{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T20:18:17Z","timestamp":1790713097628,"version":"4.1.0"},"reference-count":56,"publisher":"Akademiai Kiado Zrt.","issue":"1","content-domain":{"domain":["akjournals.com"],"crossmark-restriction":true},"short-container-title":["AMicr"],"published-print":{"date-parts":[[2022,3,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Methicillin-resistant coagulase-negative staphylococci (MR-CoNS) cause infectious diseases due to their potential to form biofilm and further colonization in hospital materials. This study evaluated the antibiotic susceptible phenotypes, biofilm-producing ability, and biofilm-associated genes (<jats:italic>mecA, ica<\/jats:italic>AD,<jats:italic>bap<\/jats:italic>,<jats:italic>cna<\/jats:italic>, and<jats:italic>fnb<\/jats:italic>A). Biofilm formation was detected through Congo red agar (CRA) method and MTP method. The presence of biofilm and associated genes in MR-<jats:italic>CoNS<\/jats:italic>were detected by PCR. A total of 310 (55.95%) isolates produced the biofilm. Among these isolates,<jats:italic>Staphylococcus haemolyticus<\/jats:italic>(34.83%),<jats:italic>Staphylococcus epidermis<\/jats:italic>(31.93%),<jats:italic>Staphylococcus capitis<\/jats:italic>(16.77%),<jats:italic>Staphylococcus cohnii<\/jats:italic>(10.96%), and<jats:italic>Staphylococcus hominis<\/jats:italic>(5.48%) were identified. The antimicrobial susceptibility pattern of CoNS isolates indicated resistance to cefoxitin (100%), erythromycin (94.8%), ciprofloxacin (66.7%), sulfamethoxazole\/trimethoprim (66.7%), gentamicin (66.12%), and clindamycin (62.9%). Resistance rate to mupirocin was 48.5% in<jats:italic>S<\/jats:italic>.<jats:italic>epidermidis<\/jats:italic>and 38.9% in<jats:italic>S. haemolyticus<\/jats:italic>isolates. All isolates were sensitive to vancomycin and linezolid.<\/jats:p><jats:p>The prevalence rates of<jats:italic>icaAD, bap, fnbA<\/jats:italic>, and<jats:italic>cna<\/jats:italic>were 18.06%, 12.5%, 47.4%, and 27.4%, respectively.<jats:italic>ica<\/jats:italic>AD and<jats:italic>bap<\/jats:italic>genes were detected in 18.06% and 12.5% of MR-CoNS isolates.<jats:italic>fnb<\/jats:italic>A and<jats:italic>cna<\/jats:italic>genes were detected in 47.41% and 27.41% of MRCoNS isolates. icaAD positive strains exhibited a significant increase in the biofilm formation compared with those that lacked<jats:italic>ica<\/jats:italic>AD (0.86 (0.42, 1.39) versus 0.36 (0.14, 0.75), respectively;<jats:italic>P<\/jats:italic>&lt; 0.001).<\/jats:p><jats:p>In conclusion, the majority of MR-CoNS isolates were biofilm producers, and<jats:italic>S<\/jats:italic>.<jats:italic>capitis<\/jats:italic>, which possessed<jats:italic>icaAD<\/jats:italic>genes, ranked as the great biofilm producer than other<jats:italic>Staphylococcus<\/jats:italic>. The study\u2019s findings are important to form a strategy to control biofilm formation as an alternative strategy to counter the spread of MR-CoNS in healthcare settings.<\/jats:p>","DOI":"10.1556\/030.2021.01538","type":"journal-article","created":{"date-parts":[[2021,12,13]],"date-time":"2021-12-13T13:18:32Z","timestamp":1639401512000},"page":"35-40","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.1","source":"Crossref","is-referenced-by-count":5,"title":["Characterization of biofilm producing methicillin resistant coagulase negative Staphylococci from India"],"prefix":"10.1556","volume":"69","author":[{"given":"A.","family":"Suneel Kumar","sequence":"first","affiliation":[{"name":"Department of Microbiology, Rajiv Gandhi Institute of Medical Sciences (RIMS), Government Medical College & Hospital, Kadapa, Andhra Pradesh, India"},{"name":"Department of Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6106-0064","authenticated-orcid":true,"given":"A.S.","family":"Smiline Girija","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Naga Srilatha","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Rajiv Gandhi Institute of Medical Sciences (RIMS), Government Medical College & Hospital, Kadapa, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"425","reference":[{"key":"ref01","doi-asserted-by":"crossref","first-page":"7","DOI":"10.21315\/mjms2017.24.5.2","article-title":"A review of staphylococcal cassette chromosome mec (SCCmec) types in coagulase-negative staphylococci (CoNS) species","volume":"24","author":"Saber","year":"2017","journal-title":"Malays