{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T19:58:22Z","timestamp":1784231902160,"version":"3.55.0"},"reference-count":49,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2023,5,24]],"date-time":"2023-05-24T00:00:00Z","timestamp":1684886400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Sciensano"},{"DOI":"10.13039\/501100003130","name":"Research Foundation Flanders","doi-asserted-by":"publisher","award":["G08818N"],"award-info":[{"award-number":["G08818N"]}],"id":[{"id":"10.13039\/501100003130","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Herpes simplex virus 1 can cause severe infections in individuals who are immunocompromised. In these patients, emergence of drug resistance mutations causes difficulties in infection management.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Seventeen herpes simplex virus 1 isolates were obtained from orofacial\/anogenital lesions in a patient with leaky severe combined immunodeficiency over 7 years, before and after stem cell transplantation. Spatial\/temporal evolution of drug resistance was characterized genotypically\u2014with Sanger and next-generation sequencing of viral thymidine kinase (TK) and DNA polymerase (DP)\u2014and phenotypically. CRISPR\/Cas9 was used to introduce the novel DP Q727R mutation, and dual infection-competition assays were performed to assess viral fitness.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Isolates had identical genetic backgrounds, suggesting that orofacial\/anogenital infections derived from the same virus lineage. Eleven isolates proved heterogeneous TK virus populations by next-generation sequencing, undetectable by Sanger sequencing. Thirteen isolates were acyclovir resistant due to TK mutations, and the Q727R isolate additionally exhibited foscarnet\/adefovir resistance. Recombinant Q727R mutant virus showed multidrug resistance and increased fitness under antiviral pressure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Long-term follow-up of a patient with severe combined immunodeficiency revealed virus evolution and frequent reactivation of wild-type and TK mutant strains, mostly as heterogeneous populations. The DP Q727R resistance phenotype was confirmed with CRISPR\/Cas9, a useful tool to validate novel drug resistance mutations.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiad184","type":"journal-article","created":{"date-parts":[[2023,5,24]],"date-time":"2023-05-24T22:41:45Z","timestamp":1684968105000},"page":"1505-1515","source":"Crossref","is-referenced-by-count":12,"title":["A Herpes Simplex Virus 1 DNA Polymerase Multidrug Resistance Mutation Identified in a Patient With Immunodeficiency and Confirmed by Gene Editing"],"prefix":"10.1093","volume":"228","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2339-4834","authenticated-orcid":false,"given":"Hanna Helena","family":"Schalkwijk","sequence":"first","affiliation":[{"name":"Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, KU Leuven"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aspasia","family":"Georgala","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Jules Bordet Institute, Universit\u00e9 Libre de Bruxelles, Brussels"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Gillemot","sequence":"additional","affiliation":[{"name":"Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, KU Leuven"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arturo","family":"Temblador","sequence":"additional","affiliation":[{"name":"Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, KU Leuven"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitri","family":"Topalis","sequence":"additional","affiliation":[{"name":"Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, KU Leuven"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Wittnebel","sequence":"additional","affiliation":[{"name":"Department of Hematology, Jules Bordet Institute, Universit\u00e9 Libre de Bruxelles , Brussels , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2609-4896","authenticated-orcid":false,"given":"Graciela","family":"Andrei","sequence":"additional","affiliation":[{"name":"Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, KU Leuven"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Snoeck","sequence":"additional","affiliation":[{"name":"Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, KU