{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:37:45Z","timestamp":1792787865938,"version":"4.5.0"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Munich Clinician Scientist Program","award":["CS-076"],"award-info":[{"award-number":["CS-076"]}]},{"name":"German Center for Infection Research","id":[{"id":"https:\/\/ror.org\/028s4q594","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Microbiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cholelithiasis is highly prevalent in the Western world and frequently requires surgical or endoscopic intervention. However, the composition and role of the biliary microbiome remain poorly understood. This study aimed to characterize and compare bacterial communities of the biliary niche with saliva and faeces in patients with cholelithiasis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective observational study, patients with symptomatic cholecystolithiasis, chronic or acute cholecystitis, and choledocholithiasis were included. Bacterial community composition was characterized across bile, gallstone, saliva, and faecal samples using 16\u00a0S rRNA-based sequencing. Community-level and genus-level differences were assessed according to anatomical niche and clinical diagnosis, complemented by compositional sensitivity analyses and predicted functional profiling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 227 samples from 81 patients were analyzed. Bacterial community composition was strongly determined by anatomical niche (PERMANOVA, R\u00b2 = 0.273,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), with bile and gallstone communities being most closely related but remaining significantly distinct (R\u00b2 = 0.146, q\u2009&lt;\u20090.001). Diagnosis-associated differences were predominantly confined to the biliary compartments and remained significant after adjustment for age, explaining 7.9% of variation in bile and 14.1% in gallstones, whereas no significant associations were observed in saliva or faeces. Compositionally aware analysis with continuous age adjustment identified robust diagnosis\n                      <jats:italic>-<\/jats:italic>\n                      associated signals in bile, including\n                      <jats:italic>Escherichia\/Shigella<\/jats:italic>\n                      ,\n                      <jats:italic>Leptotrichia<\/jats:italic>\n                      ,\n                      <jats:italic>Serratia<\/jats:italic>\n                      , and\n                      <jats:italic>Pseudomonas<\/jats:italic>\n                      . Biliary communities were characterized by taxa including\n                      <jats:italic>Enterococcus<\/jats:italic>\n                      ,\n                      <jats:italic>Escherichia\/Shigella<\/jats:italic>\n                      ,\n                      <jats:italic>Serratia<\/jats:italic>\n                      , and\n                      <jats:italic>Pseudomonas<\/jats:italic>\n                      . In bile,\n                      <jats:italic>Escherichia\/Shigella<\/jats:italic>\n                      increased with inflammatory disease, while\n                      <jats:italic>Pseudomonas<\/jats:italic>\n                      decreased; compositionally aware analysis confirmed diagnosis-associated differences for\n                      <jats:italic>Escherichia\/Shigella<\/jats:italic>\n                      ,\n                      <jats:italic>Leptotrichia<\/jats:italic>\n                      , and\n                      <jats:italic>Serratia<\/jats:italic>\n                      . Predicted bacterial functions showed even stronger anatomical compartmentalization (R\u00b2 = 0.507,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001), whereas diagnosis-associated functional differences were limited to two MetaCyc pathways in gallstones. Sensitivity analyses provided no evidence that prolonged antibiotic exposure significantly affected biliary bacterial diversity or community composition.