J Med Sci"},{"key":"ref21","article-title":"Antibiotic resistance of commensal Staphylococcus aureus and coagulase-negative staphylococci in an international cohort of surgeons: a prospective point-prevalence study","volume":"11","author":"Morgenstern","year":"2011","journal-title":"PLoS One"},{"key":"ref121","volume-title":"Performance standard for antimicrobial disk susceptibility tests, Document no M100-S23","year":"2013"},{"key":"ref521","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1186\/1756-0500-3-260","article-title":"Comparison of methods for the detection of biofilm production in coagulase-negative staphylococci","volume":"3","author":"Oliveira","year":"2010","journal-title":"BMC Res Notes"},{"key":"ref261","doi-asserted-by":"crossref","first-page":"917","DOI":"10.2217\/fmb.10.56","article-title":"Current concepts in biofilm formation of Staphylococcus epidermidis","volume":"5","author":"Fey","year":"2010","journal-title":"Future Microbiol"},{"key":"ref301","article-title":"Antibiotic resistance of commensal Staphylococcus aureus and coagulase-negative staphylococci in an international cohort of surgeons: a prospective point-prevalence study","volume":"11","author":"Morgenstern","year":"2011","journal-title":"PLoS One"},{"key":"ref341","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1128\/AEM.05594-11","article-title":"Methicillin-resistant coagulase-negative staphylococci on pig farms as a reservoir of heterogeneous staphylococcal cassette chromosome mec elements","volume":"78","author":"Tulinski","year":"2012","journal-title":"Appl Environ Microbiol"},{"key":"ref491","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.nmni.2017.05.007","article-title":"Prevalence of methicillin resistance and macrolide-lincosamide-streptogramin B resistance in Staphylococcus haemolyticus among clinical strains at a tertiary-care hospital in Thailand","volume":"19","author":"Teeraputon","year":"2017","journal-title":"New Microbes New Infect"},{"key":"ref221","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1128\/CMR.00109-13","article-title":"Coagulase-negative staphylococci","volume":"27","author":"Becker","year":"2014","journal-title":"Clin Microbiol Rev"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.vetmic.2008.09.009","article-title":"Role of coagulase-negative staphylococci in human disease","volume":"134","author":"Piette","year":"2009 Feb 16","journal-title":"Vet Microbiol"},{"key":"ref171","doi-asserted-by":"crossref","DOI":"10.1136\/jcp.42.8.872","article-title":"New method for detecting slime production by coagulase negative staphylococci","volume":"42","author":"Freeman","year":"1989","journal-title":"J Clin Pathol"},{"key":"ref281","doi-asserted-by":"crossref","first-page":"7","DOI":"10.21315\/mjms2017.24.5.2","article-title":"A review of staphylococcal cassette chromosome mec (SCCmec) types in coagulase-negative staphylococci (CoNS) species","volume":"24","author":"Saber","year":"2017","journal-title":"Malays J Med Sci"},{"key":"ref291","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.vetmic.2008.09.009","article-title":"Role of coagulase-negative staphylococci in human disease","volume":"134","author":"Piette","year":"2009 Feb 16","journal-title":"Vet Microbiol"},{"key":"ref81","doi-asserted-by":"crossref","first-page":"2177","DOI":"10.1128\/IAI.72.4.2177-2185.2004","article-title":"Role of biofilm-associated protein bap in the pathogenesis of bovine Staphylococcus aureus","volume":"72","author":"Cucarella","year":"2004","journal-title":"Infect Immun"},{"key":"ref51","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1016\/S1473-3099(11)70126-8","article-title":"Meticillin-resistant Staphylococcus aureus with a novel mecA homologue in human and bovine populations in the UK and Denmark: a descriptive study","volume":"11","author":"Garc\u00eda-\u00c1lvarez","year":"2011","journal-title":"Lancet Infect Dis"},{"key":"ref131","doi-asserted-by":"crossref","first-page":"2952","DOI":"10.1128\/JCM.37.9.2952-2961.1999","article-title":"3rd Comparison of susceptibility testing methods with mecA gene analysis for determining oxacillin (methicillin) resistance in clinical isolates of Staphylococcus aureus and coagulase-negative Staphylococcus spp","volume":"37","author":"Kohner","year":"1999","journal-title":"J Clin