{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T01:35:54Z","timestamp":1790127354313,"version":"4.0.1"},"reference-count":50,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2024,7,20]],"date-time":"2024-07-20T00:00:00Z","timestamp":1721433600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Antibiotic (AB) therapy is the first step in managing hidradenitis suppurativa (HS). Knowledge of the local patterns of antimicrobial resistance is paramount for the appropriate selection of antimicrobials. This study aimed to assess the occurrence of antibiotic resistance in patients with HS. Methods: A cross-sectional study was conducted on 103 patients with HS seen at the Dermatology Department at the University Hospital of Heraklion, Heraklion, Crete, Greece, from January 2019 to December 2023, who were not on any antibiotics in the last three months. Results: A total of 103 patients with HS participated in this study. Purulent material from 139 skin lesions of these patients was swabbed, and 79.86% (111\/139) tested positive for bacteria. Gram-positive isolates accounted for 73%, whereas Gram-negative isolates comprised 27%. Among the isolates, 85.1% were aerobes, and 14.9% were anaerobic. The most common bacterial families isolated were Staphylococcaceae (48.27%), Enterobacteriaceae (14.94%), and Streptococcaceae (6.89%). The antibiogram profiles of bacterial cultures revealed a 57.1% resistance to levofloxacin and a 53.3% resistance to penicillin in Staphylococcus lugdunensis, whereas Staphylococcus aureus showed a 76.9% resistance to penicillin and a 58.3% resistance to fusidic acid. High resistance rates of 63.5% for tigecycline, 63.3% for ampicillin, and 40.5% for colistin were observed for Gram-negative isolates. Resistances of 62.5%, 61.5%, and 53.8% to erythromycin, clindamycin, and penicillin, respectively, were observed in the anaerobes. Conclusions: Patients with HS displayed considerable resistance to bacterial proliferation. The revised therapeutic guidelines for HS should incorporate the latest insights into bacterial antibiotic resistance.<\/jats:p>","DOI":"10.3390\/jcm13144246","type":"journal-article","created":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T14:45:53Z","timestamp":1721659553000},"page":"4246","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Antimicrobial Resistance Trends in Hidradenitis Suppurativa Lesions"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7074-2374","authenticated-orcid":false,"given":"Dimitra","family":"Koumaki","sequence":"first","affiliation":[{"name":"Dermatology Department, University Hospital of Heraklion, Heraklion, 711 10 Crete, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Evangelou","sequence":"additional","affiliation":[{"name":"Dermatology Department, University Hospital of Heraklion, Heraklion, 711 10 Crete, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Maraki","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, University Hospital of Heraklion, Heraklion, 711 10 Crete, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelia","family":"Rovithi","sequence":"additional","affiliation":[{"name":"Dermatology Department, University Hospital of Heraklion, Heraklion, 711 10 Crete, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danae","family":"Petrou","sequence":"additional","affiliation":[{"name":"Dermatology Department, University Hospital of Heraklion, Heraklion, 711 10 Crete, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erato Solia","family":"Apokidou","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Agios Nikolaos General Hospital, Knosou 4, Ag. Nikolaos, 721 00 Crete, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7585-1032","authenticated-orcid":false,"given":"Stamatios","family":"Gregoriou","sequence":"additional","affiliation":[{"name":"1st Department of Dermatology and Venereology, Medical School of Athens, National and Kapodistrian University of Athens, Andreas Sygros Hospital, I. Dragoumi 5, 161 21 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasiliki","family":"Koumaki","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Medical School of Athens, National and Kapodistrian University of Athens, 75 Mikras Asias Str., Goudi, 115 27 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1082-5674","authenticated-orcid":false,"given":"Petros","family":"Ioannou","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Hospital of Heraklion, Heraklion, 711 10 Crete, Greece"},{"name":"School of Medicine, University of Crete, 700 03 Iraklio, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4446-8214","authenticated-orcid":false,"given":"Kyriaki","family":"Zografaki","sequence":"additional","affiliation":[{"name":"Dermatology Department, University Hospital of Heraklion, Heraklion, 711 10 Crete, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aikaterini","family":"Doxastaki","sequence":"additional","affiliation":[{"name":"Dermatology Department, University Hospital of Heraklion, Heraklion, 711 10 