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This comprehensive multi-niche analysis demonstrates pronounced taxonomic and predicted functional compartmentalization of bacterial communities across saliva, bile, gallstones, and faeces in patients with cholelithiasis. Diagnosis-associated alterations were predominantly observed within biliary niches, with\n                      <jats:italic>Escherichia\/Shigella<\/jats:italic>\n                      emerging as a consistent taxon associated with inflammatory biliary disease. These findings identify anatomical niche as a major determinant of bacterial community structure and support disease-associated alterations within the biliary microbiome.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>German Clinical Trials Register (Deutsches Register Klinische Studien) DRKS00030566 (retrospectively registered 20250818).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12866-026-05756-4","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:34:30Z","timestamp":1791268470000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The biliary microbiome in symptomatic cholelithiasis: a prospective comparison across distinct bacterial niches"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2366-8524","authenticated-orcid":false,"given":"Ulrich","family":"Wirth","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramiro","family":"Vilchez-Vargas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franziska","family":"Fuchs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josefine","family":"Schardey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadine","family":"Koch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"K\u00fchn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard W","family":"Renz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Werner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Schulz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim","family":"Andrassy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"5756_CR1","doi-asserted-by":"publisher","first-page":"832","DOI":"10.1093\/bjs\/znac154","volume":"109","author":"CSS Latenstein","year":"2022","unstructured":"Latenstein CSS, De Reuver PR. Tailoring diagnosis and treatment in symptomatic gallstone disease. Br J Surg. 2022;109:832\u20138. https:\/\/doi.org\/10.1093\/bjs\/znac154.","journal-title":"Br J Surg"},{"key":"5756_CR2","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1055\/a-2378-9025","volume":"44","author":"F Lammert","year":"2024","unstructured":"Lammert F, Wittenburg H, Gallstones. Prevention, Diagnosis, and Treatment. Semin Liver Dis. 2024;44:394\u2013404. https:\/\/doi.org\/10.1055\/a-2378-9025.","journal-title":"Semin Liver Dis"},{"key":"5756_CR3","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1016\/j.jhep.2016.03.005","volume":"65","author":"EASL Clinical Practice Guidelines on the","year":"2016","unstructured":"EASL Clinical Practice Guidelines on the. prevention, diagnosis and treatment of gallstones. J Hepatol. 2016;65:146\u201381. https:\/\/doi.org\/10.1016\/j.jhep.2016.03.005.","journal-title":"J Hepatol"},{"key":"5756_CR4","doi-asserted-by":"publisher","first-page":"550","DOI":"10.3390\/biom12040550","volume":"12","author":"H Sun","year":"2022","unstructured":"Sun H, Warren J, Yip J, Ji Y, Hao S, Han W, et al. Factors Influencing Gallstone Formation: A Review of the Literature. Biomolecules. 2022;12:550. https:\/\/doi.org\/10.3390\/biom12040550.","journal-title":"Biomolecules"},{"key":"5756_CR5","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1097\/MOG.0000000000000423","volume":"34","author":"A Di Ciaula","year":"2018","unstructured":"Di Ciaula A, Wang DQ-H, Portincasa P. An update on the pathogenesis of cholesterol gallstone disease. Curr Opin Gastroenterol. 2018;34:71\u201380. https:\/\/doi.org\/10.1097\/MOG.0000000000000423.","journal-title":"Curr Opin Gastroenterol"},{"key":"5756_CR6","doi-asserted-by":"publisher","first-page":"835","DOI":"10.3390\/microorganisms8060835","volume":"8","author":"IN Grigor\u2019eva","year":"2020","unstructured":"Grigor\u2019eva IN, Romanova TI. Gallstone Disease and Microbiome. Microorganisms. 