Simultaneous detection and identification of STI pathogens by multiplex Real-Time PCR in genital tract specimens in a selected area of Apulia, a region of Southern Italy

Purpose Genital tract infections are globally a major cause of morbidity in sexually active individuals. The aim of this study was to investigate the prevalence and associations of co-infections of Chlamydia trachomatis , Neisseria gonorrhoeae , Trichomonas vaginalis , Mycoplasma hominis (MH), Mycop...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Infection 2017-08, Vol.45 (4), p.469-477
Hauptverfasser: Del Prete, Raffaele, Ronga, Luigi, Lestingi, Mirella, Addati, Grazia, Angelotti, Umberto Filippo, Di Carlo, Domenico, Miragliotta, Giuseppe
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 477
container_issue 4
container_start_page 469
container_title Infection
container_volume 45
creator Del Prete, Raffaele
Ronga, Luigi
Lestingi, Mirella
Addati, Grazia
Angelotti, Umberto Filippo
Di Carlo, Domenico
Miragliotta, Giuseppe
description Purpose Genital tract infections are globally a major cause of morbidity in sexually active individuals. The aim of this study was to investigate the prevalence and associations of co-infections of Chlamydia trachomatis , Neisseria gonorrhoeae , Trichomonas vaginalis , Mycoplasma hominis (MH), Mycoplasma genitalium , Ureaplasma urealyticum (UU) and Ureaplasma parvum (UP) in specimens collected from female (SF) and male (SM) patients. Methods 1575 samples from 1575 individuals from the geographical area around Bari, Apulia region in Southern Italy, were collected and analyzed by a multiplex Real-Time PCR (mRT-PCR) (Anyplex TM II STI-7, Seegene, Inc., Seoul, Korea) assay. Results 455/1575 (28.89%) samples resulted positive for at least one of the targets named above. Statistically significant differences in prevalence of the pathogens between SF and SM were not detected except for UP (24.92% in SF vs 8.91% in SM). Prevalence of co-infections was 6.84 and 3.96% in SF and SM, respectively. Moreover, MH presence in SF, but not in SM, was associated with UU and UP. Conclusions Our data suggest different patterns of infections between females and male and the importance of an increased vigilance of sexually transmitted pathogens to reduce the burden on general population and the sequelae or the complications on reproductive organs.
doi_str_mv 10.1007/s15010-017-1002-7
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1874785734</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1923613803</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-e7f1d3d5f11c1621fe5d4acb985e4f6fcac90f1cb240b6d3ec1781e44ad9c5263</originalsourceid><addsrcrecordid>eNp1kV9rFDEUxYModq1-AF8k4IsPHc1NMpOZx7JoXSgo7fo8ZJKbbcr8M8mA-5H8lmadVkTwKdyc3zk35BDyGth7YEx9iFAyYAUDVeSZF-oJ2YAUTcEaJZ6SDROMFTXw6oy8iPGeMVY2Uj0nZ7zmFQNZbcjPWz8sfdIjTkukFhOa5KeR6tFSb3FM3nmjf19Njt7ud3TW6W464Bhpd6Qnr597_EFvUPfF3g9Iv25vqB9pRnzSPU1Bm0TjjCaL2ZUlTSP2eRFaqgPqU_LlvPReX2Qp4OFx27SkOwwj3eWc40vyzOk-4quH85x8-_Rxv_1cXH-52m0vrwsjFE8FKgdW2NIBGKg4OCyt1KZr6hKlq5zRpmEOTMcl6yor0ICqAaXUtjElr8Q5ebfmzmH6vmBM7eCjwb5f_6iFWklVl0rIjL79B72fljDm17XQcFGBqJnIFKyUCVOMAV07Bz_ocGyBtace27XHNvd4mnmrsufNQ_LSDWj_OB6LywBfgZil8YDhr9X_Tf0Fh9yqHg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1923613803</pqid></control><display><type>article</type><title>Simultaneous detection and identification of STI pathogens by multiplex Real-Time PCR in genital tract specimens in a selected area of Apulia, a region of Southern Italy</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Del Prete, Raffaele ; Ronga, Luigi ; Lestingi, Mirella ; Addati, Grazia ; Angelotti, Umberto Filippo ; Di Carlo, Domenico ; Miragliotta, Giuseppe</creator><creatorcontrib>Del Prete, Raffaele ; Ronga, Luigi ; Lestingi, Mirella ; Addati, Grazia ; Angelotti, Umberto Filippo ; Di Carlo, Domenico ; Miragliotta, Giuseppe</creatorcontrib><description>Purpose Genital tract infections are globally a major cause of morbidity in sexually active individuals. The aim of this study was to investigate the prevalence and associations of co-infections of Chlamydia trachomatis , Neisseria gonorrhoeae , Trichomonas vaginalis , Mycoplasma hominis (MH), Mycoplasma genitalium , Ureaplasma urealyticum (UU) and Ureaplasma parvum (UP) in specimens collected from female (SF) and male (SM) patients. Methods 1575 samples from 1575 individuals from the geographical area around Bari, Apulia