Leuven"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,5,24]]},"reference":[{"key":"2023112802485295200_jiad184-B1","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1097\/01.OLQ.0000092387.58746.C7","article-title":"Increasing proportion of herpes simplex virus type 1 as a cause of genital herpes infection in college students","volume":"30","author":"Roberts","year":"2003","journal-title":"Sex Transm Dis"},{"key":"2023112802485295200_jiad184-B2","doi-asserted-by":"crossref","first-page":"315","DOI":"10.2471\/BLT.19.237149","article-title":"Herpes simplex virus: global infection prevalence and incidence estimates, 2016","volume":"98","author":"James","year":"2020","journal-title":"Bull World Health Organ"},{"key":"2023112802485295200_jiad184-B3","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1086\/314052","article-title":"Resistant herpes simplex virus type 1 infection: an emerging concern after allogeneic stem cell transplantation","volume":"31","author":"Chen","year":"2000","journal-title":"Clin Infect Dis"},{"key":"2023112802485295200_jiad184-B4","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1093\/infdis\/142.3.338","article-title":"Infection with herpes simplex virus and cell-mediated immunity after marrow transplant","volume":"142","author":"Meyers","year":"1980","journal-title":"J Infect Dis"},{"key":"2023112802485295200_jiad184-B5","doi-asserted-by":"crossref","first-page":"3131","DOI":"10.1016\/j.ejca.2009.08.010","article-title":"Antiviral prophylaxis in haematological patients: systematic review and meta-analysis","volume":"45","author":"Yahav","year":"2009","journal-title":"Eur J Cancer"},{"key":"2023112802485295200_jiad184-B6","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1038\/nrmicro975","article-title":"Antivirals and antiviral strategies","volume":"2","author":"De Clercq","year":"2004","journal-title":"Nat Rev Microbiol"},{"key":"2023112802485295200_jiad184-B7","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1128\/AAC.00615-10","article-title":"Resistance of herpes simplex viruses to nucleoside analogues: mechanisms, prevalence, and management","volume":"55","author":"Piret","year":"2011","journal-title":"Antimicrob Agents Chemother"},{"key":"2023112802485295200_jiad184-B8","doi-asserted-by":"crossref","DOI":"10.1016\/j.bcp.2022.115322","article-title":"Acyclovir resistance in herpes simplex viruses: prevalence and therapeutic alternatives","volume":"206","author":"Schalkwijk","year":"2022","journal-title":"Biochem Pharmacol"},{"key":"2023112802485295200_jiad184-B9","doi-asserted-by":"crossref","first-page":"4938","DOI":"10.1128\/AAC.00977-15","article-title":"Sequence analysis of herpes simplex virus 1 thymidine kinase and DNA polymerase genes from over 300 clinical isolates from 1973 to 2014 finds novel mutations that may be relevant for development of antiviral resistance","volume":"59","author":"Schmidt","year":"2015","journal-title":"Antimicrob Agents Chemother"},{"key":"2023112802485295200_jiad184-B10","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1177\/135965350701200502","article-title":"DNA polymerase mutations in drug-resistant herpes simplex virus mutants determine in vivo neurovirulence and drug-enzyme interactions","volume":"12","author":"Andrei","year":"2007","journal-title":"Antivir Ther"},{"key":"2023112802485295200_jiad184-B11","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1093\/clinids\/18.4.570","article-title":"Successful treatment of progressive mucocutaneous infection due to acyclovir- and foscarnet-resistant herpes simplex virus with (S)-1-(3-hydroxy-2-phosphonylmethoxypropyl)cytosine (HPMPC)","volume":"18","author":"Snoeck","year":"1994","journal-title":"Clin Infect Dis"},{"key":"2023112802485295200_jiad184-B12","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1177\/1078155212448408","article-title":"Successful clearance of cutaneous acyclovir-resistant, foscarnet-refractory herpes virus lesions with topical cidofovir in an allogeneic hematopoietic stem cell transplant patient","volume":"19","author":"Muluneh","year":"2013","journal-title":"J Oncol Pharm Pract"},{"key":"2023112802485295200_jiad184-B13","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1128\/CMR.16.1.114-128.2003","article-title":"Herpes simplex virus resistance to acyclovir and penciclovir after two decades of antiviral therapy","volume":"16","author":"Bacon","year":"2003","journal-title":"Clin