{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T11:43:25Z","timestamp":1787139805692,"version":"build-2736575974"},"reference-count":51,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T00:00:00Z","timestamp":1735776000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004488","name":"Croatian Science Foundation","doi-asserted-by":"publisher","award":["UIP-2019-04-7194"],"award-info":[{"award-number":["UIP-2019-04-7194"]}],"id":[{"id":"10.13039\/501100004488","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background\/Objectives: While the concept of viral community-acquired pneumonia (CAP) changed with COVID-19, the role of non-influenza viruses as a cause of CAP is less clear. The aim of this study was to describe the clinical course, risk factors, inflammatory profiles, antibiotic use, outcomes and complications of adenoviral (AdV) CAP. Methods: A prospective, non-interventional, observational cohort study included consecutively hospitalized immunocompetent adult patients with AdV CAP during an 18-month period. Clinical and laboratory data, including lymphocyte subpopulations and serum cytokine profiles were collected and correlated to clinical outcomes. Results: Fifty-eight patients with AdV CAP were included; 81% were males, with a median age of 33 (IQR 28\u201341) years and 62% without any comorbidities. All patients initially had high-grade fever for a median duration of 6 (5\u20137) days and respiratory symptoms. Increased CRP and procalcitonin, lymphopenia, mild thrombocytopenia and liver injury were frequent. Radiographic findings mimicked bacterial pneumonia (83% had unilateral involvement). Twenty-two patients (38%) had criteria for severe CAP, and these patients had higher procalcitonin, NLR, AST, ALT, LDH and CK, and lower T-lymphocyte CD4+ count. In comparison to influenza and bacterial CAP, patients with AdV had higher serum IL-2, IL-1\u03b2, IL-8, IL-10, CXCL10 and MCP-1, and lower TGF-\u03b21 concentration. Thirteen patients required low-flow oxygen therapy, and 13 advanced respiratory support. Complications occurred in 29%, with one fatal outcome. While all patients received empirical antibiotic therapy, after AdV detection it was stopped in 21%, although only one patient had detected a possible bacterial coinfection. Conclusions: Since AdV CAP in immunocompetent patients is clinically and radiologically indistinguishable from bacterial CAP, it is associated with prolonged clinical course and lack of clinical response to antibiotics. This emphasizes the importance of AdV testing which could lead to more rational antimicrobial treatment.<\/jats:p>","DOI":"10.3390\/antibiotics14010023","type":"journal-article","created":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T07:44:53Z","timestamp":1735803893000},"page":"23","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Adenoviral Pneumonia Outbreak in Immunocompetent Adults\u2014A Missed Antimicrobial Stewardship Opportunity?"],"prefix":"10.3390","volume":"14","author":[{"given":"Branimir","family":"Gjurasin","sequence":"first","affiliation":[{"name":"Department for Intensive Care, University Hospital for Infectious Diseases \u201cDr. Fran Mihaljevi\u0107\u201d, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorna","family":"Stemberger Maric","sequence":"additional","affiliation":[{"name":"Department for Infectious Diseases, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"},{"name":"Department for Pediatric Infectious Diseases, University Hospital for Infectious Diseases \u201cDr. Fran Mihaljevi\u0107\u201d, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tvrtko","family":"Jukic","sequence":"additional","affiliation":[{"name":"Department for Intensive Care, University Hospital for Infectious Diseases \u201cDr. Fran Mihaljevi\u0107\u201d, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leona","family":"Radmanic Matotek","sequence":"additional","affiliation":[{"name":"Department for Immunological and Molecular Diagnostics, University Hospital for Infectious Diseases \u201cDr. Fran Mihaljevi\u0107\u201d, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Snjezana","family":"Zidovec Lepej","sequence":"additional","affiliation":[{"name":"Department for Immunological and Molecular Diagnostics, University Hospital for Infectious Diseases \u201cDr. Fran Mihaljevi\u0107\u201d, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marko","family":"Kutlesa","sequence":"additional","affiliation":[{"name":"Department for Intensive Care, University Hospital for Infectious Diseases \u201cDr. Fran Mihaljevi\u0107\u201d, 10000 Zagreb, Croatia"},{"name":"Department for Infectious Diseases, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5784-1343","authenticated-orcid":false,"given":"Neven","family":"Papic","sequence":"additional","affiliation":[{"name":"Department for Infectious Diseases, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"},{"name":"Department for Viral Hepatitis, University Hospital for Infectious Diseases \u201cDr. Fran