{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:06:11Z","timestamp":1789430771764,"version":"build-2803163510"},"reference-count":55,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T00:00:00Z","timestamp":1760745600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Helicobacter pylori infection represents a well-established risk factor for the development of gastric carcinogenesis, yet reliable clinical or endoscopic predictors of infection remain poorly defined. Identifying non-invasive or endoscopic markers of this infection could improve early detection, which is crucial for effective prevention and clinical management. This single-center study included 737 patients who underwent upper gastrointestinal endoscopy. We compared clinical, laboratory, and endoscopic features between H. pylori-positive and H. pylori-negative individuals. A total of 263 with H. pylori-positive gastric biopsies and 474 with H. pylori-negative biopsies were enrolled in our study. Cerebrovascular disease (9.51% vs. 5.51%, p = 0.04, OR = 1.80), type 2 diabetes mellitus (T2DM\u201422.05% vs. 15.86%, p = 0.04, OR 1.5), and alcohol consumption (18.96% vs. 9.3%, p = 0.00, OR = 2.28) were significantly more prevalent among H. pylori-positive patients. Heartburn was more commonly reported in H. pylori-negative individuals (23.77% vs. 15.38%, p = 0.01, OR = 0.58). Laboratory parameters showed no significant differences between groups. Regarding endoscopic findings, corporal erythema (26.92% vs. 16.17%, p = 0.00, OR = 1.91), corporal erosions (11.54% vs. 5.32%, p = 0.00, OR = 2.32), and submucosal hemorrhages (20.91% vs. 11.6%, p = 0.00, OR = 2.01) were associated with H. pylori infection. In the multivariate logistic regression models, alcohol consumption and corporal lesions remained independent predictors of H. pylori-associated gastritis, even after adjusting for age, sex, and PPI use. This study identifies alcohol consumption and specific corporal mucosal changes as novel, independent predictors of H. pylori infection. Heartburn was negatively associated with active H. pylori infection, while the rest of the symptoms did not predict infection or mucosal lesions. The laboratory parameters did not differ significantly between groups. These findings underscore the potential of targeted endoscopic evaluation and risk-based screening (particularly among T2DM and alcohol-consuming populations) to enhance early detection and management of H. pylori-associated disease.<\/jats:p>","DOI":"10.3390\/microorganisms13102392","type":"journal-article","created":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T09:23:34Z","timestamp":1760952214000},"page":"2392","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Helicobacter pylori-Mediated Injury: The Hidden Path to Gastric Hemorrhage and Neoplasia"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-3059-9006","authenticated-orcid":false,"given":"Sabrina-Nicoleta","family":"Munteanu","sequence":"first","affiliation":[{"name":"Department of Clinical Science-Internal Medicine, \u201cGeorge Emil Palade\u201d University of Medicine, Pharmacy, Science, and Technology, 540139 T\u00e2rgu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana-Maria","family":"Filip","sequence":"additional","affiliation":[{"name":"Department of Clinical Science-Internal Medicine, \u201cGeorge Emil Palade\u201d University of Medicine, Pharmacy, Science, and Technology, 540139 T\u00e2rgu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick-Laz\u0103r-Dominik","family":"Chiciudean","sequence":"additional","affiliation":[{"name":"Oncology Department, Mure\u0219 County Clinical Hospital, 540140 T\u00e2rgu Mure\u0219, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Pantea","sequence":"additional","affiliation":[{"name":"Department of Clinical Science-Internal Medicine, \u201cGeorge Emil Palade\u201d University of Medicine, Pharmacy, Science, and Technology, 540139 T\u00e2rgu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Mocan","sequence":"additional","affiliation":[{"name":"Pathology Department, Emergency County Hospital of T\u00e2rgu Mure\u0219, 540136 T\u00e2rgu Mure\u0219, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2115-6576","authenticated-orcid":false,"given":"Anca Elena","family":"Negovan","sequence":"additional","affiliation":[{"name":"Department of Clinical Science-Internal Medicine, \u201cGeorge Emil Palade\u201d University of Medicine, Pharmacy, Science, and Technology, 540139 T\u00e2rgu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,18]]},"reference":[{"key":"ref_1","unstructured":"IARC (1987). Monographs on the Identification of Carcinogenic Hazards to Humans, International Agency for Research on Cancer."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1053\/j.gastro.2023.12.022","article-title":"Global Prevalence of Helicobacter pylori Infection and Incidence of Gastric Cancer Between 1980 and 2022","volume":"166","author":"Chen","year":"2024","journal-title":"Gastroenterology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"261","DOI":"10.33545\/surgery.2020.v4.i1e.344","article-title":"Association of Helicobacter Pylori Infection in Carcinoma Stomach and Peptic Ulcer Disease: A Cross Sectional Analytical Study","volume":"4","author":"Tudu","year":"2020","journal-title":"Int. J. Surg. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.bpg.2006.10.005","article-title":"Epidemiology of Helicobacter pylori infection","volume":"21","author":"Malaty","year":"2007","journal-title":"Best Pract. Res. Clin. Gastroenterol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1146\/annurev-pathol-032520-024949","article-title":"The Spectrum of Helicobacter-Mediated Diseases","volume":"16","author":"Robinson","year":"2021","journal-title":"Annu. Rev. Pathol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1093\/postmj\/qgad119","article-title":"A population-based study of Helicobacter pylori: Does asymptomatic infection mean no gastroscopic lesions?","volume":"100","author":"Cai","year":"2024","journal-title":"Postgrad. Med. J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e12965","DOI":"10.1111\/hel.12965","article-title":"Microbiome and function alterations in the gastric mucosa of asymptomatic patients with Helicobacter pylori infection","volume":"28","author":"Yu","year":"2023","journal-title":"Helicobacter"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Dewayani, A., Fauzia, K.A., Alfaray, R.I., Waskito, L.A., Doohan, D., Ayu Rezkitha, Y.A., Abdurachman, A., Kobayashi, T., I\u2019tishom, R., and Yamaoka, Y. (2021). The Roles of IL-17, IL-21, and IL-23 in the Helicobacter pylori Infection and Gastrointestinal Inflammation: A Review. Toxins, 13.","DOI":"10.3390\/toxins13050315"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e161042","DOI":"10.1172\/jci.insight.161042","article-title":"Metagenomic and single-cell RNA-Seq survey of the Helicobacter pylori-infected stomach in asymptomatic individuals","volume":"8","author":"Sorini","year":"2023","journal-title":"JCI Insight"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"791","DOI":"10.3748\/wjg.v11.i6.791","article-title":"Helicobacter pylori infection, glandular atrophy and intestinal metaplasia in superficial gastritis, gastric erosion, erosive gastritis, gastric ulcer and early gastric cancer","volume":"11","author":"Zhang","year":"2005","journal-title":"World J. Gastroenterol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e12910","DOI":"10.1111\/hel.12910","article-title":"Correlation between the intensity of Helicobacter pylori colonization and severity of gastritis: Results of a prospective study","volume":"27","author":"Souissi","year":"2022","journal-title":"Helicobacter"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2195","DOI":"10.1111\/j.1572-0241.2000.02302.x","article-title":"Endoscopic and histological comparison of nonulcer dyspepsia with and without Helicobacter pylori infection evaluated by the modified Sydney system","volume":"95","author":"Ohkusa","year":"2000","journal-title":"Am. J. Gastroenterol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e12828","DOI":"10.1111\/hel.12828","article-title":"CRISPR-based Detection of Helicobacter pylori in Stool Samples","volume":"26","author":"Qiu","year":"2021","journal-title":"Helicobacter"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"486","DOI":"10.5946\/ce.2023.258","article-title":"Clinicopathological and Endoscopic Features of Helicobacter pylori Infection-Negative Gastric Cancer in Japan: A Retrospective Study","volume":"57","author":"Imamura","year":"2024","journal-title":"Clin. Endosc."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1111\/apt.14561","article-title":"Systematic Review with Meta-analysis: The Worldwide Prevalence of Helicobacter pylori Infection","volume":"47","author":"Zamani","year":"2018","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1097\/00000478-199610000-00001","article-title":"Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994","volume":"20","author":"Dixon","year":"1996","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_17","unstructured":"(2022). Interpretation of Endoscopic Biopsy\u2013Gastritis, Gastropathies and Beyond, Springer."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1136\/gutjnl-2018-318126","article-title":"British Society of Gastroenterology guidelines on the diagnosis and management of patients at risk of gastric adenocarcinoma","volume":"68","author":"Banks","year":"2019","journal-title":"Gut"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1730","DOI":"10.14309\/ajg.0000000000002968","article-title":"ACG Clinical Guideline: Treatment of Helicobacter pylori Infection","volume":"119","author":"Chey","year":"2024","journal-title":"Off. J. Am. Coll. Gastroenterol. ACG"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1097\/MEG.0000000000001389","article-title":"Sex differences in the prevalence of Helicobacter pylori infection: An individual participant data pooled analysis (StoP Project)","volume":"31","author":"Ferro","year":"2019","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Qiao, Y., Zhou, Y., Zhao, L., Yang, S., Zhang, X., and Liu, S. (2024). Sex differences in Helicobacter pylori infection and recurrence rate among 81,754 Chinese adults: A cross-sectional study. BMC Gastroenterol., 24.","DOI":"10.1186\/s12876-024-03404-7"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e36518","DOI":"10.1097\/MD.0000000000036518","article-title":"Study of Helicobacter pylori infection in patients with chronic atrophic gastritis and its relationship with lifestyle habits and dietary nutrient intake: A retrospective