Microbiol"},{"key":"ref61","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1128\/AEM.05594-11","article-title":"Methicillin-resistant coagulase-negative staphylococci on pig farms as a reservoir of heterogeneous staphylococcal cassette chromosome mec elements","volume":"78","author":"Tulinski","year":"2012","journal-title":"Appl Environ Microbiol"},{"key":"ref421","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3923\/crb.2017.1.8","article-title":"Species identification of clinical coagulase-negative staphylococci isolated in Al-Shifa hospital Gaza using matrix-assisted laser desorption\/ionization-time of flight mass spectrometry","volume":"10","author":"Al Laham","year":"2017","journal-title":"Curr Res Bacteriol"},{"key":"ref381","doi-asserted-by":"crossref","first-page":"e00413","DOI":"10.1128\/mBio.00413-15","article-title":"Staphylococcus aureus fibronectin-binding protein A mediates cell-cell adhesion through low-affinity homophilic bonds","volume":"6","author":"Herman-Bausier","year":"2015","journal-title":"MBio"},{"key":"ref311","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/S0140-6736(01)05321-1","article-title":"Antibiotic resistance of bacteria in biofilms","volume":"358","author":"Stewart","year":"2001","journal-title":"Lancet"},{"key":"ref531","first-page":"DC16","article-title":"Evaluation of ica gene in comparison with phenotypic methods for detection of biofilm production by coagulase negative staphylococci in a tertiary care hospital","volume":"9","author":"Thilakavathy","year":"2015","journal-title":"J Clin Diagn Res"},{"key":"ref271","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1099\/jmm.0.46799-0","article-title":"Formation and properties of in vitro biofilms of ica-negative Staphylococcus epidermidis clinical isolates","volume":"56","author":"Qin","year":"2007","journal-title":"J Med Microbiol"},{"key":"ref551","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1099\/jmm.0.46799-0","article-title":"Formation and properties of in vitro biofilms of ica-negative Staphylococcus epidermidis clinical isolates","volume":"56","author":"Qin","year":"2007","journal-title":"J Med Microbiol"},{"key":"ref481","doi-asserted-by":"crossref","first-page":"1579","DOI":"10.1099\/jmm.0.055210-0","article-title":"Staphylococcus epidermidis with the icaA\u2212\/icaD\u2212\/IS256\u2212 genotype and protein or protein\/extracellular-DNA biofilm is frequent in ocular infections","volume":"62","author":"Verdayes","year":"2013","journal-title":"J Med Microbiol"},{"key":"ref361","doi-asserted-by":"crossref","first-page":"2177","DOI":"10.1128\/IAI.72.4.2177-2185.2004","article-title":"Role of biofilm-associated protein bap in the pathogenesis of bovine Staphylococcus aureus","volume":"72","author":"Cucarella","year":"2004","journal-title":"Infect Immun"},{"key":"ref161","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1128\/iai.37.1.318-326.1982","article-title":"Adherence of slimeproducing strains of Staphylococcus Epidermidis to smooth surfaces","volume":"37","author":"Christensen","year":"1982","journal-title":"Infect Immun"},{"key":"ref181","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1128\/jcm.22.6.996-1006.1985","article-title":"Adherence of coagulase-negative staphylococci to plastic tissue culture plates: a quantitative model for the adherence of staphylococci to medical devices","volume":"22","author":"Christensen","year":"1985","journal-title":"J Clin Microbiol"},{"key":"ref501","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1128\/CMR.00109-13","article-title":"Coagulase-negative staphylococci","volume":"27","author":"Becker","year":"2014","journal-title":"Clin Microbiol Rev"},{"key":"ref331","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1016\/S1473-3099(11)70126-8","article-title":"Meticillin-resistant Staphylococcus aureus with a novel mecA homologue in human and bovine populations in the UK and Denmark: a descriptive study","volume":"11","author":"Garc\u00eda-\u00c1lvarez","year":"2011","journal-title":"Lancet Infect Dis"},{"key":"ref541","doi-asserted-by":"crossref","first-page":"917","DOI":"10.2217\/fmb.10.56","article-title":"Current concepts in biofilm formation of Staphylococcus epidermidis","volume":"5","author":"Fey","year":"2010","journal-title":"Future Microbiol"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/S0140-6736(01)05321-1","article-title":"Antibiotic resistance of bacteria in