Crete, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8189-7486","authenticated-orcid":false,"given":"Alexander","family":"Katoulis","sequence":"additional","affiliation":[{"name":"2nd Department of Dermatology and Venereology, Medical School, National and Kapodistrian University of Athens, \u201cAttikon\u201d General University Hospital, Rimini 1, Haidari, 124 62 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalliopi","family":"Papadopoulou","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, General Hospital of Venizeleio, Knossou Avenue 44, 71 409 Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitra","family":"Stafylaki","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, University Hospital of Heraklion, Heraklion, 711 10 Crete, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viktoria Eirini","family":"Mavromanolaki","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Agios Nikolaos General Hospital, Agios Nikolaos, 721 00 Crete, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Krasagakis","sequence":"additional","affiliation":[{"name":"Dermatology Department, University Hospital of Heraklion, Heraklion, 711 10 Crete, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1056\/NEJMcp1014163","article-title":"Clinical practice. Hidradenitis suppurativa","volume":"366","author":"Jemec","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_2","first-page":"739","article-title":"Hidradenitis suppurativa: A comprehensive review","volume":"65","author":"Alikhan","year":"2011","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1001\/jamadermatol.2023.5425","article-title":"Factors Affecting Treatment Selection Among Patients with Hidradenitis Suppurativa","volume":"160","author":"Salame","year":"2024","journal-title":"JAMA Dermatol."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Erol Mart, H.M., Bostanci, S., and Caliskan Odabas, D. (Dermatol. Surg., 2024). Demographic and Clinical Features and Factors Affecting the Quality of Life of Patients With Hidradenitis Suppurativa: A Cross-sectional Study, Dermatol. Surg., online ahead of print.","DOI":"10.1097\/DSS.0000000000004185"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"7898","DOI":"10.1038\/s41598-023-35120-9","article-title":"Cutaneous body image in patients with hidradenitis suppurativa: A hospital-based cross-sectional study","volume":"13","author":"Koumaki","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_6","first-page":"311","article-title":"Genetic and environmental risk factors for hidradenitis suppurativa","volume":"136","author":"Kimball","year":"2016","journal-title":"J. Investig. Dermatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1111\/exd.14141","article-title":"A systematic review and critical appraisal of metagenomic and culture studies in hidradenitis suppurativa","volume":"30","author":"Williams","year":"2021","journal-title":"Exp. Dermatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1111\/bjd.20642","article-title":"Large-scale serum analysis identifies unique systemic biomarkers in psoriasis and hidradenitis suppurativa","volume":"186","author":"Navrazhina","year":"2022","journal-title":"Br. J. Dermatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1016\/j.jaad.2023.11.048","article-title":"Tape strips detect molecular alterations and cutaneous biomarkers in skin of patients with hidradenitis suppurativa","volume":"90","author":"Navrazhina","year":"2024","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Chopra, D., Arens, R.A., Amornpairoj, W., Lowes, M.A., Tomic-Canic, M., Strbo, N., Lev-Tov, H., and Pastar, I. (2022). Innate immunity and microbial dysbiosis in hidradenitis suppurativa-vicious cycle of chronic inflammation. Front. Immunol., 13.","DOI":"10.3389\/fimmu.2022.960488"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1111\/exd.14398","article-title":"Yin and Yang: A disrupted skin microbiome and an aberrant host immune response in hidradenitis suppurativa","volume":"30","author":"Schell","year":"2021","journal-title":"Exp. Dermatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1007\/s13555-020-00465-w","article-title":"The Microbiome in Hidradenitis Suppurativa: A Review","volume":"11","author":"Wark","year":"2021","journal-title":"Dermatol. Ther."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1847","DOI":"10.1016\/j.jid.2020.02.046","article-title":"The Surface Microbiome of Clinically Unaffected Skinfolds in Hidradenitis Suppurativa: A Cross-Sectional Culture-Based and 16S rRNA Gene Amplicon Sequencing Study in 60 Patients","volume":"140","author":"Jais","year":"2020","journal-title":"J. Investig. Dermatol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1159\/000520288","article-title":"The Bacteriology of Skin Lesions in Patients with Hidradenitis Suppurativa Is Associated with Previous Antibiotic Treatment in the Community Setting: A Referral Center Experience","volume":"238","author":"Barmatz","year":"2022","journal-title":"Dermatology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.5114\/ada.2022.119008","article-title":"Hidradenitis suppurativa: Bacteriological study in surgical treatment","volume":"39","author":"Gierek","year":"2022","journal-title":"Postepy Dermatol. Alergol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1159\/000381959","article-title":"Aerobic and Anaerobic Bacteriology of Hidradenitis Suppurativa: A Study of 22 Cases","volume":"1","author":"Katoulis","year":"2015","journal-title":"Skin. Appendage Disord."