2020;8:835. https:\/\/doi.org\/10.3390\/microorganisms8060835.","journal-title":"Microorganisms"},{"key":"5756_CR7","doi-asserted-by":"publisher","first-page":"1193","DOI":"10.1080\/17474124.2018.1533812","volume":"12","author":"Y Wang","year":"2018","unstructured":"Wang Y, Qi M, Qin C, Hong J. Role of the biliary microbiome in gallstone disease. Expert Rev Gastroenterol Hepatol. 2018;12:1193\u2013205. https:\/\/doi.org\/10.1080\/17474124.2018.1533812.","journal-title":"Expert Rev Gastroenterol Hepatol"},{"key":"5756_CR8","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1186\/s40168-019-0712-8","volume":"7","author":"N Molinero","year":"2019","unstructured":"Molinero N, Ruiz L, Milani C, Guti\u00e9rrez-D\u00edaz I, S\u00e1nchez B, Mangifesta M, et al. The human gallbladder microbiome is related to the physiological state and the biliary metabolic profile. Microbiome. 2019;7:100. https:\/\/doi.org\/10.1186\/s40168-019-0712-8.","journal-title":"Microbiome"},{"key":"5756_CR9","doi-asserted-by":"publisher","first-page":"1700","DOI":"10.1016\/j.cmet.2022.09.017","volume":"34","author":"H Tilg","year":"2022","unstructured":"Tilg H, Adolph TE, Trauner M. Gut-liver axis: Pathophysiological concepts and clinical implications. Cell Metabol. 2022;34:1700\u201318. https:\/\/doi.org\/10.1016\/j.cmet.2022.09.017.","journal-title":"Cell Metabol"},{"key":"5756_CR10","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1038\/s41575-018-0011-z","volume":"15","author":"A Tripathi","year":"2018","unstructured":"Tripathi A, Debelius J, Brenner DA, Karin M, Loomba R, Schnabl B, et al. The gut\u2013liver axis and the intersection with the microbiome. Nat Rev Gastroenterol Hepatol. 2018;15:397\u2013411. https:\/\/doi.org\/10.1038\/s41575-018-0011-z.","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"5756_CR11","doi-asserted-by":"publisher","first-page":"1081","DOI":"10.1053\/j.gastro.2019.05.068","volume":"157","author":"R Vasapolli","year":"2019","unstructured":"Vasapolli R, Sch\u00fctte K, Schulz C, Vital M, Schomburg D, Pieper DH, et al. Analysis of Transcriptionally Active Bacteria Throughout the Gastrointestinal Tract of Healthy Individuals. Gastroenterology. 2019;157:1081\u2013e10923. https:\/\/doi.org\/10.1053\/j.gastro.2019.05.068.","journal-title":"Gastroenterology"},{"key":"5756_CR12","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1136\/gutjnl-2016-312904","volume":"67","author":"C Schulz","year":"2018","unstructured":"Schulz C, Sch\u00fctte K, Koch N, Vilchez-Vargas R, Wos-Oxley ML, Oxley APA, et al. The active bacterial assemblages of the upper GI tract in individuals with and without Helicobacter infection. Gut. 2018;67:216\u201325. https:\/\/doi.org\/10.1136\/gutjnl-2016-312904.","journal-title":"Gut"},{"key":"5756_CR13","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1186\/s40168-017-0271-9","volume":"5","author":"S Rath","year":"2017","unstructured":"Rath S, Heidrich B, Pieper DH, Vital M. Uncovering the trimethylamine-producing bacteria of the human gut microbiota. Microbiome. 2017;5:54. https:\/\/doi.org\/10.1186\/s40168-017-0271-9.","journal-title":"Microbiome"},{"key":"5756_CR14","doi-asserted-by":"publisher","first-page":"1966261","DOI":"10.1080\/19490976.2021.1966261","volume":"13","author":"K Sch\u00fctte","year":"2021","unstructured":"Sch\u00fctte K, Schulz C, Vilchez-Vargas R, Vasapolli R, Palm F, Simon B, et al. Impact of healthy aging on active bacterial assemblages throughout the gastrointestinal tract. Gut Microbes. 2021;13:1966261. https:\/\/doi.org\/10.1080\/19490976.2021.1966261.","journal-title":"Gut Microbes"},{"key":"5756_CR15","doi-asserted-by":"publisher","first-page":"e61217","DOI":"10.1371\/journal.pone.0061217","volume":"8","author":"PJ McMurdie","year":"2013","unstructured":"McMurdie PJ, Holmes S. phyloseq: An R Package for Reproducible Interactive Analysis and Graphics of Microbiome Census Data. PLoS ONE. 2013;8:e61217. https:\/\/doi.org\/10.1371\/journal.pone.0061217.","journal-title":"PLoS ONE"},{"key":"5756_CR16","doi-asserted-by":"publisher","first-page":"D643","DOI":"10.1093\/nar\/gkt1209","volume":"42","author":"P Yilmaz","year":"2014","unstructured":"Yilmaz P, Parfrey LW, Yarza P, Gerken J, Pruesse E, Quast C, et al. The SILVA and All-species Living Tree Project (LTP) taxonomic frameworks. Nucl Acids Res. 2014;42:D643\u20138. https:\/\/doi.org\/10.1093\/nar\/gkt1209.","journal-title":"Nucl Acids Res"},{"key":"5756_CR17","first-page":"9","volume":"4","author":"O Hammer","year":"2021","unstructured":"Hammer O, Harper DAT, Ryan PD. PAST: Paleontological Statistics Software Package for Education and Data Analysis. Palaeontologia Electronica. 