analysis","volume":"103","author":"Li","year":"2024","journal-title":"Medicine"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.annepidem.2009.11.009","article-title":"Alcohol consumption, serum gamma-glutamyltransferase, and Helicobacter pylori infection in a population-based study among 9733 older adults","volume":"20","author":"Gao","year":"2010","journal-title":"Ann. Epidemiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1093\/oxfordjournals.aje.a009854","article-title":"Inverse graded relation between alcohol consumption and active infection with Helicobacter pylori","volume":"149","author":"Brenner","year":"1999","journal-title":"Am. J. Epidemiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2750","DOI":"10.1111\/j.1572-0241.2002.07064.x","article-title":"Inverse relationship between alcohol consumption and active Helicobacter pylori infection: The Bristol Helicobacter project","volume":"97","author":"Murray","year":"2002","journal-title":"Am. J. Gastroenterol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1097\/MCG.0000000000001638","article-title":"Association of Alcohol Drinking and Helicobacter pylori Infection: A Meta-analysis","volume":"57","author":"Du","year":"2023","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1093\/alcalc\/agp068","article-title":"Relationship between alcohol consumption and active Helicobacter pylori infection","volume":"45","author":"Zhang","year":"2010","journal-title":"Alcohol. Alcohol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"3238","DOI":"10.1007\/s00415-020-09933-x","article-title":"Association between Helicobacter pylori infection and stroke: A meta-analysis of 273,135 patients","volume":"268","author":"Doheim","year":"2021","journal-title":"J. Neurol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e12761","DOI":"10.1111\/hel.12761","article-title":"A meta-analysis of the association between Helicobacter pylori infection and risk of atherosclerotic cardiovascular disease","volume":"25","author":"Wang","year":"2020","journal-title":"Helicobacter"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e12967","DOI":"10.1111\/hel.12967","article-title":"Helicobacter pylori infection and risk of cardiovascular disease","volume":"28","author":"Sun","year":"2023","journal-title":"Helicobacter"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"4607","DOI":"10.3748\/wjg.v20.i16.4607","article-title":"Helicobacter pylori infection and diabetes: Is it a myth or fact?","volume":"20","author":"He","year":"2014","journal-title":"World J. Gastroenterol."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Munteanu, S.-N., Hu\u021banu, D., Filip, A.-M., Cozac-Sz\u0151ke, A.R., Mocan, S., and Negovan, A. (2024). Type 2 Diabetes Mellitus and Helicobacter pylori Gastritis in Patients Referred for Endoscopy-A Single-Center Romanian Study. Life, 14.","DOI":"10.3390\/life14091160"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e70041","DOI":"10.1111\/hel.70041","article-title":"Characterization of Fecal Microbial Communities in Patients with Type 2 Diabetes Mellitus Combined with Helicobacter pylori Infection","volume":"30","author":"He","year":"2025","journal-title":"Helicobacter"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e12990","DOI":"10.1111\/hel.12990","article-title":"Risk of hospitalization for upper gastrointestinal bleeding in Helicobacter pylori eradicated patients newly started on warfarin or direct oral anticoagulants: A population-based cohort study","volume":"28","author":"Jiang","year":"2023","journal-title":"Helicobacter"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"50S","DOI":"10.1016\/S0002-9343(00)00636-7","article-title":"Nonsteroidal anti-inflammatory drug gastropathy and Helicobacter pylori: The search for an improbable consensus","volume":"110","author":"Lazzaroni","year":"2001","journal-title":"Am. J. Med."},{"key":"ref_36","first-page":"9439","article-title":"Interaction between Helicobacter pylori infection, nonsteroidal anti-inflammatory drugs and\/or low-dose aspirin use: Old question new insights","volume":"20","author":"Sostres","year":"2014","journal-title":"World J. Gastroenterol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/S1590-8658(03)00022-7","article-title":"Evaluation of dyspeptic symptoms in patients with and without Helicobacter pylori infection and normal upper gastrointestinal endoscopy","volume":"35","author":"Marzio","year":"2003","journal-title":"Dig. Liver Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1561","DOI":"10.1007\/s10620-017-4529-7","article-title":"Factors Related to Upper Gastrointestinal Symptom Generation in 2275 Helicobacter pylori Seroprevalent Adults","volume":"62","author":"Lee","year":"2017","journal-title":"Dig. Dis. Sci."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Negovan, A., Sz\u0151ke, A.