Mihaljevi\u0107\u201d, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Meregildo-Rodriguez, E.D., Asmat-Rubio, M.G., Rojas-Benites, M.J., and Vasquez-Tirado, G.A. (2023). Acute Coronary Syndrome, Stroke, and Mortality after Community-Acquired Pneumonia: Systematic Review and Meta-Analysis. J. Clin. Med., 12.","DOI":"10.3390\/jcm12072577"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1001\/jama.2016.0291","article-title":"Epidemiology, Patterns of Care, and Mortality for Patients with Acute Respiratory Distress Syndrome in Intensive Care Units in 50 Countries","volume":"315","author":"Bellani","year":"2016","journal-title":"JAMA"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/S0140-6736(19)32989-7","article-title":"Global, regional, and national sepsis incidence and mortality, 1990\u20132017: Analysis for the Global Burden of Disease Study","volume":"395","author":"Rudd","year":"2020","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1056\/NEJMoa1500245","article-title":"Community-Acquired Pneumonia Requiring Hospitalization among U.S. Adults","volume":"373","author":"Jain","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1093\/infdis\/jiv323","article-title":"Respiratory Viral Detection in Children and Adults: Comparing Asymptomatic Controls and Patients with Community-Acquired Pneumonia","volume":"213","author":"Self","year":"2016","journal-title":"J. Infect. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1164\/rccm.202102-0498ST","article-title":"Nucleic Acid-based Testing for Noninfluenza Viral Pathogens in Adults with Suspected Community-acquired Pneumonia. An Official American Thoracic Society Clinical Practice Guideline","volume":"203","author":"Evans","year":"2021","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"109548","DOI":"10.1016\/j.ejrad.2021.109548","article-title":"Radiological, epidemiological and clinical patterns of pulmonary viral infections","volume":"136","author":"Stefanidis","year":"2021","journal-title":"Eur. J. Radiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1055\/s-0040-1710537","article-title":"Other Respiratory Viruses as a Cause of Community-Acquired Pneumonia","volume":"41","author":"Walter","year":"2020","journal-title":"Semin. Respir. Crit. Care Med."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Lin, F., Zhou, Q., Li, W., Xiao, W., Li, S., Liu, B., Li, H., Cui, Y., Lu, R., and Li, Y. (2023). A prediction model for acute respiratory distress syndrome in immunocompetent adults with adenovirus-associated Pneumonia: A multicenter retrospective analysis. BMC Pulm. Med., 23.","DOI":"10.1186\/s12890-023-02742-8"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1177\/0284185116681039","article-title":"Thin-section computed tomography findings in 104 immunocompetent patients with adenovirus pneumonia","volume":"58","author":"Park","year":"2017","journal-title":"Acta Radiol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Hu, C., Zeng, Y., Zhong, Z., Yang, L., Li, H., Zhang, H.M., Xia, H., and Jiang, M.Y. (2023). Clinical characteristics and severity prediction score of Adenovirus pneumonia in immunocompetent adult. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0281590"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1097\/TP.0000000000003988","article-title":"Adenovirus Infection and Transplantation","volume":"106","author":"Cathro","year":"2022","journal-title":"Transplantation"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Zhang, J., Zhu, Y., Zhou, Y., Gao, F., Qiu, X., Li, J., Yuan, H., Jin, W., and Lin, W. (2023). Pediatric adenovirus pneumonia: Clinical practice and current treatment. Front. Med., 10.","DOI":"10.3389\/fmed.2023.1207568"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1056\/NEJMoa1405870","article-title":"Community-acquired pneumonia requiring hospitalization among U.S. children","volume":"372","author":"Jain","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.1086\/522970","article-title":"Abrupt emergence of diverse species B adenoviruses at US military recruit training centers","volume":"196","author":"Metzgar","year":"2007","journal-title":"J. Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1093\/infdis\/jir040","article-title":"Pneumonia in military trainees: A comparison study based on adenovirus serotype 14 infection","volume":"203","author":"Vento","year":"2011","journal-title":"J. Infect. Dis."},{"key":"ref_17","first-page":"6","article-title":"Characteristics of fever and response to antipyretic therapy in military personnel with adenovirus-positive community-acquired pneumonia","volume":"7","author":"Yoo","year":"2020","journal-title":"Mil. Med. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.7205\/MILMED-D-03-0208","article-title":"Adenovirus serotype 14 pneumonia at a basic military training site in the United States, spring 2007: A case series","volume":"174","author":"Brosch","year":"2009","journal-title":"Mil. Med"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1086\/598520","article-title":"Outbreak of severe respiratory disease associated with emergent human adenovirus serotype 14 at a US air force training facility in 2007","volume":"199","author":"Tate","year":"2009","journal-title":"J. Infect. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"359","DOI":"10.7883\/yoken.66.359","article-title":"Outbreak of febrile respiratory illness caused by adenovirus at a South Korean military training facility: Clinical and radiological characteristics of adenovirus pneumonia","volume":"66","author":"Hwang","year":"2013","journal-title":"Jpn. J. Infect. Dis."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Park, J.Y., Kim, B.J., Lee, E.J., Park, K.S., Park, H.S., Jung, S.S., and Kim, J.O. (2017). Clinical Features and Courses of Adenovirus Pneumonia in Healthy Young Adults during an Outbreak among Korean Military Personnel. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0170592"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"287","DOI":"10.3346\/jkms.2017.32.2.287","article-title":"Characteristics of Adenovirus Pneumonia in Korean Military Personnel, 2012-2016","volume":"32","author":"Yoon","year":"2017","journal-title":"J. Korean Med. Sci."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Guo, Z., Zhang, Z., Prajapati, M., and Li, Y. (2021). Lymphopenia Caused by Virus Infections and the Mechanisms Beyond. Viruses, 13.","DOI":"10.3390\/v13091876"},{"key":"ref_24","first-page":"275","article-title":"T-cells immune response controls the high incidence of adenovirus infection in adult allogenic hematopoietic transplantation recipients","volume":"106","author":"Merino","year":"2021","journal-title":"Haematologica"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Zheng, R., Li, Y., Chen, D., Su, J., Han, N., Chen, H., Ning, Z., Xiao, M., Zhao, M., and Zhu, B. (2021). Changes of Host Immunity Mediated by IFN-\u03b3+ CD8+ T Cells in Children with Adenovirus Pneumonia in Different Severity of Illness. Viruses, 13.","DOI":"10.3390\/v13122384"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1180","DOI":"10.1093\/infdis\/jiaa237","article-title":"Adenovirus Viral Kinetics and Mortality in Ex Vivo T Cell-Depleted Hematopoietic Cell Transplant Recipients With Adenovirus Infection From a Single Center","volume":"222","author":"Lee","year":"2020","journal-title":"J. Infect. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Paranga, T.G., Mitu, I., Pavel-Tanasa, M., Rosu, M.F., Miftode, I.L., Constantinescu, D., Obreja, M., Plesca, C.E., and Miftode, E. (2024). Cytokine Storm in COVID-19: Exploring IL-6 Signaling and Cytokine-Microbiome Interactions as Emerging Therapeutic Approaches. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms252111411"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Papageorgiou, D., Gogos, C., and Akinosoglou, K. (2024). Macrophage Activation Syndrome in Viral Sepsis. Viruses, 16.","DOI":"10.3390\/v16071004"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.cytogfr.2020.11.003","article-title":"Macrophage-derived cytokines in pneumonia: Linking cellular immunology and genetics","volume":"59","author":"Dukhinova","year":"2021","journal-title":"Cytokine Growth Factor. Rev."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Sun, J., Ma, X., Zhang, M., Xie, M., Zhang, X., Han, X., Li, X., Zhou, E., Wang, J., and Wang, J. (2023). Comparisons of lymphocytes profiles and inflammatory cytokines levels in blood of patients with differed severity of infection by human adenovirus type 7. BMC Infect. Dis., 23.","DOI":"10.1186\/s12879-023-08132-z"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Li, J., Wei, J., Xu, Z., Jiang, C., Li, M., Chen, J., Li, Y., Yang, M., Gu, Y., and Wang, F. (2021). Cytokine\/Chemokine Expression Is Closely Associated Disease Severity of Human Adenovirus Infections in Immunocompetent Adults and Predicts Disease Progression. Front. Immunol., 12.","DOI":"10.3389\/fimmu.2021.691879"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1929","DOI":"10.1007\/s11739-024-03699-0","article-title":"Association of serum interleukin-2 with severity and prognosis in hospitalized patients with community-acquired pneumonia: A prospective cohort study","volume":"19","author":"Zhu","year":"2024","journal-title":"Intern. Emerg. Med."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Papic, N., Samadan, L., Vrsaljko, N., Radmanic, L., Jelicic, K., Simicic, P., Svoboda, P., Lepej, S.Z., and Vince, A. (2022). Distinct Cytokine Profiles in Severe COVID-19 and Non-Alcoholic Fatty Liver Disease. Life, 12.","DOI":"10.3390\/life12060795"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Cesta, M.C., Zippoli, M., Marsiglia, C., Gavioli, E.M., Mantelli, F., Allegretti, M., and Balk, R.A. (2021). The Role of Interleukin-8 in Lung Inflammation and Injury: Implications for the Management of COVID-19 and Hyperinflammatory Acute Respiratory Distress Syndrome. Front. Pharmacol., 12.","DOI":"10.3389\/fphar.2021.808797"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1093\/jleuko\/qiad070","article-title":"Neutrophil responsiveness to IL-10 impairs clearance of Streptococcus pneumoniae from the lungs","volume":"115","author":"Horn","year":"2024","journal-title":"J. Leukoc. Biol."