{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T03:38:01Z","timestamp":1791430681751,"version":"4.3.3"},"reference-count":61,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2019,10,5]],"date-time":"2019-10-05T00:00:00Z","timestamp":1570233600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009045","name":"Uniwersytet Jagiello\u0144ski Collegium Medicum","doi-asserted-by":"publisher","award":["K\/ZDS\/007955"],"award-info":[{"award-number":["K\/ZDS\/007955"]}],"id":[{"id":"10.13039\/100009045","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>The chronically inflamed mucosa in patients with chronic rhinosinusitis (CRS) can additionally be infected by bacteria, which results in an acute exacerbation of the disease (AECRS). Currently, AECRS is universally treated with antibiotics following the guidelines for acute bacterial rhinosinusitis (ABRS), as our understanding of its microbiology is insufficient to establish specific treatment recommendations. Unfortunately, antibiotics frequently fail to control the symptoms of AECRS due to biofilm formation, disruption of the natural microbiota, and arising antibiotic resistance. These issues can potentially be addressed by phage therapy. In this study, the endoscopically-guided cultures were postoperatively obtained from 50 patients in order to explore the microbiology of AECRS, evaluate options for antibiotic treatment, and, most importantly, assess a possibility of efficient phage therapy. Staphylococcus aureus and coagulase-negative staphylococci were the most frequently isolated bacteria, followed by Haemophilus influenzae, Pseudomonas aeruginosa, and Enterobacteriaceae. Alarmingly, mechanisms of antibiotic resistance were detected in the isolates from 46% of the patients. Bacteria not sensitive to amoxicillin were carried by 28% of the patients. The lowest rates of resistance were noted for fluoroquinolones and aminoglycosides. Fortunately, 60% of the patients carried bacterial strains that were sensitive to bacteriophages from the Biophage Pharma collection and 81% of the antibiotic-resistant strains turned out to be sensitive to bacteriophages. The results showed that microbiology of AECRS is distinct from ABRS and amoxicillin should not be the antibiotic of first choice. Currently available bacteriophages could be used instead of antibiotics or as an adjunct to antibiotics in the majority of patients with AECRS.<\/jats:p>","DOI":"10.3390\/antibiotics8040175","type":"journal-article","created":{"date-parts":[[2019,10,7]],"date-time":"2019-10-07T03:34:01Z","timestamp":1570419241000},"page":"175","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Exacerbations of Chronic Rhinosinusitis\u2014Microbiology and Perspectives of Phage Therapy"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7980-0497","authenticated-orcid":false,"given":"Joanna","family":"Szaleniec","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Faculty of Medicine, Jagiellonian University Medical College, Sniadeckich 2, 31-531 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9369-1135","authenticated-orcid":false,"given":"Agnieszka","family":"Giba\u0142a","sequence":"additional","affiliation":[{"name":"Jerzy Haber Institute of Catalysis and Surface Chemistry Polish Academy of Sciences, Niezapominajek 8, 30-239 Krakow, Poland"},{"name":"Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Cracow Branch, Garncarska 11, 31-115 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Pobiega","sequence":"additional","affiliation":[{"name":"Biophage Pharma S.A., Mogilska 40, 31-546 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylwia","family":"Parasion","sequence":"additional","affiliation":[{"name":"Biophage Pharma S.A., Mogilska 40, 31-546 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacek","family":"Sk\u0142adzie\u0144","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Faculty of Medicine, Jagiellonian University Medical College, Sniadeckich 2, 31-531 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawe\u0142","family":"Str\u0119k","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Faculty of Medicine, Jagiellonian University Medical College, Sniadeckich 2, 31-531 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4725-5943","authenticated-orcid":false,"given":"Tomasz","family":"Gosiewski","sequence":"additional","affiliation":[{"name":"Department of Molecular Medical Microbiology Unit, Faculty of Medicine, Jagiellonian University Medical College, Czysta 18, 31-121 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7650-9263","authenticated-orcid":false,"given":"Maciej","family":"Szaleniec","sequence":"additional","affiliation":[{"name":"Jerzy Haber Institute of Catalysis and Surface Chemistry Polish Academy of Sciences, Niezapominajek 8, 30-239 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,10,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.1111\/j.1398-9995.2011.02646.x","article-title":"Chronic rhinosinusitis in Europe\u2014An underestimated disease. A GA(2)LEN study","volume":"66","author":"Hastan","year":"2011","journal-title":"Allergy"},{"key":"ref_2","first-page":"1","article-title":"Summary health statistics