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1159\/000504537","article-title":"Staphylococcus aureus Carriage Status in Patients with Hidradenitis Suppurativa: An Observational Cohort Study in a Tertiary Referral Hospital in Athens, Greece","volume":"236","author":"Katoulis","year":"2020","journal-title":"Dermatology"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Koumaki, D., Koumaki, V., Ioannou, P., and Evangelou, G. (J. Eur. Acad. Dermatol. Venereol., 2023). Dalbavancin for the treatment of severe hidradenitis suppurativa, J. Eur. Acad. Dermatol. Venereol., online ahead of print.","DOI":"10.1111\/jdv.19078"},{"key":"ref_19","first-page":"6","article-title":"Antibiotic Resistance in Dermatology Part 2: Combating Resistance","volume":"28","author":"Miller","year":"2023","journal-title":"Skin. Ther. Lett."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"930","DOI":"10.1111\/jdv.15332","article-title":"Rates of antibiotic resistance\/sensitivity in bacterial cultures of hidradenitis suppurativa patients","volume":"33","author":"Bettoli","year":"2019","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.jaad.2016.08.001","article-title":"Patterns of antimicrobial resistance in lesions of hidradenitis suppurativa","volume":"76","author":"Fischer","year":"2017","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1159\/000446812","article-title":"Microbial Profile and Antimicrobial Susceptibility of Bacteria Found in Inflammatory Hidradenitis Suppurativa Lesions","volume":"29","author":"Hessam","year":"2016","journal-title":"Skin. Pharmacol. Physiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.det.2015.08.013","article-title":"Antibiotic Treatment of Hidradenitis Suppurativa","volume":"34","author":"Bettoli","year":"2016","journal-title":"Dermatol. Clin."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Humphries, R., Bobenchik, A.M., Hindler, J.A., and Schuetz, A.N. (2021). Overview of Changes to the Clinical and Laboratory Standards Institute Performance Standards for Antimicrobial Susceptibility Testing, M100, 31st Edition. J. Clin. Microbiol., 59.","DOI":"10.1128\/JCM.00213-21"},{"key":"ref_25","unstructured":"European Committee on Antimicrobial Susceptibility Testing (2024). Breakpoint Tables for Interpretation for MICs and Zone Diameters: Version 14.0, Valid from 2024-01-01, EUCAST."},{"key":"ref_26","unstructured":"(2023). Performance Standards for Antimicrobial Susceptibility Testing, 33rd ed (Standard No. CLSI M100-Ed33)."},{"key":"ref_27","unstructured":"IBM Corp (2017). Released 2017. IBM SPSS Statistics for Windows, Version 25.0, IBM Corp."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1111\/exd.12793","article-title":"The bacteriology of hidradenitis suppurativa: A systematic review","volume":"24","author":"Ring","year":"2015","journal-title":"Exp. Dermatol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1159\/000228334","article-title":"Combination therapy with clindamycin and rifampicin for hidradenitis suppurativa: A series of 116 consecutive patients","volume":"219","author":"Gener","year":"2009","journal-title":"Dermatology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1159\/000228337","article-title":"The effect of combined treatment with oral clindamycin and oral rifampicin in patients with hidradenitis suppurativa","volume":"219","author":"Boer","year":"2009","journal-title":"Dermatology"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Horissian, M., Samaan, C., Cohrs, A., and Kirby, J. (Br. J. Dermatol, 2024). Trends in antibiotic prescriptions in hidradenitis suppurativa from 2015\u20132021, Br. J. Dermatol, online ahead of print.","DOI":"10.1093\/bjd\/ljae155"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1001\/jamadermatol.2023.6201","article-title":"Efficacy and Durability of Intravenous Ertapenem Therapy for Recalcitrant Hidradenitis Suppurativa","volume":"160","author":"Nosrati","year":"2024","journal-title":"JAMA Dermatol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e12","DOI":"10.36849\/JDD.4936","article-title":"Dapsone to Treat Moderate-to-Severe Hidradenitis Suppurativa: A Retrospective Case-Series","volume":"22","author":"Baroudi","year":"2023","journal-title":"J. Drugs Dermatol."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Aarts, P., van Huijstee, J.C., van der Zee, H.H., van Straalen, K.R., and Prens, E.P. (J. Eur. Acad. Dermatol. Venereol., 2023). Improved clinical effectiveness of adalimumab when initiated with clindamycin and rifampicin in hidradenitis suppurativa, J. Eur. Acad. Dermatol. Venereol., online ahead of print.","DOI":"10.1111\/jdv.19725"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"515","DOI":"10.5021\/ad.2021.33.6.515","article-title":"Clindamycin Mono-Therapy of Hidradenitis Suppurativa Patients: A Single-Center Retrospective Study","volume":"33","author":"An","year":"2021","journal-title":"Ann. Dermatol."