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Kameda, M., Otsuka, M., Chiba, H., Kuronuma, K., Hasegawa, T., Takahashi, H., and Takahashi, H. (2020). CXCL9, CXCL10, and CXCL11; biomarkers of pulmonary inflammation associated with autoimmunity in patients with collagen vascular diseases-associated interstitial lung disease and interstitial pneumonia with autoimmune features. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0241719"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1038\/mi.2017.77","article-title":"Epithelial-derived TGF-beta1 acts as a pro-viral factor in the lung during influenza A infection","volume":"11","author":"Denney","year":"2018","journal-title":"Mucosal Immunol."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Susak, F., Vrsaljko, N., Vince, A., and Papic, N. (2023). TGF Beta as a Prognostic Biomarker of COVID-19 Severity in Patients with NAFLD-A Prospective Case-Control Study. Microorganisms, 11.","DOI":"10.3390\/microorganisms11061571"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1165\/rcmb.2002-0092OC","article-title":"The acute respiratory distress syndrome: A role for transforming growth factor-beta 1","volume":"28","author":"Fahy","year":"2003","journal-title":"Am. J. Respir. Cell Mol. Biol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e45","DOI":"10.1164\/rccm.201908-1581ST","article-title":"Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America","volume":"200","author":"Metlay","year":"2019","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_41","unstructured":"(2023). Pneumonia in Adults: Diagnosis and Management, National Institute for Health and Care Excellence."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1056\/NEJMcp2303286","article-title":"Community-Acquired Pneumonia","volume":"389","author":"File","year":"2023","journal-title":"N. Engl. J. Med."},{"key":"ref_43","unstructured":"IDSA (2024, November 28). CAP Clinical Pathway. Available online: https:\/\/www.idsociety.org\/globalassets\/idsa\/practice-guidelines\/community-acquired-pneumonia-in-adults\/cap-clinical-pathway-final-online.pdf."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1007\/s00134-023-07033-8","article-title":"ERS\/ESICM\/ESCMID\/ALAT guidelines for the management of severe community-acquired pneumonia","volume":"49","author":"Torres","year":"2023","journal-title":"Intensive Care Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1186\/s13054-015-1120-5","article-title":"Impact of antibacterials on subsequent resistance and clinical outcomes in adult patients with viral pneumonia: An opportunity for stewardship","volume":"19","author":"Crotty","year":"2015","journal-title":"Crit. Care"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1016\/j.cmi.2019.06.012","article-title":"Evaluation of a molecular point-of-care testing for viral and atypical pathogens on intravenous antibiotic duration in hospitalized adults with lower respiratory tract infection: A randomized clinical trial","volume":"25","author":"Shengchen","year":"2019","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"10-1128","DOI":"10.1128\/JCM.00861-19","article-title":"Opportunities Revealed for Antimicrobial Stewardship and Clinical Practice with Implementation of a Rapid Respiratory Multiplex Assay","volume":"57","author":"Weiss","year":"2019","journal-title":"J. Clin. Microbiol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1007\/s00134-022-06684-3","article-title":"Low-dose methylprednisolone treatment in critically ill patients with severe community-acquired pneumonia","volume":"48","author":"Meduri","year":"2022","journal-title":"Intensive Care Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"S27","DOI":"10.1086\/511159","article-title":"Infectious Diseases Society of America\/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults","volume":"44","author":"Mandell","year":"2007","journal-title":"Clin. Infect. Dis."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1164\/rccm.202303-0558WS","article-title":"A New Global Definition of Acute Respiratory Distress Syndrome","volume":"209","author":"Matthay","year":"2024","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"c179","DOI":"10.1159\/000339789","article-title":"KDIGO clinical practice guidelines for acute kidney injury","volume":"120","author":"Khwaja","year":"2012","journal-title":"Nephron Clin. Pract."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/14\/1\/23\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T10:22:03Z","timestamp":1759918923000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/14\/1\/23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,2]]},"references-count":51,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1]]}},"alternative-id":["antibiotics14010023"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics14010023","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,2]]}}}