for U.S. adults: National health interview survey, 2012","volume":"260","author":"Blackwell","year":"2014","journal-title":"Vital Health Stat. 10"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/S0194-59989570152-4","article-title":"The health impact of chronic sinusitis in patients seeking otolaryngologic care","volume":"113","author":"Gliklich","year":"1995","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1177\/000348941112000701","article-title":"Incremental health care utilization and expenditures for chronic rhinosinusitis in the United States","volume":"120","author":"Bhattacharyya","year":"2011","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"134","DOI":"10.2500\/ajra.2016.30.4297","article-title":"Chronic rhinosinusitis: Epidemiology and burden of disease","volume":"30","author":"DeConde","year":"2016","journal-title":"Am. J. Rhinol. Allergy"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"467","DOI":"10.2500\/ajra.2013.27.3960","article-title":"Chronic rhinosinusitis and antibiotics: The good, the bad, and the ugly","volume":"27","author":"Kennedy","year":"2013","journal-title":"Am. J. Rhinol. Allergy"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1016\/j.jaci.2013.07.009","article-title":"National burden of antibiotic use for adult rhinosinusitis","volume":"132","author":"Smith","year":"2013","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1002\/lary.21438","article-title":"Do biofilms contribute to the initiation and recalcitrance of chronic rhinosinusitis?","volume":"121","author":"Foreman","year":"2011","journal-title":"Laryngoscope"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"169","DOI":"10.2500\/ajra.2010.24.3462","article-title":"The impact of biofilms on outcomes after endoscopic sinus surgery","volume":"24","author":"Singhal","year":"2010","journal-title":"Am. J. Rhinol. Allergy"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.jaci.2011.02.022","article-title":"Asthma and biofilm-forming bacteria are independently associated with revision sinus surgeries for chronic rhinosinusitis","volume":"128","author":"Zhang","year":"2011","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1128\/CMR.00060-16","article-title":"Chronic rhinosinusitis and the evolving understanding of microbial ecology in chronic inflammatory mucosal disease","volume":"30","author":"Hoggard","year":"2017","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1097\/MOO.0000000000000221","article-title":"The sinonasal bacterial microbiome in health and disease","volume":"24","author":"Ramakrishnan","year":"2016","journal-title":"Curr. Opin. Otolaryngol. Head Neck Surg."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Boase, S., Foreman, A., Cleland, E., Tan, L., Melton-Kreft, R., Pant, H., Hu, F.Z., Ehrlich, G.D., and Wormald, P.J. (2013). The microbiome of chronic rhinosinusitis: Culture, molecular diagnostics and biofilm detection. BMC Infect. Dis., 13.","DOI":"10.1186\/1471-2334-13-210"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1002\/lio2.61","article-title":"The role of infection and antibiotics in chronic rhinosinusitis","volume":"2","author":"Barshak","year":"2017","journal-title":"Laryngoscope Investig. Otolaryngol."},{"key":"ref_15","first-page":"CD011994","article-title":"Systemic and topical antibiotics for chronic rhinosinusitis","volume":"4","author":"Head","year":"2016","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1097\/MOO.0000000000000010","article-title":"When and how should we treat biofilms in chronic sinusitis?","volume":"22","author":"Jain","year":"2014","journal-title":"Curr. Opin. Otolaryngol. Head Neck Surg."},{"key":"ref_17","first-page":"S22","article-title":"International consensus statement on allergy and rhinology: Rhinosinusitis","volume":"6","author":"Orlandi","year":"2016","journal-title":"Int. Forum Allergy Rhinol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1001\/archotol.132.10.1099","article-title":"Bacteriology of chronic sinusitis and acute exacerbation of chronic sinusitis","volume":"132","author":"Brook","year":"2006","journal-title":"Arch. Otolaryngol. Head Neck Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1053\/hn.2003.v128.amhn0312811","article-title":"Adult chronic rhinosinusitis: Definitions, diagnosis, epidemiology, and pathophysiology","volume":"129","author":"Benninger","year":"2003","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1002\/alr.21170","article-title":"Comparison of endoscopically-guided swab vs aspirate culture techniques in post-endoscopic sinus surgery patients: Blinded, prospective analysis","volume":"3","author":"Walgama","year":"2013","journal-title":"Int. Forum Allergy Rhinol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.amjoto.2005.09.006","article-title":"Treatment of chronic rhinosinusitis exacerbations due to methicillin-resistant Staphylococcus aureus with mupirocin irrigations","volume":"27","author":"Solares","year":"2006","journal-title":"Am. J. Otolaryngol."},{"key":"ref_22","first-page":"3","article-title":"European Position Paper on Rhinosinusitis and Nasal Polyps 2012","volume":"50","author":"Fokkens","year":"2012","journal-title":"Rhinol. Suppl."