biofilms","volume":"358","author":"Stewart","year":"2001","journal-title":"Lancet"},{"key":"ref351","doi-asserted-by":"crossref","first-page":"4433","DOI":"10.1128\/IAI.70.8.4433-4440.2002","article-title":"Immunochemical properties of the staphylococcal poly-N-acetylglucosamine surface polysaccharide","volume":"70","author":"Maira-Litr\u00e1n","year":"2002 Aug 1","journal-title":"Infect Immun"},{"key":"ref401","volume-title":"Performance standard for antimicrobial disk susceptibility tests, Document no M100-S23","year":"2013"},{"key":"ref251","first-page":"DC16","article-title":"Evaluation of ica gene in comparison with phenotypic methods for detection of biofilm production by coagulase negative staphylococci in a tertiary care hospital","volume":"9","author":"Thilakavathy","year":"2015","journal-title":"J Clin Diagn Res"},{"key":"ref411","doi-asserted-by":"crossref","first-page":"2952","DOI":"10.1128\/JCM.37.9.2952-2961.1999","article-title":"3rd Comparison of susceptibility testing methods with mecA gene analysis for determining oxacillin (methicillin) resistance in clinical isolates of Staphylococcus aureus and coagulase-negative Staphylococcus spp","volume":"37","author":"Kohner","year":"1999","journal-title":"J Clin Microbiol"},{"key":"ref461","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1128\/jcm.22.6.996-1006.1985","article-title":"Adherence of coagulase-negative staphylococci to plastic tissue culture plates: a quantitative model for the adherence of staphylococci to medical devices","volume":"22","author":"Christensen","year":"1985","journal-title":"J Clin Microbiol"},{"key":"ref471","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0184172","article-title":"Biofilm formation of methicillin-resistant coagulase negative staphylococci (MR-coNS) isolated from community and hospital environments","volume":"12","author":"Seng","year":"2017","journal-title":"PLoS One"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1128\/JCM.05563-11","article-title":"Staphylococcus haemolyticus as an important hospital pathogen and carrier of methicillin resistance genes","volume":"50","author":"Barros","year":"2012","journal-title":"J Clin Microbiol"},{"key":"ref231","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1186\/s13756-017-0251-7","article-title":"Antibiotic resistance and biofilm formation among coagulase-negative staphylococci isolated from clinical samples at a tertiary care hospital of Eastern Nepal","volume":"6","author":"Shrestha","year":"2017","journal-title":"Antimicrob Resist Infect Control"},{"key":"ref101","doi-asserted-by":"crossref","first-page":"e00413","DOI":"10.1128\/mBio.00413-15","article-title":"Staphylococcus aureus fibronectin-binding protein A mediates cell-cell adhesion through low-affinity homophilic bonds","volume":"6","author":"Herman-Bausier","year":"2015","journal-title":"MBio"},{"key":"ref151","doi-asserted-by":"crossref","first-page":"1437","DOI":"10.1128\/JCM.06746-11","article-title":"Comparative study using phenotypic, genotypic, and proteomics methods for identification of coagulase-negative staphylococci","volume":"50","author":"Loonen","year":"2012","journal-title":"J Clin Microbiol"},{"key":"ref211","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.nmni.2017.05.007","article-title":"Prevalence of methicillin resistance and macrolide-lincosamide-streptogramin B resistance in Staphylococcus haemolyticus among clinical strains at a tertiary-care hospital in Thailand","volume":"19","author":"Teeraputon","year":"2017","journal-title":"New Microbes New Infect"},{"key":"ref371","doi-asserted-by":"crossref","first-page":"2465","DOI":"10.1099\/mic.0.27865-0","article-title":"Bap-dependent biofilm formation by pathogenic species of Staphylococcus: evidence of horizontal gene transfer?","volume":"151","author":"Tormo","year":"2005","journal-title":"Microbiology"},{"key":"ref391","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1128\/jcm.1.1.82-88.1975","article-title":"Simplified scheme for routine identification of human staphylococcus species","volume":"1","author":"Kloos","year":"1975","journal-title":"J Clin Microbiol"},{"key":"ref241","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1186\/1756-0500-3-260","article-title":"Comparison of methods for the detection of biofilm production in coagulase-negative staphylococci","volume":"3","author":"Oliveira","year":"2010","journal-title":"BMC Res