Broad Spectrum Research Articles

Novel Approaches for Treatment of Intraoral Microbial Infections.

Historically, broad-spectrum antibiotics have represented a major component of the therapeutic armamentarium used to treat common oral diseases associated with a bacterial etiology. The fact that these diseases are due to the accumulation of multispecies biofilms composed of ever-increasing numbers of resistant organisms has dramatically affected the efficacy of many of these drugs. Furthermore, it is now appreciated that repeated use of broad-spectrum antibiotics also affects the composition of the host commensal microbiota, which can have both local and systemic implications. In recognition of the limitations of classical antibiotics, alternative chemical, physical, and mechanical strategies are either in use or development. These include novel narrow-spectrum antimicrobials such as antitoxins, bacteriophages, and antibody-conjugated drugs that can target specific microbes while minimizing the emergence of resistant organisms and preserving eubiotic microbes. Other approaches, such as new broad-spectrum non-antibiotic strategies and probiotics, are aimed at disrupting or altering the composition of oral biofilms and their extracellular matrices to facilitate the elimination of overt pathogens by the host response and/or adjunctive antimicrobials. This critical review describes the use and limitations of broad- and narrow-spectrum strategies currently being used to treat common bacterially induced oral diseases as well as alternative methods in development.

Perioperative Broad-spectrum Antibiotics are Associated With Decreased Surgical Site Infections Compared to 1st–3rd Generation Cephalosporins After Open Pancreaticoduodenectomy in Patients With Jaundice or a Biliary Stent: Erratum

Perioperative Broad-spectrum Antibiotics are Associated With Decreased Surgical Site Infections Compared to 1st–3rd Generation Cephalosporins After Open Pancreaticoduodenectomy in Patients With Jaundice or a Biliary Stent: Erratum

A comparison of outcomes between transferred patients versus patients who presented directly to the emergency department with necrotizing fasciitis

IntroductionNecrotizing Fasciitis (NF) is a rare life-threatening bacterial infection that necessitates emergent resuscitation and operative intervention. Most of the literature has emphasized the need for early surgical intervention. This is problematic for patients being treated at a facility lacking surgical support, with concerns for increasing mortality and morbidity rates.MethodsThis is a 10-year retrospective study of emergency department (ED) documentation and surgical operative reports of patients seen at Arrowhead Regional Medical Center from January 1, 2011, to December 31, 2020. The patients were divided into two groups: the Transfer Group (TG), consisting of those transferred from another facility, and the Direct Admit Group (DAG), comprising those who presented directly to the ED. A comparison was conducted to identify statistically significant differences between the 2 groups of patients with a final diagnosis of NF, with specific emphasis on mortality rate, hospital length of stay (LOS), and intensive care unit (ICU) LOS.ResultsA total of 134 patients with a confirmed diagnosis of NF were included in the final analysis. More than half (50.8%, n = 68) of the patients presented as transfers from area hospitals. Compared to the DAG, the TG had a significantly higher percentage of patients undergoing surgical intervention within six hours of ED presentation (95.6% vs. 10.6%, respectively; p < 0.0001). The TG had a lower mortality rate compared to the DAG (11.8% vs. 22.7%), though the difference did not reach statistical significance. There was no statistically significant difference in hospital LOS (13 days vs. 13.5 days, p = 0.9046) or ICU LOS (3 days for both groups, p = 0.4845) between these two groups.ConclusionAggressive management with broad-spectrum antibiotics and intravenous fluid resuscitation may mitigate the effect on mortality in patients with necrotizing fasciitis when prompt surgical intervention is not available.