-R., Mocan, S., and B\u0103nescu, C. (2022). Helicobacter pylori-Positive Gastric Biopsies-Association with Clinical Predictors. Life, 12.","DOI":"10.3390\/life12111789"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1111\/apt.16585","article-title":"Systematic review with meta-analysis: Association of Helicobacter pylori infection with gastro-oesophageal reflux and its complications","volume":"54","author":"Zamani","year":"2021","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2391","DOI":"10.1111\/jgh.70009","article-title":"Helicobacter pylori Infection and Eradication in Relation to Gastroesophageal Reflux Disease","volume":"40","author":"Wang","year":"2025","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1055\/s-2003-43479","article-title":"Relationship of gastroscopic features to histological findings in gastritis and Helicobacter pylori infection in a general population sample","volume":"35","author":"Petersson","year":"2003","journal-title":"Endoscopy"},{"key":"ref_43","unstructured":"Abu Baker, F., Hazzan, R., Gal, O., Natour, R., Nicola, D., Farah, A., and Mari, A. (2025). Correlating endoscopic findings with pathology to optimize biopsy strategies in gastritis: Insights from a large cohort study. Eur. J. Gastroenterol. Hepatol., 10.1097."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"976","DOI":"10.3748\/wjg.v11.i7.976","article-title":"Comparison of Helicobacter pylori infection and gastric mucosal histological features of gastric ulcer patients with chronic gastritis patients","volume":"11","author":"Zhang","year":"2005","journal-title":"World J. Gastroenterol."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Shi, H., Xiong, H., Qian, W., and Lin, R. (2018). Helicobacter pylori infection progresses proximally associated with pyloric metaplasia in age-dependent tendency: A cross-sectional study. BMC Gastroenterol., 18.","DOI":"10.1186\/s12876-018-0883-y"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1421","DOI":"10.21873\/invivo.13584","article-title":"Histopathology Features of H. pylori Gastritis Associated with Altered Lipid Profile: An Observational Study from a Tertiary Healthcare Center in Northwest Romania","volume":"38","author":"Cardos","year":"2024","journal-title":"In Vivo"},{"key":"ref_47","first-page":"3488","article-title":"Prevalence of Helicobacter pylori infection among dyspeptic patients in Northwestern Romania: A decreasing epidemiological trend in the last 30 years","volume":"20","author":"Corojan","year":"2020","journal-title":"Exp. Ther. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1080\/00365529950172989","article-title":"Role of aging in the expression of Helicobacter pylori gastritis in the antrum, corpus, and cardia","volume":"34","author":"Hackelsberger","year":"1999","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"afaf047","DOI":"10.1093\/ageing\/afaf047","article-title":"Common occurrence of atrophic gastritis in an ageing non-hospitalised population: An autopsy study","volume":"54","author":"Karhunen","year":"2025","journal-title":"Age Ageing"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"e12669","DOI":"10.1111\/hel.12669","article-title":"Previous Helicobacter pylori infection-induced atrophic gastritis: A distinct disease entity in an understudied population without a history of eradication","volume":"25","author":"Kishikawa","year":"2020","journal-title":"Helicobacter"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Xu, M.-Y., Cao, B., Yuan, B.-S., Yin, J., Liu, L., and Lu, Q.-B. (2017). Association of anaemia with Helicobacter pylori infection: A retrospective study. Sci. Rep., 7.","DOI":"10.1038\/s41598-017-13955-3"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Sarbecha, N., Fikade, M., Wondimnew, T., Kene, K., Kebede, N., Gebresillasie, H., and Assefa, Z. (2024). Comparison of hematologic parameters, serum electrolytes, and lipid profiles among dyspeptic patients with and without Helicobacter pylori infection attending Jimma Medical Center, Jimma, Southwest Ethiopia. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0310047"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Ramasamy, J., Peter, M., John, N.M., Varghese, J.J., Prem, S., Varghese, J., Mani, T., Simon, E.G., and Jacob, M. (2025). The presence of a H. pylori infection blunted the upregulation of iron-related duodenal proteins in response to anemia. J. Nutr. Biochem., 146.","DOI":"10.1016\/j.jnutbio.2025.110048"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Shang, H., Wang, J., Zhang, X., Zhang, D., Yue, K., and Xu, S. (2025). Helicobacter pylori infection increases the risk of dyslipidemia in Chinese non-obese and non-diabetic population from the perspective of age category: A retrospective cross-sectional study. BMC Infect. Dis., 25.","DOI":"10.1186\/s12879-025-11202-z"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Shimamoto, T., Yamamichi, N., Gondo, K., Takahashi, Y., Takeuchi, C., Wada, R., Mitsushima, T., and Koike, K. (2020). The association of Helicobacter pylori infection with serum lipid profiles: An evaluation based on a combination of meta-analysis and a propensity score-based observational approach. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0234433"}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/13\/10\/2392\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T04:22:32Z","timestamp":1761020552000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/13\/10\/2392"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,18]]},"references-count":55,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["microorganisms13102392"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms13102392","relation":{},"ISSN":["2076-2607"],"issn-type":[{"value":"2076-2607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,18]]}}}