Microbiol Rev"},{"key":"2023112802485295200_jiad184-B14","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.jcv.2017.10.002","article-title":"A European multi-centre external quality assessment (EQA) study on phenotypic and genotypic methods used for herpes simplex virus (HSV) drug resistance testing","volume":"96","author":"Afshar","year":"2017","journal-title":"J Clin Virol"},{"key":"2023112802485295200_jiad184-B15","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1093\/jac\/dkv285","article-title":"Database on natural polymorphisms and resistance-related non-synonymous mutations in thymidine kinase and DNA polymerase genes of herpes simplex virus types 1 and 2","volume":"71","author":"Sauerbrei","year":"2016","journal-title":"J Antimicrob Chemother"},{"key":"2023112802485295200_jiad184-B16","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.antiviral.2014.08.013","article-title":"Resistance of herpes simplex viruses to acyclovir: an update from a ten-year survey in France","volume":"111","author":"Frobert","year":"2014","journal-title":"Antiviral Res"},{"key":"2023112802485295200_jiad184-B17","doi-asserted-by":"crossref","first-page":"3153","DOI":"10.1093\/jac\/dkac297","article-title":"Heterogeneity and viral replication fitness of HSV-1 clinical isolates with mutations in the thymidine kinase and DNA polymerase","volume":"77","author":"Schalkwijk","year":"2022","journal-title":"J Antimicrob Chemother"},{"key":"2023112802485295200_jiad184-B18","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.3390\/cancers11091260","article-title":"CRISPR\/Cas9 editing of the polyomavirus tumor antigens inhibits Merkel cell carcinoma growth in vitro","volume":"11","author":"Temblador","year":"2019","journal-title":"Cancers (Basel)"},{"key":"2023112802485295200_jiad184-B19","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1093\/infdis\/jit019","article-title":"Heterogeneity and evolution of thymidine kinase and DNA polymerase mutants of herpes simplex virus type 1: implications for antiviral therapy","volume":"207","author":"Andrei","year":"2013","journal-title":"J Infect Dis"},{"key":"2023112802485295200_jiad184-B20","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.jcv.2013.10.025","article-title":"Acyclovir-resistant herpes simplex encephalitis in a patient treated with anti-tumor necrosis factor-\u03b1 monoclonal antibodies","volume":"59","author":"Schepers","year":"2014","journal-title":"J Clin Virol"},{"key":"2023112802485295200_jiad184-B21","doi-asserted-by":"crossref","first-page":"34531","DOI":"10.1038\/srep34531","article-title":"Increasing the efficiency of CRISPR\/Cas9-mediated precise genome editing of HSV-1 virus in human cells","volume":"6","author":"Lin","year":"2016","journal-title":"Sci Rep"},{"key":"2023112802485295200_jiad184-B22","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1038\/nbt.3481","article-title":"Enhancing homology-directed genome editing by catalytically active and inactive CRISPR-Cas9 using asymmetric donor DNA","volume":"34","author":"Richardson","year":"2016","journal-title":"Nat Biotechnol"},{"key":"2023112802485295200_jiad184-B23","doi-asserted-by":"crossref","first-page":"18193","DOI":"10.1074\/jbc.M602414200","article-title":"Crystal structure of the herpes simplex virus 1 DNA polymerase","volume":"281","author":"Liu","year":"2006","journal-title":"J Biol Chem"},{"key":"2023112802485295200_jiad184-B24","first-page":"9530","article-title":"Distribution and effects of amino acid changes in drug-resistant \u03b1 and \u03b2 herpesviruses DNA polymerase","volume":"44","author":"Topalis","year":"2016","journal-title":"Nucleic Acids Res"},{"key":"2023112802485295200_jiad184-B25","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1128\/JVI.01987-13","article-title":"Evolution and diversity in human herpes simplex virus genomes","volume":"88","author":"Szpara","year":"2014","journal-title":"J Virol"},{"key":"2023112802485295200_jiad184-B26","doi-asserted-by":"crossref","first-page":"13666","DOI":"10.1038\/s41598-017-13936-6","article-title":"Inferred father-to-son transmission of herpes simplex virus results in near-perfect preservation of viral genome identity and in vivo phenotypes","volume":"7","author":"Pandey","year":"2017","journal-title":"Sci