Septic Shock on Bartholinitis: Case Report and Modern Surgical Approaches

Bartholinitis, or Bartholin's gland abscess, is a relatively common gynecological condition among women of reproductive age. Its annual incidence is estimated at approximately 0.5 per 1,000 women, which corresponds to a lifetime cumulative risk of about 2%. The condition primarily affects patients between 20 and 50 years old, with a peak frequency observed between 35 and 50 years. After menopause, due to the natural involution of the gland, Bartholin's cysts and abscesses become less frequent, although they can still occur. Moreover, in women over 50, the appearance of a new mass in the gland region should prompt caution, as it may, in rare cases, indicate a carcinoma of the Bartholin's gland or an adjacent vulvar cancer. Therefore, for patients over 40 presenting with a newly emerged cyst or abscess, clinical guidelines recommend performing a biopsy or excision to rule out malignancy. We present the case of a 50-year-old woman with no significant medical history, who was urgently referred to the gynecological emergency department due to confusion, unexplained fever of 40 °C, and resistant leucorrhoea following a week of corticosteroid antibiotic therapy. Clinical examination revealed a large, tender right vulvar mass, indicative of an acute Bartholin's abscess. The patient exhibited signs of septic shock and was admitted to the ICU. Following a diagnosis of sepsis, broad-spectrum antibiotic therapy was initiated, alongside fluid resuscitation and norepinephrine support. Surgical drainage of the abscess confirmed the presence of E. coli. The patient's condition improved rapidly, and she was discharged on postoperative day 8 with no complications. This case underscores that while Bartholin's abscess is typically benign, severe complications, including septic shock, can occur—especially in patients over 50. The appearance of a new Bartholin's region mass in older women should prompt consideration of malignancy, necessitating biopsy or excision. Recent studies compare various therapeutic approaches including simple incision and drainage, Word catheter placement, marsupialization, silver nitrate application, and complete gland excision. Each method has its advantages and drawbacks, with marsupialization offering lower recurrence rates and higher patient satisfaction in many instances.

Microbial Butyrate Modified by Melatonin Alleviates Colon Inflammation by Inhibiting GPR109A/Caspase-1-Dependent Macrophage M1 Polarization.

Recurrent ulcerative colitis (UC) seriously affects the quality of life of patients. Melatonin affects the alteration of the gut microbiota and can effectively relieve inflammation-associated diseases. In the present study, we determined that melatonin effectively alleviated intestinal inflammation and delayed weight loss in mice. Analysis of ileocecal contents in mice via 16S-rRNA and GC-MS revealed that melatonin could elevate the diversity of the gut microbiota and the abundance of short-chain fatty acids producing bacteria and promote the secretion of butyrate. Subsequently, butyrate negatively regulates the NLRP3-mediated inflammatory signaling pathway to inhibit the secretion of proinflammatory mediators such as caspase-1 and IL-1β to restrict the further development of intestinal inflammation. The NLRP3 expression increased, and the GPR109A expression was reduced significantly in the intestinal tissues of active UC patients, which was also closely related to clinical indicators CRP and ESR closely. However, disrupting the gut microbiota with broad-spectrum antibiotics (ABX) blocks melatonin's role in reducing intestinal inflammation. Collectively, we indicate that melatonin arrests UC in mice by modulating the microbiome and the NLRP3/caspase-1 inflammatory signaling pathways to skew macrophage polarization, which may have potential implications in the development of new approaches to treat acute UC.

Exploring the Impact of Chemotherapy on the Emergence of Antibiotic Resistance in the Gut Microbiota of Colorectal Cancer Patients

With nearly half of colorectal cancer (CRC) patients diagnosed at advanced stages where surgery alone is insufficient, chemotherapy remains a cornerstone for this cancer treatment. To prevent infections and improve outcomes, antibiotics are often co-administered. However, chemotherapeutic interactions with the gut microbiota cause significant non-selective toxicity, affecting not only tumor and normal epithelial cells but also the gut microbiota. This toxicity triggers the bacterial SOS response and loss of microbial diversity, leading to bacterial mutations and dysbiosis. Consequently, pathogenic overgrowth and systemic infections increase, necessitating broad-spectrum antibiotics intervention. This review underscores how prolonged antibiotic use during chemotherapy, combined with chemotherapy-induced bacterial mutations, creates selective pressures that drive de novo antimicrobial resistance (AMR), allowing resistant bacteria to dominate the gut. This compromises the treatment efficacy and elevates the mortality risk. Restoring gut microbial diversity may mitigate chemotherapy-induced toxicity and improve therapeutic outcomes, and emerging strategies, such as fecal microbiota transplantation (FMT), probiotics, and prebiotics, show considerable promise. Given the global threat posed by antibiotic resistance to cancer treatment, prioritizing antimicrobial stewardship is essential for optimizing antibiotic use and preventing resistance in CRC patients undergoing chemotherapy. Future research should aim to minimize chemotherapy’s impact on the gut microbiota and develop targeted interventions to restore microbial diversity affected during chemotherapy.