2021;4:9\u201317.","journal-title":"Palaeontologia Electronica"},{"key":"5756_CR18","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1111\/j.1541-0420.2005.00440.x","volume":"62","author":"MJ Anderson","year":"2006","unstructured":"Anderson MJ. Distance-Based Tests for Homogeneity of Multivariate Dispersions. Biometrics. 2006;62:245\u201353. https:\/\/doi.org\/10.1111\/j.1541-0420.2005.00440.x.","journal-title":"Biometrics"},{"key":"5756_CR19","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1038\/s41592-023-02092-7","volume":"21","author":"H Lin","year":"2024","unstructured":"Lin H, Peddada SD. Multigroup analysis of compositions of microbiomes with covariate adjustments and repeated measures. Nat Methods. 2024;21:83\u201391. https:\/\/doi.org\/10.1038\/s41592-023-02092-7.","journal-title":"Nat Methods"},{"key":"5756_CR20","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1038\/s41587-020-0548-6","volume":"38","author":"GM Douglas","year":"2020","unstructured":"Douglas GM, Maffei VJ, Zaneveld JR, Yurgel SN, Brown JR, Taylor CM, et al. PICRUSt2 for prediction of metagenome functions. Nat Biotechnol. 2020;38:685\u20138. https:\/\/doi.org\/10.1038\/s41587-020-0548-6.","journal-title":"Nat Biotechnol"},{"key":"5756_CR21","doi-asserted-by":"publisher","first-page":"e1009442","DOI":"10.1371\/journal.pcbi.1009442","volume":"17","author":"H Mallick","year":"2021","unstructured":"Mallick H, Rahnavard A, McIver LJ, Ma S, Zhang Y, Nguyen LH, et al. Multivariable association discovery in population-scale meta-omics studies. PLoS Comput Biol. 2021;17:e1009442. https:\/\/doi.org\/10.1371\/journal.pcbi.1009442.","journal-title":"PLoS Comput Biol"},{"key":"5756_CR22","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/j.tim.2018.11.003","volume":"27","author":"R Eisenhofer","year":"2019","unstructured":"Eisenhofer R, Minich JJ, Marotz C, Cooper A, Knight R, Weyrich LS. Contamination in Low Microbial Biomass Microbiome Studies: Issues and Recommendations. Trends Microbiol. 2019;27:105\u201317. https:\/\/doi.org\/10.1016\/j.tim.2018.11.003.","journal-title":"Trends Microbiol"},{"key":"5756_CR23","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1515\/mr-2024-0003","volume":"4","author":"L Jin","year":"2024","unstructured":"Jin L, Shi L, Huang W. The role of bile acids in human aging. Med Rev. 2024;4:154\u20137. https:\/\/doi.org\/10.1515\/mr-2024-0003.","journal-title":"Med Rev"},{"key":"5756_CR24","doi-asserted-by":"publisher","first-page":"772","DOI":"10.1038\/s41579-023-00933-y","volume":"21","author":"SRS Fishbein","year":"2023","unstructured":"Fishbein SRS, Mahmud B, Dantas G. Antibiotic perturbations to the gut microbiome. Nat Rev Microbiol. 2023;21:772\u201388. https:\/\/doi.org\/10.1038\/s41579-023-00933-y.","journal-title":"Nat Rev Microbiol"},{"key":"5756_CR25","doi-asserted-by":"publisher","first-page":"616","DOI":"10.5009\/gnl20214","volume":"15","author":"Y Karasawa","year":"2021","unstructured":"Karasawa Y, Kato J, Kawamura S, Kojima K, Ohki T, Seki M, et al. Risk Factors for Acute Cholangitis Caused by Enterococcus faecalis and Enterococcus faecium. Gut Liver. 2021;15:616\u201324. https:\/\/doi.org\/10.5009\/gnl20214.","journal-title":"Gut Liver"},{"key":"5756_CR26","doi-asserted-by":"publisher","unstructured":"Fiore E, Van Tyne D, Gilmore MS. Pathogenicity of Enterococci. Microbiol Spectr. 2019;7. https:\/\/doi.org\/10.1128\/microbiolspec.GPP3-0053-2018. 7.4.9.","DOI":"10.1128\/microbiolspec.GPP3-0053-2018"},{"key":"5756_CR27","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1007\/s00284-013-0362-1","volume":"67","author":"P Jarocki","year":"2013","unstructured":"Jarocki P, Targo\u0144ski Z. Genetic Diversity of Bile Salt Hydrolases Among Human Intestinal Bifidobacteria. Curr Microbiol. 