{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T22:54:35Z","timestamp":1792018475368,"version":"4.4.0"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      This study aimed to investigate the epidemiology, clinical treatment and outcomes, antimicrobial resistance profiles and genotypic analysis of 214\n                      <jats:italic>Nocardia<\/jats:italic>\n                      strains collected from 9 hospitals in Henan Province spanning 9 years.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Through retrospective analysis of hospitalized patients with nocardiosis, the epidemiological characteristics of 214\n                      <jats:italic>Nocardia<\/jats:italic>\n                      strains were elucidated. These isolates were identified and subjected to the broth microdilution method for the antimicrobial susceptibility profiles, and the resistance and virulence genes were determined using whole-genome sequencing (WGS).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of all strains, 74.8% were collected from lower respiratory tract specimens, and\n                      <jats:italic>N. cyriacigeorgica<\/jats:italic>\n                      was the most commonly isolated species (28%), followed by\n                      <jats:italic>N. farcinica<\/jats:italic>\n                      (24.8%),\n                      <jats:italic>N. abscessus<\/jats:italic>\n                      (7.9%),\n                      <jats:italic>N. amamiensis<\/jats:italic>\n                      (7.9%),\n                      <jats:italic>N. otitidiscaviarum<\/jats:italic>\n                      (7.5%). 93.9% were obtained from in-province patients, and Nanyang City (28.0%) was with the highest isolation rate in Henan Province. Simultaneously, all of the strains were susceptible to linezolid (LZD), and 99.1% susceptible to trimethoprim-sulfamethoxazole (TMP-SMX). The antibiotic resistance profiles of other antibiotics varied tremendously among different\n                      <jats:italic>Nocardia<\/jats:italic>\n                      species. Of all the patients, 108 (50.7%) received TMP-SMX monotherapy or multidrug regimen; moreover, 182 (85.5%) patients recovered after treatment. Notably, 12 antibiotic resistance genes and 11 virulence genes were identified, implicating the complexity of resistance and pathogenicity mechanisms. Meanwhile, the MDR rates for\n                      <jats:italic>Nocardia<\/jats:italic>\n                      species ranged from 68.8% in\n                      <jats:italic>N. otitidiscaviarum<\/jats:italic>\n                      to 17.7% in\n                      <jats:italic>N. amamiensis.<\/jats:italic>\n                      No strains exhibited the XDR and PDR phenotypes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This study provides a comprehensive evaluation of the epidemiology, phenotypic and genotypic profiles, and clinical treatment of\n                      <jats:italic>Nocardia<\/jats:italic>\n                      species in Henan, China. TMP-SMX and LZD can be used respectively for the clinical routine and critical treatment of nocardiosis. Particular emphasis is placed on the fact that antibiotic resistance and pathogenicity are species - specific, therefore, the AST of\n                      <jats:italic>Nocardia<\/jats:italic>\n                      isolates should be conducted and standardized, and attempts should be made to monitor its resistance molecular mechanisms.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1728269","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T05:22:20Z","timestamp":1770960140000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Epidemiology, clinical treatment and outcomes, susceptibility patterns and genotypic analysis of 214 Nocardia strains from multiple centers in Henan Province"],"prefix":"10.3389","volume":"16","author":[{"given":"Xiaogai","family":"Li","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, Henan, China"]},{"name":"Key Clinical Laboratory of Henan Province","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cailin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, Henan, China"]},{"name":"Key Clinical Laboratory of Henan Province","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinyin","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Clinical laboratory, Nanyang Central Hospital","place":["Nanyang, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, Henan, China"]},{"name":"Key Clinical Laboratory of Henan Province","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haijun","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, Henan, China"]},{"name":"Key Clinical Laboratory of Henan Province","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingjing","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, Henan, China"]},{"name":"Key Clinical Laboratory of Henan Province","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangyang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Clinical laboratory, The Fifth Clinical Medical College