Heterogeneity in clinical patterns of adult lung abscess patients: an 8-year retrospective study in a tertiary hospital

BackgroundThe widespread use of broad-spectrum antibiotics has led to changes in both the microbiological and clinical characteristics of lung abscesses. It is necessary to re-evaluate the bacterial spectrum associated with these infections. As a novel method for pathogen detection, metagenomic next-generation sequencing (mNGS) is increasingly being applied in clinical practice. There is limited research evaluating the use of mNGS in patients with lung abscesses.MethodsA retrospective analysis was conducted on patients with lung abscess who were hospitalized between July 2015 and July 2023 at a teaching hospital in China. Patients who underwent both computerized tomography (CT) imaging and conventional pathogen testing were included in the study. The efficacy of pathogen detection using conventional methods was compared with that of mNGS. Additionally, the clinical and radiological features were analyzed to provide a comprehensive understanding of the disease patterns.ResultsA total of 782 patients with lung abscess were included in the study and hematogenous abscess accounting for 7.16% (56/782) of cases. The overall hospital mortality rate was 1.53%. The mean age of the patients with lung abscess was 60 years, with a male predominance (80.2%). A significant proportion of patients had comorbid conditions, including diabetes (29.7%) and cardiovascular disease (18.2%). Lung abscesses were predominantly located in the right lung, and pleural effusion was more commonly observed in the deceased group. The detection rate of pathogen via conventional test was lower at 41.8% (327/782). Among patients with positive mNGS results, only 51.9% had pathogens identified through conventional testing methods. Klebsiella pneumoniae was the most frequently detected pathogen by conventional culture, while mNGS identified was Parvimonas micra. Infections caused solely by anaerobic bacteria or facultative anaerobes were associated with shorter hospital stays. Patient infected with Gram-negative bacilli (GNB) had a higher proportion of liver abscesses (11.8%).ConclusionCompared to conventional testing methods, mNGS demonstrates superior performance in detecting anaerobic and facultative anaerobic bacteria. The low detection rate of conventional tests may result in an underestimation of the clinical significance of anaerobic bacteria infections. In patients with lung abscess caused by GNB, hematogenous dissemination, liver abscess and diabetes were more commonly observed and these patients tended to have longer hospital stays.

A Rare Case of Catheter-Related Bloodstream Infection Caused by Cupriavidus pauculus

Background: Cupriavidus pauculus is a gram-negative, aerobic bacillus found in environment. This microorganism can rarely cause serious infections in immunocompromised patients. Catheter-related bloodstream infection caused by Cupriavidus pauculus is a hospital acquired infection which is an infrequent state with very few cases reported in the literature. In this research, we report the first case of Cupriavidus pauculus infection in Iran. Methods: Blood cultures were performed using the BD BACTEC (Becton, Dickinson, USA) automated haemoculture system and subsequently the gram negative bacilli with regular borders, smooth consistency and dry appearance colonies were identified as Cupriavidus pauculus by the BD Phoenix M50 Compact automated system. Results: In this paper, we report the first case of Cupriavidus pauculus infection in Iran. this strain was susceptible to Piperacillin-Tazobactam, Ceftazidime, Cefepime, Trimethoprim-Sulfamethoxazole, Ciprofloxacin, Levofloxacin and resistant to Cefazolin, Ampicillin and Amoxicillin-Clavulanate and is intrinsically resistant to Aminoglycosides, first generation Cephalosporins, Aminopenicillins, Ampicillin-Sulbactam, Ticarcillin and Ceftriaxone. Conclusion: There are little evidence in the literature about infections caused by Cupriavidus pauculus. Catheter-related bloodstream infection caused by Cupriavidus pauculus is an infrequent infection in humans, but this microorganism should be considered as a potential pathogen in hospitalized immunocompromised patients which can cause serious infections in these individuals, requiring broad-spectrum antibiotic therapy.

Recommendations for Pneumonia in Hospitalized Children With Neurologic Impairment.