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1016\/j.jaip.2016.09.015","article-title":"Acute exacerbations mediate quality of life impairment in chronic rhinosinusitis","volume":"5","author":"Phillips","year":"2017","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/j.jaip.2015.12.008","article-title":"Are antibiotics useful for chronic rhinosinusitis?","volume":"4","author":"Bachert","year":"2016","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"66","DOI":"10.4161\/bact.1.2.15845","article-title":"Phage treatment of human infections","volume":"1","author":"Abedon","year":"2011","journal-title":"Bacteriophage"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"69","DOI":"10.2174\/138920110790725401","article-title":"Phage therapy in clinical practice: Treatment of human infections","volume":"11","author":"Kutter","year":"2010","journal-title":"Curr. Pharm. Biotechnol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/B978-0-12-394438-2.00003-7","article-title":"Clinical aspects of phage therapy","volume":"83","author":"Miedzybrodzki","year":"2012","journal-title":"Adv. Virus Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"261","DOI":"10.2174\/138920108785161604","article-title":"The use of phages for the removal of infectious biofilms","volume":"9","author":"Azeredo","year":"2008","journal-title":"Curr. Pharm. Biotechnol."},{"key":"ref_29","first-page":"183","article-title":"Staging in rhinosinusitus","volume":"31","author":"Lund","year":"1993","journal-title":"Rhinology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2216","DOI":"10.1002\/lary.24654","article-title":"Modification of the Lund-Kennedy endoscopic scoring system improves its reliability and correlation with patient-reported outcome measures","volume":"124","author":"Psaltis","year":"2014","journal-title":"Laryngoscope"},{"key":"ref_31","first-page":"S1","article-title":"Clinical practice guideline (update): Adult sinusitis","volume":"152","author":"Rosenfeld","year":"2015","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1177\/000348940511400714","article-title":"Microbiology of acute exacerbation of chronic sinusitis","volume":"114","author":"Brook","year":"2005","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1513\/pats.201003-028RN","article-title":"Treatment options for chronic rhinosinusitis","volume":"8","author":"Suh","year":"2011","journal-title":"Proc. Am. Thorac. Soc."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1001\/archotol.125.10.1117","article-title":"The microbiology of recurrent rhinosinusitis after endoscopic sinus surgery","volume":"125","author":"Bhattacharyya","year":"1999","journal-title":"Arch. Otolaryngol. Head Neck Surg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1002\/alr.22147","article-title":"Comparison of outcomes following culture-directed vs. non-culture-directed antibiotics in treatment of acute exacerbations of chronic rhinosinusitis","volume":"8","author":"Yan","year":"2018","journal-title":"Int. Forum Allergy Rhinol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1016\/j.amjoto.2015.04.009","article-title":"Endoscopic culture-directed antibiotic therapy: Impact on patient symptoms in chronic rhinosinusitis","volume":"36","author":"Jiang","year":"2015","journal-title":"Am. J. Otolaryngol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1562","DOI":"10.1097\/01.mlg.0000230402.66579.07","article-title":"The impact of endoscopic cultures on care in rhinosinusitis","volume":"116","author":"Cincik","year":"2006","journal-title":"Laryngoscope"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/j.amjoto.2004.03.003","article-title":"The microbiology and antimicrobial resistance patterns in chronic rhinosinusitis","volume":"25","author":"Kingdom","year":"2004","journal-title":"Am. J. Otolaryngol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1177\/000348940811700608","article-title":"Assessment of trends in antimicrobial resistance in chronic rhinosinusitis","volume":"117","author":"Bhattacharyya","year":"2008","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1427","DOI":"10.2217\/fmb-2017-0073","article-title":"Can phage therapy solve the problem of recalcitrant chronic rhinosinusitis?","volume":"12","author":"Szaleniec","year":"2017","journal-title":"Future Microbiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"3","DOI":"10.2500\/ajra.2014.28.4001","article-title":"Bacteriophage reduces biofilm of Staphylococcus aureus ex vivo isolates from chronic rhinosinusitis patients","volume":"28","author":"Drilling","year":"2014","journal-title":"Am. J. Rhinol. Allergy"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"418","DOI":"10.3389\/fcimb.2017.00418","article-title":"Activity of bacteriophages in removing biofilms of Pseudomonas aeruginosa isolates from chronic rhinosinusitis patients","volume":"7","author":"Fong","year":"2017","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1002\/alr.22046","article-title":"Bacteriophage effectively kills multidrug resistant Staphylococcus aureus clinical isolates from chronic rhinosinusitis patients","volume":"8","author":"Zhang","year":"2018","journal-title":"Int. Forum Allergy Rhinol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1002\/alr.21270","article-title":"Safety and efficacy of topical bacteriophage and ethylenediaminetetraacetic acid treatment of Staphylococcus aureus infection in a sheep model of sinusitis","volume":"4","author":"Drilling","year":"2014","journal-title":"Int. Forum Allergy Rhinol."