region in Southern Italy, were collected and analyzed by a multiplex Real-Time PCR (mRT-PCR) (Anyplex TM II STI-7, Seegene, Inc., Seoul, Korea) assay. Results 455/1575 (28.89%) samples resulted positive for at least one of the targets named above. Statistically significant differences in prevalence of the pathogens between SF and SM were not detected except for UP (24.92% in SF vs 8.91% in SM). Prevalence of co-infections was 6.84 and 3.96% in SF and SM, respectively. Moreover, MH presence in SF, but not in SM, was associated with UU and UP. Conclusions Our data suggest different patterns of infections between females and male and the importance of an increased vigilance of sexually transmitted pathogens to reduce the burden on general population and the sequelae or the complications on reproductive organs.</description><identifier>ISSN: 0300-8126</identifier><identifier>EISSN: 1439-0973</identifier><identifier>DOI: 10.1007/s15010-017-1002-7</identifier><identifier>PMID: 28260146</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Bacteria ; Bacteria - isolation &amp; purification ; Coinfection - epidemiology ; Coinfection - microbiology ; Complications ; Family Medicine ; Female ; Females ; General Practice ; Genital tract ; Humans ; Infections ; Infectious Diseases ; Internal Medicine ; Italy - epidemiology ; Male ; Medicine ; Medicine &amp; Public Health ; Middle Aged ; Morbidity ; Multiplex Polymerase Chain Reaction ; Multiplexing ; Organs ; Original Paper ; Pathogens ; Polymerase chain reaction ; Prevalence ; Real time ; Real-Time Polymerase Chain Reaction ; Reproductive organs ; Sexually transmitted diseases ; Sexually Transmitted Diseases - epidemiology ; Sexually Transmitted Diseases - microbiology ; Statistical analysis ; Statistical methods ; STD ; Vigilance</subject><ispartof>Infection, 2017-08, Vol.45 (4), p.469-477</ispartof><rights>Springer-Verlag Berlin Heidelberg 2017</rights><rights>Infection is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-e7f1d3d5f11c1621fe5d4acb985e4f6fcac90f1cb240b6d3ec1781e44ad9c5263</citedby><cites>FETCH-LOGICAL-c372t-e7f1d3d5f11c1621fe5d4acb985e4f6fcac90f1cb240b6d3ec1781e44ad9c5263</cites><orcidid>0000-0002-9409-3388</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s15010-017-1002-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s15010-017-1002-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,777,781,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28260146$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Del Prete, Raffaele</creatorcontrib><creatorcontrib>Ronga, Luigi</creatorcontrib><creatorcontrib>Lestingi, Mirella</creatorcontrib><creatorcontrib>Addati, Grazia</creatorcontrib><creatorcontrib>Angelotti, Umberto Filippo</creatorcontrib><creatorcontrib>Di Carlo, Domenico</creatorcontrib><creatorcontrib>Miragliotta, Giuseppe</creatorcontrib><title>Simultaneous detection and identification of STI pathogens by multiplex Real-Time PCR in genital tract specimens in a selected area of Apulia, a region of Southern Italy</title><title>Infection</title><addtitle>Infection</addtitle><addtitle>Infection</addtitle><description>Purpose Genital tract infections are globally a major cause of morbidity in sexually active individuals. The aim of this study was to investigate the prevalence and associations of co-infections of Chlamydia trachomatis , Neisseria gonorrhoeae , Trichomonas vaginalis , Mycoplasma hominis (MH), Mycoplasma genitalium , Ureaplasma urealyticum (UU) and Ureaplasma parvum (UP) in specimens collected from female (SF) and male (SM) patients. Methods 1575 samples from 1575 individuals from the geographical area around Bari, Apulia region in Southern Italy, were collected and analyzed by a multiplex Real-Time PCR (mRT-PCR) (Anyplex TM II STI-7, Seegene, Inc., Seoul, Korea) assay. Results 455/1575 (28.89%) samples resulted positive for at least one of the targets named above. Statistically significant differences in prevalence of the pathogens between SF and SM were not detected except for UP (24.92% in SF vs 8.91% in SM). Prevalence of co-infections was 6.84 and 3.96% in SF and SM, respectively. Moreover, MH presence in SF, but not in SM, was associated with UU and UP. Conclusions Our data suggest different patterns of infections between females and male and the importance of an increased vigilance of sexually transmitted pathogens to reduce the burden on general population and the sequelae or the complications on reproductive organs.