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Molinelli, E., De Simoni, E., Candelora, M., Sapigni, C., Brisigotti, V., Rizzetto, G., Offidani, A., and Simonetti, O. (2023). Systemic Antibiotic Therapy in Hidradenitis Suppurativa: A Review on Treatment Landscape and Current Issues. Antibiotics, 12.","DOI":"10.3390\/antibiotics12060978"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1111\/bjd.17265","article-title":"Long-term clinical safety of clindamycin and rifampicin combination for the treatment of hidradenitis suppurativa. A Critically Appraised Topic","volume":"180","author":"Albrecht","year":"2019","journal-title":"Br. J. Dermatol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e12792","DOI":"10.1111\/dth.12792","article-title":"Clindamycin as unique antibiotic choice in Hidradenitis Suppurativa","volume":"32","author":"Rosi","year":"2019","journal-title":"Dermatol. Ther."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1016\/j.jaad.2018.11.035","article-title":"Clindamycin versus clindamycin plus rifampicin in hidradenitis suppurativa treatment: Clinical and ultrasound observations","volume":"80","author":"Cannizzaro","year":"2019","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Martora, F., Potestio, L., Battista, T., and Megna, M. (J. Eur. Acad. Dermatol. Venereol., 2024). Reply to \u201cImproved clinical effectiveness of adalimumab when initiated with clindamycin and rifampicin in hidradenitis suppurativa\u201d, J. Eur. Acad. Dermatol. Venereol., online ahead of print.","DOI":"10.1111\/jdv.19837"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Langan, E.A., Recke, A., Bokor-Billmann, T., Billmann, F., Kahle, B.K., and Zillikens, D. (2020). The Role of the Cutaneous Microbiome in Hidradenitis Suppurativa-Light at the End of the Microbiological Tunnel. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21041205"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1001\/jamadermatol.2017.0904","article-title":"The Follicular Skin Microbiome in Patients with Hidradenitis Suppurativa and Healthy Controls","volume":"153","author":"Ring","year":"2017","journal-title":"JAMA Dermatol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1111\/jdv.19481","article-title":"Hidradenitis suppurativa: Detangling phenotypes and identifying common denominators","volume":"38","author":"Costache","year":"2024","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"699","DOI":"10.4103\/ijd.ijd_623_21","article-title":"Hidradenitis Suppurativa: Consequences of Microbiome Dysbiosis on Immune Dysregulation and Disease Severity","volume":"67","author":"Chung","year":"2022","journal-title":"Indian. J. Dermatol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e15087","DOI":"10.1111\/exd.15087","article-title":"Gram-negative anaerobes elicit a robust keratinocytes immune response with potential insights into HS pathogenesis","volume":"33","author":"Williams","year":"2024","journal-title":"Exp. Dermatol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.jaad.2019.02.068","article-title":"North American clinical management guidelines for hidradenitis suppurativa: A publication from the United States and Canadian Hidradenitis Suppurativa Foundations: Part II: Topical, intralesional, and systemic medical management","volume":"81","author":"Alikhan","year":"2019","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1111\/ajd.12075","article-title":"Non-antibiotic properties of tetracyclines and their clinical application in dermatology","volume":"55","author":"Perret","year":"2014","journal-title":"Australas. J. Dermatol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.bcp.2016.09.007","article-title":"Antibiotic use and microbiome function","volume":"134","author":"Ferrer","year":"2017","journal-title":"Biochem. Pharmacol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"7303","DOI":"10.1128\/AAC.01289-16","article-title":"Topical Decolonization Does Not Eradicate the Skin Microbiota of Community-Dwelling or Hospitalized Adults","volume":"60","author":"Burnham","year":"2016","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1080\/17512433.2020.1762571","article-title":"The pharmacology of antibiotic therapy in hidradenitis suppurativa","volume":"13","author":"Marasca","year":"2020","journal-title":"Expert. Rev. Clin. Pharmacol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/14\/4246\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:20:24Z","timestamp":1760109624000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/14\/4246"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,20]]},"references-count":50,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2024,7]]}},"alternative-id":["jcm13144246"],"URL":"https:\/\/doi.org\/10.3390\/jcm13144246","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,20]]}}}