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Drilling, A.J., Ooi, M.L., Miljkovic, D., James, C., Speck, P., Vreugde, S., Clark, J., and Wormald, P.J. (2017). Long-term safety of topical bacteriophage application to the frontal sinus region. Front. Cell. Infect. Microbiol., 7.","DOI":"10.3389\/fcimb.2017.00049"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"404","DOI":"10.4161\/bbug.1.6.13422","article-title":"The truncated phage lysin CHAP(k) eliminates Staphylococcus aureus in the nares of mice","volume":"1","author":"Fenton","year":"2010","journal-title":"Bioeng. Bugs"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Chhibber, S., Gupta, P., and Kaur, S. (2014). Bacteriophage as effective decolonising agent for elimination of MRSA from anterior nares of BALB\/c mice. BMC Microbiol., 14.","DOI":"10.1186\/s12866-014-0212-8"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.trsl.2018.12.002","article-title":"Safety and efficacy of a bacteriophage cocktail in an in vivo model of Pseudomonas aeruginosa sinusitis","volume":"206","author":"Fong","year":"2019","journal-title":"Transl. Res."},{"key":"ref_49","first-page":"291","article-title":"The application of bacteriophages in the treatment of chronic purulent maxillary sinusitis","volume":"5","author":"Mulczyk","year":"1996","journal-title":"Post. Med. Klin. Do\u015bw."},{"key":"ref_50","first-page":"547","article-title":"Bacteriophage therapy of bacterial infections: An update on our institute\u2019s experience","volume":"48","author":"Mulczyk","year":"2000","journal-title":"Arch. Immunol. Ther. Exp. (Warsz.)"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"605","DOI":"10.2217\/fmb-2017-0264","article-title":"Is phage therapy suitable for treating chronic sinusitis Staphylococcus aureus infection?","volume":"13","author":"Speck","year":"2018","journal-title":"Future Microbiol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1001\/jamaoto.2019.1191","article-title":"Safety and tolerability of bacteriophage therapy for chronic rhinosinusitis due to Staphylococcus aureus","volume":"145","author":"Ooi","year":"2019","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"233","DOI":"10.2500\/105065898781390000","article-title":"Endoscopically guided cultures in chronic sinusitis","volume":"12","author":"Nadel","year":"1998","journal-title":"Am. J. Rhinol."},{"key":"ref_54","unstructured":"The European Committee on Antimicrobial Susceptibility Testing (2017). EUCAST Disk Diffusion Method for Antimicrobial Susceptibility Testing v 6.0., EUCAST. Available online: http:\/\/www.eucast.org."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"O255","DOI":"10.1111\/1469-0691.12373","article-title":"Development of the EUCAST disk diffusion antimicrobial susceptibility testing method and its implementation in routine microbiology laboratories","volume":"20","author":"Matuschek","year":"2014","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_56","unstructured":"(2018, April 01). Clinical Breakpoints\u2014Bacteria (v 8.0). Available online: www.eucast.org."},{"key":"ref_57","unstructured":"Rak, G. (2015). New Strains of Bacteriophages, Specific to Bacteria Belonging to Pseudomonas genus and Their Application in Production of the Preparations Fighting Bacterial Infections. (PL 228 848 B1)."},{"key":"ref_58","unstructured":"Rak, G. (2015). New Strains of Bacteriophages, Specific to Bacteria Belonging to Staphylococcus genus and Their Application in Production of the Preparations Fighting Bacterial Infections. (PL 228 849 B1)."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1007\/978-1-60327-164-6_14","article-title":"Phage host range and efficiency of plating","volume":"501","author":"Kutter","year":"2009","journal-title":"Methods Mol. Biol."},{"key":"ref_60","first-page":"611","article-title":"Phage types recognized within Salmonella enteritidis strains isolated in Poland in 1996\u20132007","volume":"66","year":"2012","journal-title":"Przegl. Epidemiol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"303","DOI":"10.18388\/abp.2015_1114","article-title":"Differentiation of polyvalent bacteriophages specific to uropathogenic Proteus mirabilis strains based on the host range pattern and RFLP","volume":"63","author":"Maszewska","year":"2016","journal-title":"Acta Biochim. Pol."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/8\/4\/175\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:27:46Z","timestamp":1760189266000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/8\/4\/175"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,5]]},"references-count":61,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2019,12]]}},"alternative-id":["antibiotics8040175"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics8040175","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,5]]}}}