</description><subject>Adult</subject><subject>Bacteria</subject><subject>Bacteria - isolation &amp; purification</subject><subject>Coinfection - epidemiology</subject><subject>Coinfection - microbiology</subject><subject>Complications</subject><subject>Family Medicine</subject><subject>Female</subject><subject>Females</subject><subject>General Practice</subject><subject>Genital tract</subject><subject>Humans</subject><subject>Infections</subject><subject>Infectious Diseases</subject><subject>Internal Medicine</subject><subject>Italy - epidemiology</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Multiplex Polymerase Chain Reaction</subject><subject>Multiplexing</subject><subject>Organs</subject><subject>Original Paper</subject><subject>Pathogens</subject><subject>Polymerase chain reaction</subject><subject>Prevalence</subject><subject>Real time</subject><subject>Real-Time Polymerase Chain Reaction</subject><subject>Reproductive organs</subject><subject>Sexually transmitted diseases</subject><subject>Sexually Transmitted Diseases - epidemiology</subject><subject>Sexually Transmitted Diseases - microbiology</subject><subject>Statistical analysis</subject><subject>Statistical methods</subject><subject>STD</subject><subject>Vigilance</subject><issn>0300-8126</issn><issn>1439-0973</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kV9rFDEUxYModq1-AF8k4IsPHc1NMpOZx7JoXSgo7fo8ZJKbbcr8M8mA-5H8lmadVkTwKdyc3zk35BDyGth7YEx9iFAyYAUDVeSZF-oJ2YAUTcEaJZ6SDROMFTXw6oy8iPGeMVY2Uj0nZ7zmFQNZbcjPWz8sfdIjTkukFhOa5KeR6tFSb3FM3nmjf19Njt7ud3TW6W464Bhpd6Qnr597_EFvUPfF3g9Iv25vqB9pRnzSPU1Bm0TjjCaL2ZUlTSP2eRFaqgPqU_LlvPReX2Qp4OFx27SkOwwj3eWc40vyzOk-4quH85x8-_Rxv_1cXH-52m0vrwsjFE8FKgdW2NIBGKg4OCyt1KZr6hKlq5zRpmEOTMcl6yor0ICqAaXUtjElr8Q5ebfmzmH6vmBM7eCjwb5f_6iFWklVl0rIjL79B72fljDm17XQcFGBqJnIFKyUCVOMAV07Bz_ocGyBtace27XHNvd4mnmrsufNQ_LSDWj_OB6LywBfgZil8YDhr9X_Tf0Fh9yqHg</recordid><startdate>20170801</startdate><enddate>20170801</enddate><creator>Del Prete, Raffaele</creator><creator>Ronga, Luigi</creator><creator>Lestingi, Mirella</creator><creator>Addati, Grazia</creator><creator>Angelotti, Umberto Filippo</creator><creator>Di Carlo, Domenico</creator><creator>Miragliotta, Giuseppe</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7RV</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>RC3</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9409-3388</orcidid></search><sort><creationdate>20170801</creationdate><title>Simultaneous detection and identification of STI pathogens by multiplex Real-Time PCR in genital tract specimens in a selected area of Apulia, a region of Southern Italy</title><author>Del Prete, Raffaele ; Ronga, Luigi ; Lestingi, Mirella ; Addati, Grazia ; Angelotti, Umberto Filippo ; Di Carlo, Domenico ; Miragliotta, Giuseppe</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-e7f1d3d5f11c1621fe5d4acb985e4f6fcac90f1cb240b6d3ec1781e44ad9c5263</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Bacteria</topic><topic>Bacteria - isolation &amp; purification</topic><topic>Coinfection - epidemiology</topic><topic>Coinfection - microbiology</topic><topic>Complications</topic><topic>Family Medicine</topic><topic>Female</topic><topic>Females</topic><topic>General Practice</topic><topic>Genital tract</topic><topic>Humans</topic><topic>Infections</topic><topic>Infectious Diseases</topic><topic>Internal Medicine</topic><topic>Italy - epidemiology</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine &amp; Public Health</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>Multiplex Polymerase Chain Reaction</topic><topic>Multiplexing</topic><topic>Organs</topic><topic>Original Paper</topic><topic>Pathogens</topic><topic>Polymerase chain reaction</topic><topic>Prevalence</topic><topic>Real time</topic><topic>Real-Time Polymerase Chain Reaction</topic><topic>Reproductive organs</topic><topic>Sexually transmitted diseases</topic><topic>Sexually Transmitted Diseases - epidemiology</topic><topic>Sexually Transmitted Diseases - microbiology</topic><topic>Statistical analysis</topic><topic>Statistical methods</topic><topic>STD</topic><topic>Vigilance</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Del Prete, Raffaele</creatorcontrib><creatorcontrib>Ronga, Luigi</creatorcontrib><creatorcontrib>Lestingi, Mirella</creatorcontrib><creatorcontrib>Addati, Grazia</creatorcontrib><creatorcontrib>Angelotti, Umberto