of Henan University of Chinese Medicine (Zhengzhou People\u2019s Hospital)","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujuan","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Clinical laboratory, Luoyang Central Hospital","place":["Luoyang, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Clinical laboratory, The Fifteenth People\u2019s Hospital of Zhengzhou","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gongchang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Clinical laboratory, The Second Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiuping","family":"Lei","sequence":"additional","affiliation":[{"name":"Department of Clinical laboratory, Xiangcheng City Traditional Chinese Medicine Hospital","place":["Zhoukou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Limin","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Clinical laboratory, Xinxiang Central Hospital","place":["Xinxiang, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juhua","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Clinical laboratory, Xinyang Maternal and Child Health Care Hospital","place":["Xinyang, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanhai","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, Henan, China"]},{"name":"Key Clinical Laboratory of Henan Province","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjid.2023.102806","article-title":"Nocardiosis: a single-center experience and literature review","volume":"27","author":"Besteiro","year":"2023","journal-title":"Braz. J. Infect. Dis."},{"key":"B2","doi-asserted-by":"publisher","first-page":"e00237","DOI":"10.1128\/JCM.00237-18","article-title":"Evaluation of the vitek MS v3.0 matrix-assisted laser desorption ionization-time of flight mass spectrometry system for identification of Mycobacterium and Nocardia species","volume":"56","author":"Body","year":"2018","journal-title":"J. Clin. Microbiol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1016\/j.jgar.2022.03.004","article-title":"Complete genome sequencing of transposon-mediated sulfamethoxazole resistance encoded by the Sul1 gene in multidrug-resistant Nocardia farcinica SZ 1509","volume":"30","author":"Che","year":"2022","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.00914-25","article-title":"Population-based microbiological characterization of Nocardia strains causing invasive infections during a multiyear period in a large Canadian healthcare region","volume":"13","author":"Church","year":"2025","journal-title":"Microbiol. Spectr."},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaa090","article-title":"Safety and outcomes of linezolid use for Nocardiosis","volume":"7","author":"Davidson","year":"2020","journal-title":"Open Forum Infect. Dis."},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.micpath.2025.107602","article-title":"Genomic diversity of Nocardia cyriacigeorgica and Nocardia farcinica infections","volume":"205","author":"Di","year":"2025","journal-title":"Microb. Pathog."},{"key":"B7","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1016\/j.jiac.2016.08.004","article-title":"Clinical characteristics of pulmonary nocardiosis in immunocompetent patients","volume":"22","author":"Fujita","year":"2016","journal-title":"J. Infect. Chemother."},{"key":"B8","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1016\/j.ijid.2020.10.087","article-title":"Revisiting nocardiosis at a tertiary care institution: any change in recent years","volume":"102","author":"Galar","year":"2021","journal-title":"Int. J. Infect. Dis."},{"key":"B9","doi-asserted-by":"publisher","first-page":"e01868","DOI":"10.1128\/AAC.01868-19","article-title":"Antimicrob agents chemother. Retrospective analysis of antimicrobial susceptibility profiles of Nocardia species from a tertiary hospital and reference laboratory, 2011 to 2017","volume":"64","author":"Hamdi","year":"2020","journal-title":"Antimicrob. Agents Chemother."},{"key":"B10","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1186\/s12941-024-00677-4","article-title":"Clinical characteristics and drug resistance of Nocardia in Henan, China, 2017-2023","volume":"23","author":"Han","year":"2024","journal-title":"Ann. Clin. Microbiol. Antimicrob."},{"key":"B11","doi-asserted-by":"publisher","first-page":"2306","DOI":"10.1093\/jac\/dkad236","article-title":"Phenotypic and genotypic analysis of antimicrobial resistance in Nocardia species","volume":"78","author":"Hershko","year":"2023","journal-title":"J. Antimicrob. Chemother."},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2025.116954","article-title":"Successful management of Nocardia farcinica brain abscess in an immunocompetent adult with trimethoprim\/sulfamethoxazole hypersensitivity: A case report and review","volume":"113","author":"Hong","year":"2025","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"B13","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1016\/j.diagmicrobio.2018.12.007","article-title":"Clinical features, identification, antimicrobial resistance patterns of Nocardia species in China: 2009-2017","volume":"94","author":"Huang","year":"2019","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000017913","article-title":"Characteristics of nocardiosis patients with different immune status from a Chinese tertiary general hospital during 8-year period: a STROBE-compliment observational study","volume":"98","author":"Huang","year":"2019","journal-title":"Med. (Baltimore)."