Rep"},{"key":"2023112802485295200_jiad184-B27","doi-asserted-by":"crossref","first-page":"2035","DOI":"10.1093\/infdis\/jiaa020","article-title":"Evaluation of genotypic antiviral resistance testing as an alternative to phenotypic testing in a patient with DOCK8 deficiency and severe HSV-1 disease","volume":"221","author":"Casto","year":"2020","journal-title":"J Infect Dis"},{"key":"2023112802485295200_jiad184-B28","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1146\/annurev-virology-010320-061642","article-title":"Within-host viral diversity: a window into viral evolution","volume":"7","author":"Lauring","year":"2020","journal-title":"Annu Rev Virol"},{"key":"2023112802485295200_jiad184-B29","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/bs.aivir.2021.05.001","article-title":"A holistic perspective on herpes simplex virus (HSV) ecology and evolution","volume":"110","author":"Rathbun","year":"2021","journal-title":"Adv Virus Res"},{"key":"2023112802485295200_jiad184-B30","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.jviromet.2017.10.019","article-title":"Application of next-generation sequencing to detect acyclovir-resistant herpes simplex virus type 1 variants at low frequency in thymidine kinase gene of the isolates recovered from patients with hematopoietic stem cell transplantation","volume":"251","author":"Fujii","year":"2018","journal-title":"J Virol Methods"},{"key":"2023112802485295200_jiad184-B31","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1186\/1471-2164-13-341","article-title":"A tale of three next generation sequencing platforms: comparison of Ion Torrent, Pacific Biosciences and Illumina MiSeq sequencers","volume":"13","author":"Quail","year":"2012","journal-title":"BMC Genomics"},{"key":"2023112802485295200_jiad184-B32","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.antiviral.2019.05.017","article-title":"Added value of ultra-deep sequencing (UDS) approach for detection of genotypic antiviral resistance of herpes simplex virus (HSV)","volume":"168","author":"Mercier-Darty","year":"2019","journal-title":"Antiviral Res"},{"key":"2023112802485295200_jiad184-B33","doi-asserted-by":"crossref","first-page":"6817","DOI":"10.1128\/JVI.00166-07","article-title":"Diverse herpes simplex virus type 1 thymidine kinase mutants in individual human neurons and Ganglia","volume":"81","author":"Wang","year":"2007","journal-title":"J Virol"},{"key":"2023112802485295200_jiad184-B34","doi-asserted-by":"crossref","first-page":"3495","DOI":"10.1099\/vir.0.82223-0","article-title":"Competition and complementation between thymidine kinase-negative and wild-type herpes simplex virus during co-infection of mouse trigeminal ganglia","volume":"87","author":"Chen","year":"2006","journal-title":"J Gen Virol"},{"key":"2023112802485295200_jiad184-B35","doi-asserted-by":"crossref","first-page":"8356","DOI":"10.1128\/JVI.00484-07","article-title":"Expression of extremely low levels of thymidine kinase from an acyclovir-resistant herpes simplex virus mutant supports reactivation from latently infected mouse trigeminal ganglia","volume":"81","author":"Besecker","year":"2007","journal-title":"J Virol"},{"key":"2023112802485295200_jiad184-B36","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1086\/515375","article-title":"Recurrent acyclovir-resistant herpes simplex in an immunocompromised patient: can strain differences compensate for loss of thymidine kinase in pathogenesis?","volume":"178","author":"Horsburgh","year":"1998","journal-title":"J Infect Dis"},{"key":"2023112802485295200_jiad184-B37","doi-asserted-by":"crossref","first-page":"2120","DOI":"10.1128\/AAC.39.9.2120","article-title":"Biochemical basis for increased susceptibility to cidofovir of herpes simplex viruses with altered or deficient thymidine kinase activity","volume":"39","author":"Mendel","year":"1995","journal-title":"Antimicrob Agents Chemother"},{"key":"2023112802485295200_jiad184-B38","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.virusres.2017.01.019","article-title":"Herpesvirus DNA polymerases: structures, functions and inhibitors","volume":"234","author":"Zarrouk","year":"2017","journal-title":"Virus Res"},{"key":"2023112802485295200_jiad184-B39","doi-asserted-by":"crossref","first-page":"7820","DOI":"10.1128\/JVI.77.14.7820-7829.2003","article-title":"Drug resistance patterns of recombinant herpes simplex virus DNA polymerase mutants generated with a set of overlapping cosmids and