Children with neurologic impairment (CNI) are commonly hospitalized with pneumonia but are often excluded from practice guidelines. We sought to develop evidence-based, expert-panel endorsed recommendations for the care of CNI hospitalized with pneumonia. We conducted an extensive literature search that formed the basis of drafted candidate recommendations for diagnostic testing, antimicrobial treatment, airway clearance, and discharge criteria. We convened a national panel of individuals with expertise in nursing, pediatric medicine (infectious diseases, pulmonology, hospital medicine, complex care), and family advocacy. Using the RAND/University of California Los Angeles Appropriateness Method, including a moderated panel meeting, panelists rated recommendations for appropriateness in 2 sequential rounds. The panel assessed 73 drafted recommendations for diagnostic testing, antimicrobial treatment, airway clearance, and discharge criteria for CNI hospitalized with pneumonia. After modifications to 2 of the drafted recommendations, the panel reached agreement on the appropriateness of 72 recommendations. Recommendations include management that minimizes the use of broad-spectrum antibiotics. Recommendations further emphasize collaboration with respiratory therapists for airway clearance and with families, outpatient managing physicians, and homecare providers for discharge. The recommendations for pneumonia diagnosis and management account for heterogeneity in the patient population, including comorbidities and risk factors (eg, aspiration risk), as well as severity of presenting illness. Recommendations for appropriate diagnostic testing, antimicrobial treatment, airway clearance, and discharge criteria for CNI hospitalized with pneumonia can be used to inform clinical care. The effect of these recommendations on patient- and family-centered outcomes should be studied.

Unveiling Ralstonia spp. in the Neonatal Intensive Care Unit: Clinical Impacts and Antibiotic Resistance

Background/Objectives:Ralstonia spp., opportunistic Gram-negative bacilli, pose increasing risks for nosocomial infections, particularly in neonatal intensive care units (NICUs). This study investigates an outbreak caused by Ralstonia mannitolilytica in an NICU during the COVID-19 pandemic, examining colonization and infection risk factors, clinical outcomes, and antibiotic resistance. Methods: A retrospective analysis was conducted on neonates hospitalized in a tertiary NICU from 2020 to 2021. Colonization and infection were identified via microbiological testing of clinical samples. Risk factors, such as mechanical ventilation, vascular access, mode of feeding, and antibiotic use, were recorded. Environmental sampling identified potential contamination sources. Antibiotic susceptibility was determined using EUCAST PK/PD breakpoints. Results: Among 36 neonates affected, 31 were colonized, and 5 developed infections, including bloodstream infection, pneumonia, surgical site infection, and urinary tract infection. Environmental investigations revealed contaminated water heaters as the primary sources. All isolates showed resistance to carbapenems and aminoglycosides but retained susceptibility to trimethoprim-sulfamethoxazole. The vast majority were susceptible to fluoroquinolones. Conclusions: This outbreak underscores the role of environmental water reservoirs, invasive procedures, and broad-spectrum antibiotics in R. mannitolilytica colonization and infection. Biofilm formation and antibiotic resistance complicate eradication and treatment. Heightened surveillance, rigorous infection control, and antimicrobial stewardship are crucial for mitigating risks in NICU settings.

An under-recognised rapidly fatal condition: phlegmonous gastritis

Phlegmonous gastritis is a rare condition, characterised by an infectious process in the gastric wall. There is an association with haemolytic Streptococcus infection in approximately 70% of cases, less frequently with other infectious agents such as Staphylococcus aureus, Pneumococcus and Enterococcus. Diagnosis is often delayed due to non-specific symptoms, such as abdominal pain, nausea, vomiting and fever. Abdominal computed tomography (CT) typically reveals thickening of the gastric wall, low-intensity areas within the gastric wall and gas accumulation. The therapeutic approach includes broad-spectrum antibiotics, and surgical resection of the gastric area involved in complicated cases. The authors present the clinical case of a 58-year-old male admitted to the hospital with headache, vomiting, abdominal pain and fever. Laboratory evaluation showed increased inflammatory parameters. An abdominal CT scan showed markedly diffuse parietal thickening of the stomach with increased mucosal enhancement and densification of perigastric fat. There was rapid progression to septic shock and the patient was admitted to the intensive care unit. An urgent upper gastrointestinal endoscopy revealed diffuse oedema of the gastric mucosal with no signs of tumour infiltration, confirming the diagnosis of phlegmonous gastritis. Broad-spectrum antibiotic therapy was started, and the patient underwent an urgent total gastrectomy. Despite the interventions carried out, refractory shock with multi-organ dysfunction occurred, resulting in death. Histopathologic findings in the gastrectomy specimen were compatible with phlegmonous gastritis. The clinical case presented demonstrates the need for high clinical suspicion for an early diagnosis of phlegmonous gastritis, especially in patients with gastrointestinal symptoms and clinical severity, for early treatment and improvement of the prognosis.