Filippo</creatorcontrib><creatorcontrib>Di Carlo, Domenico</creatorcontrib><creatorcontrib>Miragliotta, Giuseppe</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Nursing &amp; Allied Health Database</collection><collection>Virology and AIDS Abstracts</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Infection</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Del Prete, Raffaele</au><au>Ronga, Luigi</au><au>Lestingi, Mirella</au><au>Addati, Grazia</au><au>Angelotti, Umberto Filippo</au><au>Di Carlo, Domenico</au><au>Miragliotta, Giuseppe</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Simultaneous detection and identification of STI pathogens by multiplex Real-Time PCR in genital tract specimens in a selected area of Apulia, a region of Southern Italy</atitle><jtitle>Infection</jtitle><stitle>Infection</stitle><addtitle>Infection</addtitle><date>2017-08-01</date><risdate>2017</risdate><volume>45</volume><issue>4</issue><spage>469</spage><epage>477</epage><pages>469-477</pages><issn>0300-8126</issn><eissn>1439-0973</eissn><abstract>Purpose Genital tract infections are globally a major cause of morbidity in sexually active individuals. The aim of this study was to investigate the prevalence and associations of co-infections of Chlamydia trachomatis , Neisseria gonorrhoeae , Trichomonas vaginalis , Mycoplasma hominis (MH), Mycoplasma genitalium , Ureaplasma urealyticum (UU) and Ureaplasma parvum (UP) in specimens collected from female (SF) and male (SM) patients. Methods 1575 samples from 1575 individuals from the geographical area around Bari, Apulia region in Southern Italy, were collected and analyzed by a multiplex Real-Time PCR (mRT-PCR) (Anyplex TM II STI-7, Seegene, Inc., Seoul, Korea) assay. Results 455/1575 (28.89%) samples resulted positive for at least one of the targets named above. Statistically significant differences in prevalence of the pathogens between SF and SM were not detected except for UP (24.92% in SF vs 8.91% in SM). Prevalence of co-infections was 6.84 and 3.96% in SF and SM, respectively. Moreover, MH presence in SF, but not in SM, was associated with UU and UP. Conclusions Our data suggest different patterns of infections between females and male and the importance of an increased vigilance of sexually transmitted pathogens to reduce the burden on general population and the sequelae or the complications on reproductive organs.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>28260146</pmid><doi>10.1007/s15010-017-1002-7</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-9409-3388</orcidid></addata></record>
fulltext fulltext
identifier ISSN: 0300-8126
ispartof Infection, 2017-08, Vol.45 (4), p.469-477
issn 0300-8126
1439-0973
language eng
recordid cdi_proquest_miscellaneous_1874785734
source MEDLINE; SpringerLink Journals - AutoHoldings
subjects Adult
Bacteria
Bacteria - isolation & purification
Coinfection - epidemiology
Coinfection - microbiology
Complications
Family Medicine
Female
Females
General Practice
Genital tract
Humans
Infections
Infectious Diseases
Internal Medicine
Italy - epidemiology
Male
Medicine
Medicine & Public Health
Middle Aged
Morbidity
Multiplex Polymerase Chain Reaction
Multiplexing
Organs
Original Paper
Pathogens
Polymerase chain reaction
Prevalence
Real time
Real-Time Polymerase Chain Reaction
Reproductive organs
Sexually transmitted diseases
Sexually Transmitted Diseases - epidemiology
Sexually Transmitted Diseases - microbiology
Statistical analysis
Statistical methods
STD
Vigilance
title Simultaneous detection and identification of STI pathogens by multiplex Real-Time PCR in genital tract specimens in a selected area of Apulia, a region of Southern Italy
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-19T16%3A07%3A28IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Simultaneous%20detection%20and%20identification%20of%20STI%20pathogens%20by%20multiplex%20Real-Time%20PCR%20in%20genital%20tract%20specimens%20in%20a%20selected%20area%20of%20Apulia,%20a%20region%20of%20Southern%20Italy&rft.jtitle=Infection&rft.au=Del%20Prete,%20Raffaele&rft.date=2017-08-01&rft.volume=45&rft.issue=4&rft.spage=469&rft.epage=477&rft.pages=469-477&rft.issn=0300-8126&rft.eissn=1439-0973&rft_id=info:doi/10.1007/s15010-017-1002-7&rft_dat=%3Cproquest_cross%3E1923613803%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1923613803&rft_id=info:pmid/28260146&rfr_iscdi=true