Healthcare Epidemiology of America Research Network","volume":"44","author":"Baghdadi","year":"2023","journal-title":"Infect Control Hosp Epidemiol"},{"key":"2026070722325357500_ciag126-B24","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1001\/jamainternmed.2013.1589","article-title":"A cluster randomized trial of decision support strategies for reducing antibiotic use in acute bronchitis","volume":"173","author":"Gonzales","year":"2013","journal-title":"JAMA Intern Med"},{"key":"2026070722325357500_ciag126-B25","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1016\/j.ajem.2006.11.031","article-title":"Vital-sign abnormalities as predictors of pneumonia in adults with acute cough illness","volume":"25","author":"Nolt","year":"2007","journal-title":"Am J Emergency Med"},{"key":"2026070722325357500_ciag126-B26","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1099\/jmm.0.067108-0","article-title":"The value of signs and symptoms in differentiating between bacterial, viral and mixed aetiology in patients with community-acquired pneumonia","volume":"63","author":"Huijskens","year":"2014","journal-title":"J Med Microbiol"},{"key":"2026070722325357500_ciag126-B27","doi-asserted-by":"crossref","first-page":"1202","DOI":"10.1161\/STROKEAHA.114.007843","article-title":"How is pneumonia diagnosed in clinical stroke research? A systematic review and meta-analysis","volume":"46","author":"Kishore","year":"2015","journal-title":"Stroke"},{"key":"2026070722325357500_ciag126-B28","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.1016\/j.rmed.2012.04.008","article-title":"The natural history of community-acquired pneumonia in COPD patients: a population database analysis","volume":"106","author":"M\u00fcllerova","year":"2012","journal-title":"Respir Med"},{"key":"2026070722325357500_ciag126-B29","doi-asserted-by":"crossref","first-page":"e174","DOI":"10.1097\/MD.0000000000000174","article-title":"Risk of pneumonia among patients with chronic kidney disease in outpatient and inpatient settings: a nationwide population-based study","volume":"93","author":"Chou","year":"2014","journal-title":"Medicine (Baltimore)"},{"key":"2026070722325357500_ciag126-B30","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1086\/511640","article-title":"Measurement of adult antibacterial drug use in 130 US hospitals: comparison of defined daily dose and days of therapy","volume":"44","author":"Polk","year":"2007","journal-title":"Clin Infect Dis"},{"key":"2026070722325357500_ciag126-B31","doi-asserted-by":"crossref","first-page":"e51","DOI":"10.1093\/cid\/ciw118","article-title":"Implementing an antibiotic stewardship program: guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America","volume":"62","author":"Barlam","year":"2016","journal-title":"Clin Infect Dis"},{"key":"2026070722325357500_ciag126-B32","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1093\/cid\/ciab1034","article-title":"Days of antibiotic spectrum coverage: a novel metric for inpatient antibiotic consumption","volume":"75","author":"Kakiuchi","year":"2022","journal-title":"Clin Infect Dis"},{"key":"2026070722325357500_ciag126-B33","doi-asserted-by":"crossref","first-page":"HO2","DOI":"10.7326\/M21-1913","article-title":"Annals for hospitalists inpatient notes\u2014a critical look at procalcitonin testing in pneumonia","volume":"174","author":"Pulia","year":"2021","journal-title":"Ann Intern Med"},{"key":"2026070722325357500_ciag126-B34","doi-asserted-by":"crossref","first-page":"2744","DOI":"10.1093\/cid\/ciaa508","article-title":"Molecular testing for acute respiratory tract infections: clinical and diagnostic recommendations from the IDSA's Diagnostics Committee","volume":"71","author":"Hanson","year":"2020","journal-title":"Clin Infect Dis"},{"key":"2026070722325357500_ciag126-B35","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.1001\/jama.2023.1678","article-title":"Diagnostic stewardship to prevent diagnostic error","volume":"329","author":"Morgan","year":"2023","journal-title":"JAMA"},{"key":"2026070722325357500_ciag126-B36","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1017\/ice.2020.400","article-title":"Conditional reflex to urine culture: evaluation of a diagnostic stewardship intervention within the Veterans' Affairs and Centers for Disease Control and Prevention Practice-based Research Network","volume":"42","author":"Claeys","year":"2021","journal-title":"Infect Control Hosp Epidemiol"},{"key":"2026070722325357500_ciag126-B37","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1017\/ice.2018.53","article-title":"Reduced Clostridium difficile tests and laboratory-identified events with a computerized clinical decision support tool and financial incentive","volume":"39","author":"Madden","year":"2018","journal-title":"Infect Control Hosp Epidemiol"},{"key":"2026070722325357500_ciag126-B38","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1017\/ice.2020.12","article-title":"The impact of an electronic medical record nudge on reducing testing for hospital-onset Clostridioides difficile infection","volume":"41","author":"Howard-Anderson","year":"2020","journal-title":"Infect Control Hosp Epidemiol"},{"key":"2026070722325357500_ciag126-B39","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1093\/cid\/civ447","article-title":"Randomized trial of rapid multiplex polymerase chain reaction\u2013based blood culture identification and susceptibility testing","volume":"61","author":"Banerjee","year":"2015","journal-title":"Clin Infect Dis"},{"key":"2026070722325357500_ciag126-B40","doi-asserted-by":"crossref","first-page":"ofy162","DOI":"10.1093\/ofid\/ofy162","article-title":"Microbiology comment nudge improves pneumonia prescribing","volume":"5","author":"Musgrove","year":"2018","journal-title":"Open Forum Infect Dis"},{"key":"2026070722325357500_ciag126-B41","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1016\/S0140-6736(21)00313-5","article-title":"Discontinuing \u03b2-lactam treatment after 3 days for patients with community-acquired pneumonia in non-critical care wards (PTC): a double-blind, randomised, placebo-controlled, non-inferiority trial","volume":"397","author":"Dinh","year":"2021","journal-title":"The Lancet"},{"key":"2026070722325357500_ciag126-B42","doi-asserted-by":"crossref","first-page":"1282","DOI":"10.1001\/jama.2024.14796","article-title":"Community-acquired pneumonia: a review","volume":"332","author":"Vaughn","year":"2024","journal-title":"JAMA"},{"key":"2026070722325357500_ciag126-B43","doi-asserted-by":"crossref","first-page":"e2010700","DOI":"10.1001\/jamanetworkopen.2020.10700","article-title":"Prevalence of clinical signs within reference ranges among hospitalized patients prescribed antibiotics for pneumonia","volume":"3","author":"Klompas","year":"2020","journal-title":"JAMA Netw Open"},{"key":"2026070722325357500_ciag126-B44","doi-asserted-by":"crossref","first-page":"1412","DOI":"10.1093\/cid\/ciad743","article-title":"Excellence in antibiotic stewardship: a mixed-methods study comparing high-, medium-, and low-performing hospitals","volume":"78","author":"Vaughn","year":"2024","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\/ciag126\/67338457\/ciag126.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/82\/6\/954\/67338457\/ciag126.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/82\/6\/954\/67338457\/ciag126.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T02:33:34Z","timestamp":1783478014000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/82\/6\/954\/8519125"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,13]]},"references-count":44,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,3,13]]},"published-print":{"date-parts":[[2026,7,8]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciag126","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,6,15]]},"published":{"date-parts":[[2026,3,13]]}}}