Assessment of physicians’ proficiency concerning antibiotic use for upper respiratory tract infections in children: a cross-sectional study

Since most upper respiratory tract infections (URTIs) are caused by viruses, treatment with antibiotics is considered nonbeneficial and futile. Nonetheless, antibiotic misuse remains a concern that has a profound impact on global health, owing to the possible development of antibiotic resistance. Therefore, understanding the factors influencing physicians’ practices and attitudes and assessing their level of knowledge regarding antibiotic prescriptions for children with URTIs is advisable to determine the factors that lead to the emergence of antibiotic resistance. A cross-sectional study was conducted among pediatricians and pediatric residents in the northern West Bank, Palestine, from December 2021 to the end of January 2022. Data were collected via a validated self-administered questionnaire with four sections: demographic details, knowledge (scored 0–1), attitudes (11-item Likert scale, maximum 55), and prescribing behavior for pediatric URTIs (scored 1–5, maximum 55). Statistical analysis was performed via SPSS v21, with nonparametric tests (Mann‒Whitney U, Kruskal‒Wallis) applied for nonnormal variables (p < 0.05). Demographics, knowledge, attitudes, and behaviors were summarized using frequencies, percentages, medians, and interquartile ranges. A total of 108 questionnaires were collected and returned, yielding a response rate of 90%. The overall level of knowledge among the respondents was commendable but concerning, as 22% of them mistakenly believed that antibiotics functioned as anti-inflammatory drugs. T The participants’ attitudes ranged from 29 to 52 points, with a maximum possible score of 55. The average score was 41.1 ± 3.6, reflecting generally favorable attitudes toward antibiotic usage among the participants. However, 6.5% of the respondents expressed a preference for the use of broad-spectrum antibiotics for most cases of acute URTIs. The practice score also followed a normal distribution, with an average score of 35.4 ± 7.7 out of 55. Some respondents identified challenges in properly prescribing antibiotics, such as the time required to explain antibiotics to parents, parental requests for antibiotics, and uncertainty regarding the illness. The age of the respondents was significantly positively correlated with their behavioral state (p = 0.037), with older respondents exhibiting better behavioral patterns. Pediatric residents and female respondents had comparatively lower perceptions of antibiotic behavior and practices (p = 0.004 and p = 0.03, respectively). Additionally, the results revealed positive correlations between participants’ attitudes and practices (rs = 0.434, p < 0.001) and between their knowledge and practices (rs = 0.355, p < 0.001). Several factors influencing physicians’ practices, as well as factors related to parents, were identified. Thus, enhancing knowledge alone may not be sufficient. Possible recommendations were examined, with a focus on improving the doctor‒patient relationship and implementing essential educational interventions to increase awareness of antibiotic resistance and promote better prescribing and purchasing behaviors for both physicians and the general public.

An open source interactive physiologically based pharmacokinetic (iPBPK) model of tylosin in broiler chickens and laying hens.

An open source interactive physiologically based pharmacokinetic (iPBPK) model of tylosin in broiler chickens and laying hens.

Prevention and Management of Infectious Complications in Pediatric Patients With Cancer: A Survey Assessment of Current Practices Across Children's Oncology Group Institutions.

While clinical practice guidelines (CPGs) for pediatric oncology infection prophylaxis and management exist, few data describe actual management occurring at pediatric oncology centers. An electronic survey querying infection management practices in nontransplant pediatric oncology patients was iteratively created by the Children's Oncology Group (COG) Cancer Control and Supportive Care Infectious Diseases Subcommittee and sent to leaders at all COG institutions, limiting each site to one response to represent their institution. The response rate was 57% (129/227 institutions). Many sites reported utilizing COG-endorsed CPGs for antibacterial (76%) and antifungal prophylaxis (74%), and fever and neutropenia (FN, 64%). Most institutions reported using antimicrobial prophylaxis for patients with acute myeloid leukemia (88% antibacterial, 100% antifungal) and relapsed acute lymphoblastic leukemia (82% antibacterial, 95% antifungal). Definitions of fever, phagocyte recovery, and antibiotic duration in febrile patients varied. Most institutions administer empiric broad-spectrum antibiotics for nonneutropenic fever, although 14% reported withholding antibiotics based on initial clinical status or risk stratification tools. Most respondents reported (70%) admitting FN patients for at least 48 h, however 15% have low-risk FN protocols allowing outpatient management. FN patients remain admitted on antibiotics through count recovery in 50% of institutions, whereas the others employed various early discharge/early antibiotic discontinuation strategies. There is often consistency but also substantial variability in reported antimicrobial prophylaxis strategies and management of patients with fever and represents an opportunity for implementation studies to standardize application of CPG recommendations and randomized trials to advance evidence where knowledge gaps exist.