},{"key":"B15","doi-asserted-by":"publisher","first-page":"2109","DOI":"10.1016\/j.jfma.2022.06.011","article-title":"Clinical manifestations and antimicrobial susceptibility of Nocardia species at a tertiary hospital in Taiwan, 2011-2020","volume":"121","author":"Lao","year":"2022","journal-title":"J. Formos Med. Assoc."},{"key":"B16","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1016\/j.cmi.2018.06.013","article-title":"Antibiotic susceptibility testing and species identification of Nocardia isolates: a retrospective analysis of data from a French expert laboratory, 2010-2015","volume":"25","author":"Lebeaux","year":"2019","journal-title":"Clin. Microbiol. Infect."},{"key":"B17","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1016\/j.cmi.2020.12.019","article-title":"How do I manage nocardiosis","volume":"27","author":"Margalit","year":"2021","journal-title":"Clin. Microbiol. Infect."},{"key":"B18","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1016\/j.ijid.2004.06.011","article-title":"Nocardiosis in srinagarind hospital, Thailand: review of 70 cases from 1996- 2001","volume":"9","author":"Mootsikapun","year":"2005","journal-title":"Int. J. Infect. Dis."},{"key":"B19","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1007\/s00203-023-03799-z","article-title":"Exploring Nocardia's ecological spectrum and novel therapeutic frontiers through whole-genome sequencing: unraveling drug resistance and virulence factors","volume":"206","author":"Nathar","year":"2024","journal-title":"Arch. Microbiol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"108","DOI":"10.5578\/mb.20239909","article-title":"The importance of gram-stained smears in the diagnosis of Nocardia infections","volume":"57","author":"\u00d6lmez","year":"2023","journal-title":"Mikrobiyol. Bul."},{"key":"B21","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1016\/j.ijid.2018.12.010","article-title":"OPINION Study Group. Pulmonary nocardiosis in Western Europe-clinical evaluation of 43 patients and population-based estimates of hospitalization rates","volume":"81","author":"Ott","year":"2019","journal-title":"Int. J. Infect. Dis."},{"key":"B22","article-title":"CLSI. Performance Standards for Susceptibility Testing of Mycobacteria, Nocardia spp., and Other Aerobic Actinomycetes","volume-title":"CLSI supplement M24S","author":"Parrish","year":"2023"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1307","DOI":"10.1086\/514340","article-title":"Risk factors, clinical characteristics, and outcome of Nocardia infection in organ transplant recipients: a matched case-control study","volume":"44","author":"Peleg","year":"2007","journal-title":"Clin. Infect. Dis."},{"key":"B24","article-title":"Nocardia","volume-title":"StatPearls","author":"Rathish","year":"2025"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13509","article-title":"Infectious Diseases Community of Practice of the American Society of Transplantation. Nocardia infections in solid organ transplantation: Guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation","volume":"33","author":"Restrepo","year":"2019","journal-title":"Clin. Transplant."},{"key":"B26","doi-asserted-by":"publisher","first-page":"778","DOI":"10.1111\/1751-7915.14146","article-title":"Identification of Nocardia and non-tuberculous Mycobacterium species by MALDI-TOF MS using the VITEK MS coupled to IVD and RUO databases","volume":"16","author":"Rodr\u00edguez-Temporal","year":"2023","journal-title":"Microb. Biotechnol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"214","DOI":"10.3855\/jidc.10169","article-title":"Fatal pulmonary infection by trimethoprim-sulfamethoxazole resistant Nocardia otitidiscaviarum: report of two cases and review","volume":"14","author":"Saksena","year":"2020","journal-title":"J. Infect. Dev. Ctries."},{"key":"B28","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1128\/AAC.01531-13","article-title":"Antimicrob Agents Chemother. Susceptibility profiles of Nocardia isolates based on current taxonomy","volume":"58","author":"Schlaberg","year":"2014","journal-title":"Antimicrob. Agents Chemother."},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2024.116477","article-title":"Evaluation of VITEK MS Version 3.0 MALDI-TOF for the identification of anaerobes, mycobacteria, Nocardia, and moulds","volume":"110","author":"Sharma","year":"2024","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2025.1672889","article-title":"Genomic and phenotypic characterization of antimicrobial resistance in clinical Nocardia species isolates","volume":"15","author":"Song","year":"2025","journal-title":"Front. Cell Infect. Microbiol."