2013;67:286\u201392. https:\/\/doi.org\/10.1007\/s00284-013-0362-1.","journal-title":"Curr Microbiol"},{"key":"5756_CR28","doi-asserted-by":"publisher","first-page":"5057","DOI":"10.1007\/s11033-013-2607-2","volume":"40","author":"R Kumar","year":"2013","unstructured":"Kumar R, Rajkumar H, Kumar M, Varikuti SR, Athimamula R, Shujauddin, Mohd, et al. Molecular cloning, characterization and heterologous expression of bile salt hydrolase (Bsh) from Lactobacillus fermentum NCDO394. Mol Biol Rep. 2013;40:5057\u201366. https:\/\/doi.org\/10.1007\/s11033-013-2607-2.","journal-title":"Mol Biol Rep"},{"key":"5756_CR29","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1080\/19490976.2015.1127483","volume":"7","author":"JM Ridlon","year":"2016","unstructured":"Ridlon JM, Harris SC, Bhowmik S, Kang D-J, Hylemon PB. Consequences of bile salt biotransformations by intestinal bacteria. Gut Microbes. 2016;7:22\u201339. https:\/\/doi.org\/10.1080\/19490976.2015.1127483.","journal-title":"Gut Microbes"},{"key":"5756_CR30","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1128\/CMR.00031-16","volume":"29","author":"JR Sistrunk","year":"2016","unstructured":"Sistrunk JR, Nickerson KP, Chanin RB, Rasko DA, Faherty CS. Survival of the Fittest: How Bacterial Pathogens Utilize Bile To Enhance Infection. Clin Microbiol Rev. 2016;29:819\u201336. https:\/\/doi.org\/10.1128\/CMR.00031-16.","journal-title":"Clin Microbiol Rev"},{"key":"5756_CR31","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1038\/nrmicro3552","volume":"14","author":"GP Donaldson","year":"2016","unstructured":"Donaldson GP, Lee SM, Mazmanian SK. Gut biogeography of the bacterial microbiota. Nat Rev Microbiol. 2016;14:20\u201332. https:\/\/doi.org\/10.1038\/nrmicro3552.","journal-title":"Nat Rev Microbiol"},{"key":"5756_CR32","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1038\/s41579-023-00969-0","volume":"22","author":"G McCallum","year":"2024","unstructured":"McCallum G, Tropini C. The gut microbiota and its biogeography. Nat Rev Microbiol. 2024;22:105\u201318. https:\/\/doi.org\/10.1038\/s41579-023-00969-0.","journal-title":"Nat Rev Microbiol"},{"key":"5756_CR33","doi-asserted-by":"publisher","unstructured":"Limoli DH, Jones CJ, Wozniak DJ. Bacterial Extracellular Polysaccharides in Biofilm Formation and Function. Microbiol Spectr. 2015;3. https:\/\/doi.org\/10.1128\/microbiolspec.MB-0011-2014. 3.3.29.","DOI":"10.1128\/microbiolspec.MB-0011-2014"},{"key":"5756_CR34","doi-asserted-by":"publisher","unstructured":"Liu J, Yan Q, Luo F, Shang D, Wu D, Zhang H, et al. Acute cholecystitis associated with infection of Enterobacteriaceae from gut microbiota. Clin Microbiol Infect. 2015;21. https:\/\/doi.org\/10.1016\/j.cmi.2015.05.017. :851.e1-851.e9.","DOI":"10.1016\/j.cmi.2015.05.017"}],"container-title":["BMC Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12866-026-05756-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12866-026-05756-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12866-026-05756-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:52:38Z","timestamp":1791269558000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12866-026-05756-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,6]]},"references-count":34,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["5756"],"URL":"https:\/\/doi.org\/10.1186\/s12866-026-05756-4","relation":{},"ISSN":["1471-2180"],"issn-type":[{"value":"1471-2180","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,6]]},"assertion":[{"value":"8 July 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 September 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 October 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study was conducted in accordance with the Declaration of Helsinki and was approved by the Institutional Review Board (Ludwig Maximilians-University Munich, approval No. 21\u20130404). Written informed consent was obtained from all participants prior to study enrollment.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not Applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"869"}}