plasmids","volume":"77","author":"Bestman-Smith","year":"2003","journal-title":"J Virol"},{"key":"2023112802485295200_jiad184-B40","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1093\/infdis\/jix605","article-title":"The anti-human immunodeficiency virus drug tenofovir, a reverse transcriptase inhibitor, also targets the herpes simplex virus DNA polymerase","volume":"217","author":"Andrei","year":"2018","journal-title":"J Infect Dis"},{"key":"2023112802485295200_jiad184-B41","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1002\/(SICI)1096-9071(199909)59:1<84::AID-JMV14>3.0.CO;2-N","article-title":"Point mutations in the varicella-zoster virus DNA polymerase gene confers resistance to foscarnet and slow growth phenotype","volume":"59","author":"Visse","year":"1999","journal-title":"J Med Virol"},{"key":"2023112802485295200_jiad184-B42","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1177\/09564624211006568","article-title":"Use of pritelivir in refractory aciclovir-resistant herpes simplex virus type 2","volume":"32","author":"Cannon","year":"2021","journal-title":"Int J STD AIDS"},{"key":"2023112802485295200_jiad184-B43","doi-asserted-by":"crossref","first-page":"2303","DOI":"10.1093\/jac\/dkac165","article-title":"Pritelivir for recurrent aciclovir-resistant herpes simplex virus 2 infections in immunocompromised patients","volume":"77","author":"Serris","year":"2022","journal-title":"J Antimicrob Chemother"},{"key":"2023112802485295200_jiad184-B44","doi-asserted-by":"crossref","DOI":"10.1128\/aac.01732-22","article-title":"Salvage treatment of refractory HSV oral lesions with pritelivir in allogeneic hematopoietic cell transplant recipients","volume":"67","author":"Bosetti","year":"2023","journal-title":"Antimicrob Agents Chemother"},{"key":"2023112802485295200_jiad184-B45","doi-asserted-by":"crossref","DOI":"10.1371\/journal.ppat.1005701","article-title":"CRISPR\/Cas9-mediated genome editing of herpesviruses limits productive and latent infections","volume":"12","author":"van Diemen","year":"2016","journal-title":"PLoS Pathog"},{"key":"2023112802485295200_jiad184-B46","doi-asserted-by":"crossref","first-page":"985","DOI":"10.3390\/v13060985","article-title":"An MHV-68 mutator phenotype mutant virus, confirmed by CRISPR\/Cas9-mediated gene editing of the viral DNA polymerase gene, shows reduced viral fitness","volume":"13","author":"Trompet","year":"2021","journal-title":"Viruses"},{"key":"2023112802485295200_jiad184-B47","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/j.virol.2019.01.021","article-title":"Editing the human cytomegalovirus genome with the CRISPR\/Cas9 system","volume":"529","author":"King","year":"2019","journal-title":"Virology"},{"key":"2023112802485295200_jiad184-B48","doi-asserted-by":"crossref","DOI":"10.1128\/AAC.00390-21","article-title":"Impact of amino acid substitutions in region II and helix K of herpes simplex virus 1 and human cytomegalovirus DNA polymerases on resistance to Foscarnet","volume":"65","author":"Zarrouk","year":"2021","journal-title":"Antimicrob Agents Chemother"},{"key":"2023112802485295200_jiad184-B49","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1111\/1348-0421.12180","article-title":"Engineering large viral DNA genomes using the CRISPR-Cas9 system","volume":"58","author":"Suenaga","year":"2014","journal-title":"Microbiol Immunol"}],"container-title":["The Journal of Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jid\/advance-article-pdf\/doi\/10.1093\/infdis\/jiad184\/50852565\/jiad184.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jid\/article-pdf\/228\/11\/1505\/53850459\/jiad184.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jid\/article-pdf\/228\/11\/1505\/53850459\/jiad184.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T02:49:15Z","timestamp":1701139755000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jid\/article\/228\/11\/1505\/7177683"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,24]]},"references-count":49,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,5,24]]},"published-print":{"date-parts":[[2023,11,28]]}},"URL":"https:\/\/doi.org\/10.1093\/infdis\/jiad184","relation":{},"ISSN":["0022-1899","1537-6613"],"issn-type":[{"value":"0022-1899","type":"print"},{"value":"1537-6613","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,12,1]]},"published":{"date-parts":[[2023,5,24]]}}}