},{"key":"B31","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1016\/j.jgar.2019.06.018","article-title":"Antimicrobial susceptibility profiles and species distribution of medically relevant Nocardia species: results from a large tertiary laboratory in Australia","volume":"20","author":"Tan","year":"2020","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"B32","doi-asserted-by":"publisher","first-page":"16742","DOI":"10.1038\/s41598-021-95870-2","article-title":"Identification and antimicrobial susceptibility profiles of Nocardia species clinically isolated in Japan","volume":"11","author":"Toyokawa","year":"2021","journal-title":"Sci. Rep."},{"key":"B33","doi-asserted-by":"publisher","first-page":"754","DOI":"10.1093\/jac\/dkw489","article-title":"Epidemiology and susceptibility to antimicrobial agents of the main Nocardia species in Spain","volume":"72","author":"Valdezate","year":"2017","journal-title":"J. Antimicrob. Chemother."},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2015.00376","article-title":"Resistance gene pool to co-trimoxazole in non-susceptible Nocardia strains","volume":"6","author":"Valdezate","year":"2015","journal-title":"Front. Microbiol."},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics11050612","article-title":"Antibiotic therapy for difficult-to-treat infections in lung transplant recipients: A practical approach","volume":"11","author":"Van den Bogaart","year":"2022","journal-title":"Antibiotics (Basel)"},{"key":"B36","doi-asserted-by":"publisher","first-page":"52289","DOI":"10.1021\/acsomega.5c02351","article-title":"In vitro activity of sulfamethoxazole-trimethoprim, amikacin, oxazolidinones, fluoroquinolones and fidaxomicin against isolates of Nocardia","volume":"10","author":"Wang","year":"2025","journal-title":"ACS Omega"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0011432","article-title":"The species distribution and antimicrobial resistance profiles of Nocardia species in China: A systematic review and meta-analysis","volume":"17","author":"Wang","year":"2023","journal-title":"PloS Negl. Trop. Dis."},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.01560-21","article-title":"Epidemiology and antimicrobial resistance profiles of the Nocardia species in China, 2009 to 2021","volume":"10","author":"Wang","year":"2022","journal-title":"Microbiol. Spectr."},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000039019","article-title":"Multiple brain abscesses caused by Nocardia farcinica infection after hand injury: A case report and literature review","volume":"103","author":"Xue","year":"2024","journal-title":"Med. (Baltimore)."},{"key":"B40","doi-asserted-by":"publisher","first-page":"382","DOI":"10.1016\/j.jmii.2022.11.002","article-title":"Clinical manifestations and outcome of nocardiosis and antimicrobial susceptibility of Nocardia species in southern Taiwan, 2011-2021","volume":"56","author":"Yang","year":"2023","journal-title":"J. Microbiol. Immunol. Infect."},{"key":"B41","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1016\/j.ijid.2023.02.023","article-title":"Clinical characteristics, susceptibility profiles, and treatment of nocardiosis: a multicenter retrospective study in 2015-2021","volume":"130","author":"Yang","year":"2023","journal-title":"Int. J. Infect. Dis."},{"key":"B42","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1186\/s12941-025-00791-x","article-title":"Genomic characteristics, virulence potential, antimicrobial resistance profiles, and phylogenetic insights into Nocardia cyriacigeorgica","volume":"24","author":"Yang","year":"2025","journal-title":"Ann. Clin. Microbiol. Antimicrob."},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.001581","article-title":"Identification and antimicrobial susceptibility of referred Nocardia isolates in Victoria, Australia 2009-2019","volume":"71","author":"Yeoh","year":"2022","journal-title":"J. Med. Microbiol."},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofad409","article-title":"Mortality after Nocardiosis: risk factors and evaluation of disseminated infection","volume":"10","author":"Yetmar","year":"2023","journal-title":"Open Forum Infect. Dis."},{"key":"B45","doi-asserted-by":"publisher","first-page":"206.e1","DOI":"10.1016\/j.jtct.2022.12.004","article-title":"Risk factors and outcomes of Nocardiosis in hematopoietic stem cell transplantation recipients","volume":"29","author":"Yetmar","year":"2023","journal-title":"Transplant. Cell Ther."}],"container-title":["Frontiers in Cellular and Infection Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2026.1728269\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T10:28:08Z","timestamp":1771928888000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2026.1728269\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,13]]},"references-count":45,"alternative-id":["10.3389\/fcimb.2026.1728269"],"URL":"https:\/\/doi.org\/10.3389\/fcimb.2026.1728269","relation":{},"ISSN":["2235-2988"],"issn-type":[{"value":"2235-2988","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,13]]},"article-number":"1728269"}}