Notes"},{"key":"ref141","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3923\/crb.2017.1.8","article-title":"Species identification of clinical coagulase-negative staphylococci isolated in Al-Shifa hospital Gaza using matrix-assisted laser desorption\/ionization-time of flight mass spectrometry","volume":"10","author":"Al Laham","year":"2017","journal-title":"Curr Res Bacteriol"},{"key":"ref71","doi-asserted-by":"crossref","first-page":"4433","DOI":"10.1128\/IAI.70.8.4433-4440.2002","article-title":"Immunochemical properties of the staphylococcal poly-N-acetylglucosamine surface polysaccharide","volume":"70","author":"Maira-Litr\u00e1n","year":"2002 Aug 1","journal-title":"Infect Immun"},{"key":"ref191","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0184172","article-title":"Biofilm formation of methicillin-resistant coagulase negative staphylococci (MR-coNS) isolated from community and hospital environments","volume":"12","author":"Seng","year":"2017","journal-title":"PLoS One"},{"key":"ref451","doi-asserted-by":"crossref","DOI":"10.1136\/jcp.42.8.872","article-title":"New method for detecting slime production by coagulase negative staphylococci","volume":"42","author":"Freeman","year":"1989","journal-title":"J Clin Pathol"},{"key":"ref511","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1186\/s13756-017-0251-7","article-title":"Antibiotic resistance and biofilm formation among coagulase-negative staphylococci isolated from clinical samples at a tertiary care hospital of Eastern Nepal","volume":"6","author":"Shrestha","year":"2017","journal-title":"Antimicrob Resist Infect Control"},{"key":"ref201","doi-asserted-by":"crossref","first-page":"1579","DOI":"10.1099\/jmm.0.055210-0","article-title":"Staphylococcus epidermidis with the icaA\u2212\/icaD\u2212\/IS256\u2212 genotype and protein or protein\/extracellular-DNA biofilm is frequent in ocular infections","volume":"62","author":"Verdayes","year":"2013","journal-title":"J Med Microbiol"},{"key":"ref431","doi-asserted-by":"crossref","first-page":"1437","DOI":"10.1128\/JCM.06746-11","article-title":"Comparative study using phenotypic, genotypic, and proteomics methods for identification of coagulase-negative staphylococci","volume":"50","author":"Loonen","year":"2012","journal-title":"J Clin Microbiol"},{"key":"ref321","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1128\/JCM.05563-11","article-title":"Staphylococcus haemolyticus as an important hospital pathogen and carrier of methicillin resistance genes","volume":"50","author":"Barros","year":"2012","journal-title":"J Clin Microbiol"},{"key":"ref111","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1128\/jcm.1.1.82-88.1975","article-title":"Simplified scheme for routine identification of human staphylococcus species","volume":"1","author":"Kloos","year":"1975","journal-title":"J Clin Microbiol"},{"key":"ref441","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1128\/iai.37.1.318-326.1982","article-title":"Adherence of slimeproducing strains of Staphylococcus Epidermidis to smooth surfaces","volume":"37","author":"Christensen","year":"1982","journal-title":"Infect Immun"},{"key":"ref91","doi-asserted-by":"crossref","first-page":"2465","DOI":"10.1099\/mic.0.27865-0","article-title":"Bap-dependent biofilm formation by pathogenic species of Staphylococcus: evidence of horizontal gene transfer?","volume":"151","author":"Tormo","year":"2005","journal-title":"Microbiology"}],"container-title":["Acta Microbiologica et Immunologica Hungarica"],"original-title":[],"link":[{"URL":"https:\/\/akjournals.com\/view\/journals\/030\/69\/1\/article-p35.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/akjournals.com\/downloadpdf\/journals\/030\/69\/1\/article-p35.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/akjournals.com\/downloadpdf\/journals\/030\/69\/1\/article-p35.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,14]],"date-time":"2024-09-14T09:15:07Z","timestamp":1726305307000},"score":1,"resource":{"primary":{"URL":"https:\/\/akjournals.com\/view\/journals\/030\/69\/1\/article-p35.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,2]]},"references-count":56,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.1556\/030.2021.01538","relation":{},"ISSN":["1217-8950","1588-2640"],"issn-type":[{"value":"1217-8950","type":"print"},{"value":"1588-2640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,2]]}}}