BefA protein alleviates progression of non-alcoholic fatty liver disease by modulating the AMPK signaling pathway through the gut-liver axis.

BefA protein alleviates progression of non-alcoholic fatty liver disease by modulating the AMPK signaling pathway through the gut-liver axis.

Impact of Enterococcus infection in HSCT recipients: a national analysis.

Enterococci are the third most common cause of healthcare-associated infections in the United States, affecting 10-12% of all transplant recipients worldwide. Enterococcal bacteremia complicates the post-transplant recovery and raises mortality to 18%. This study aims to identify factors linked to mortality in hematopoietic stem cell transplant (HSCT) recipients with Enterococcus infection. We conducted a retrospective analysis using the National Inpatient Sample Database (2018-2021). Adults treated with HSCT and admitted for Enterococcus infection were identified using ICD-10 codes. The analysis utilized descriptive statistics and multivariate regression, with significance at a p-value ≤0.05. A total of 40,462 HSCT patients, 1.3% were admitted with Enterococcus infection. The crude mortality rate was higher in the Enterococcus cohort than in the non-Enterococcus cohort (10.4% vs. 4.6%); however, the mortality risk was substantially lower in the Enterococcus cohort (p<0.001). In the Enterococcus cohort, patients with fungal infections, sepsis, acute respiratory failure, and those with invasive ventilation had a high mortality risk (p<0.05). In leukemia patients treated with HSCT, the Enterococcus cohort had higher mortality than the non-Enterococcus cohort (12.5% vs. 5.0%; aOR 1.8, 95% CI 1.9-2.6, p=0.005). In HSCT recipients, Enterococcus infection is a clinical marker for poor prognosis. Early broad-spectrum antibiotic therapy is essential for patients with sepsis, respiratory compromise, and fungal co-infections. Additionally, a multidisciplinary team is crucial for managing respiratory and renal failure.

Evaluation of tree-injected oxytetracycline and antisense oligonucleotides targeting Candidatus Liberibacter asiaticus in citrus.

Huanglongbing (HLB) is a systemic disease of citrus caused by the bacterial pathogen Candidatus Liberibacter asiaticus (CLas) that limits citrus production worldwide. CLas is an obligate bacterial pathogen that multiplies in citrus trees and in the insect vector, the Asian citrus psyllid (ACP), Diaphorina citri Kuwayama. There is no cure for HLB currently and broad-spectrum antibiotics represent one possible therapeutic against disease symptoms. Single-stranded nucleic acid analogs, 2'-deoxy-2'-Fluoro-β-D-arabinonucleic antisense oligonucleotides (FANA ASOs), can modulate gene expression by enzymatic degradation or steric blocking of an RNA target. FANA ASOs recognize and bind to specific RNA forms, including mRNA, miRNA and long noncoding RNA, through complementary base-pairing. Injection of oxytetracycline (OTC) into mature citrus trees with HLB ameliorated symptoms of disease, increased fruit yield and quality of juice as compared with that produced by noninjected controls. Injection of trees with FANA ASOs reduced CLas abundance but did not improve fruit yield and quality above control levels at the injection dosage tested. Reduced pathogen relative abundance following OTC injection was coincident with lower CLas acquisition and inoculation by laboratory deployed and wild-type D. citri collected from the field, respectively. However, injections of FANA ASOs did not consistently reduce CLas transmission as compared with noninjected controls. Trunk injection of OTC may be useful in management of HLB by reducing CLas infection in trees and disrupting transmission. However, more research is needed to verify the potential usefulness of FANA ASOs. Optimizing FANA ASO dosage in trees and exploring the potential of multiplex FANA ASOs that simultaneously target multiple mRNAs could possibly enhance their efficacy against CLas. © 2024 Society of Chemical Industry.

Incidental neutropenia: An emergency medicine focused approach.

Incidental neutropenia: An emergency medicine focused approach.

ICU-Acquired Superinfections Before And During The COVID-19 Pandemic: Similarities And Differences.

ICU-Acquired Superinfections Before And During The COVID-19 Pandemic: Similarities And Differences.

Role of plasma and blood-cell co-metagenomic sequencing in precise diagnosis and severity evaluation of sepsis, a prospective cohort study in sepsis patients.

Role of plasma and blood-cell co-metagenomic sequencing in precise diagnosis and severity evaluation of sepsis, a prospective cohort study in sepsis patients.