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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Cell. Infect. Microbiol.</journal-id>
<journal-title>Frontiers in Cellular and Infection Microbiology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Cell. Infect. Microbiol.</abbrev-journal-title>
<issn pub-type="epub">2235-2988</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fcimb.2023.1208473</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Cellular and Infection Microbiology</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Genomic characterization of <italic>Pantoea anthophila</italic> strain UI705 causing urinary tract infections in China</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Zhang</surname>
<given-names>Yingmiao</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="author-notes" rid="fn003">
<sup>&#x2020;</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/875281"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Fan</surname>
<given-names>Yue</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="author-notes" rid="fn003">
<sup>&#x2020;</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Zhan</surname>
<given-names>Yu</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Wang</surname>
<given-names>Hao</given-names>
</name>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Li</surname>
<given-names>Xun</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Wang</surname>
<given-names>Hui</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Feng</surname>
<given-names>Tian</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Shi</surname>
<given-names>Lifeng</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Wang</surname>
<given-names>Jing</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Wang</surname>
<given-names>Hui</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1170033"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Lu</surname>
<given-names>Zhongxin</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff3">
<sup>3</sup>
</xref>
<xref ref-type="author-notes" rid="fn001">
<sup>*</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/2027879"/>
</contrib>
</contrib-group>
<aff id="aff1">
<sup>1</sup>
<institution>Department of Medical Laboratory, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology</institution>, <addr-line>Wuhan</addr-line>, <country>China</country>
</aff>
<aff id="aff2">
<sup>2</sup>
<institution>Department of Medical Laboratory, Shiyan Hospital of Integrated Traditional and Western Medicine</institution>, <addr-line>Shiyan</addr-line>, <country>China</country>
</aff>
<aff id="aff3">
<sup>3</sup>
<institution>Cancer Research Institute of Wuhan, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology</institution>, <addr-line>Wuhan</addr-line>, <country>China</country>
</aff>
<author-notes>
<fn fn-type="edited-by">
<p>Edited by: Michael Marceau, Universit&#xe9; Lille Nord de France, France</p>
</fn>
<fn fn-type="edited-by">
<p>Reviewed by: Grzegorz Czerwonka, Jan Kochanowski University, Poland; Kunal Jani, University of Ulm, Germany</p>
</fn>
<fn fn-type="corresp" id="fn001">
<p>*Correspondence: Zhongxin Lu, <email xlink:href="mailto:luzhongxin@zxhospital.com">luzhongxin@zxhospital.com</email>
</p>
</fn>
<fn fn-type="equal" id="fn003">
<p>&#x2020;These authors have contributed equally to this work</p>
</fn>
</author-notes>
<pub-date pub-type="epub">
<day>14</day>
<month>07</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="collection">
<year>2023</year>
</pub-date>
<volume>13</volume>
<elocation-id>1208473</elocation-id>
<history>
<date date-type="received">
<day>19</day>
<month>04</month>
<year>2023</year>
</date>
<date date-type="accepted">
<day>26</day>
<month>06</month>
<year>2023</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#xa9; 2023 Zhang, Fan, Zhan, Wang, Li, Wang, Feng, Shi, Wang, Wang and Lu</copyright-statement>
<copyright-year>2023</copyright-year>
<copyright-holder>Zhang, Fan, Zhan, Wang, Li, Wang, Feng, Shi, Wang, Wang and Lu</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p>
</license>
</permissions>
<abstract>
<sec>
<title>Introduction</title>
<p>
<italic>Pantoea anthophila</italic> (<italic>P. anthophila</italic>) is a Gram-negative bacterium initially isolated from <italic>Impatiens balsamina</italic> in India. <italic>P. anthophila</italic> has been characterized with low pathogenicity, and no human infections caused by this organism have been reported yet. We report the first case of urinary tract infection caused by <italic>P. anthophila</italic> in a 73-year-old man after bladder cancer surgery.</p>
</sec>
<sec>
<title>Methods</title>
<p>The bacterial isolate gained from urine was named UI705 and identified as <italic>P. anthophila</italic> by MALDI-TOF mass spectrometry. The genome sequencing and analysis were performed to further characterize the pathogenesis of the clinical isolate.</p>
</sec>
<sec>
<title>Result and discussion</title>
<p>To the best of our knowledge, this is the first report of human infection caused by <italic>P. anthophila</italic> in China. The draft genome sequence of <italic>P. anthophila</italic> UI705 provides a fundamental resource for subsequent investigation of its virulence factors, antibiotic resistance, host&#x2013;pathogen interactions, and comparative genomics of genus <italic>Pantoea</italic>.</p>
</sec>
</abstract>
<kwd-group>
<kwd>
<italic>Pantoea anthophila</italic>
</kwd>
<kwd>urinary tract infection</kwd>
<kwd>16S rRNA</kwd>
<kwd>MALDI-TOF MS</kwd>
<kwd>whole genome sequencing (WGS)</kwd>
</kwd-group>
<counts>
<fig-count count="5"/>
<table-count count="3"/>
<equation-count count="0"/>
<ref-count count="42"/>
<page-count count="9"/>
<word-count count="3852"/>
</counts>
<custom-meta-wrap>
<custom-meta>
<meta-name>section-in-acceptance</meta-name>
<meta-value>Clinical Microbiology</meta-value>
</custom-meta>
</custom-meta-wrap>
</article-meta>
</front>
<body>
<sec id="s1" sec-type="intro">
<title>Introduction</title>
<p>The genus <italic>Pantoea</italic> are Gram-negative, facultatively anaerobic, motile, and non-spore-forming bacteria that are generally isolated from agricultural or clinical sources, such as eucalyptus, <italic>Impatiens balsamina</italic>, maize, and human feces (<xref ref-type="bibr" rid="B9">Brady et&#xa0;al., 2008</xref>). At present, the genus comprises 18 species with validly published names in the List of Prokaryotic names with Standing in Nomenclature (LPSN) database (<xref ref-type="bibr" rid="B31">Meier-Kolthoff et&#xa0;al., 2022</xref>). Among those species, only a few species have been reported to be associated with human infectious diseases, including <italic>Pantoea agglomerans</italic>, <italic>Pantoea ananatis</italic>, and <italic>Pantoea dispersa</italic> (<xref ref-type="bibr" rid="B14">Cruz et&#xa0;al., 2007</xref>; <xref ref-type="bibr" rid="B27">Manoharan et&#xa0;al., 2012</xref>; <xref ref-type="bibr" rid="B30">Mehar et&#xa0;al., 2013</xref>). <italic>P. anthophila</italic> is a member of the genus <italic>Pantoea</italic>, which was originally isolated from <italic>I. balsamina</italic> in India in the 20th century. <italic>P. anthophila</italic> was once assigned to protein profile group VII in the &#x201c;<italic>Erwinia herbicola</italic>&#x2013;<italic>Enterobacter agglomerans</italic> complex&#x201d; (<xref ref-type="bibr" rid="B5">Beji et&#xa0;al., 1988</xref>). Studies by Brady et&#xa0;al. placed this strain into a separate cluster and proposed its current name as <italic>P. anthophila</italic> by using multilocus sequence analyses (MLSAs), amplified fragment length polymorphism (AFLP) analysis, and DNA&#x2013;DNA hybridization in 2009 (<xref ref-type="bibr" rid="B10">Brady et&#xa0;al., 2009</xref>). Upon searching in PubMed, only one study reported that <italic>P. anthophila</italic> is pathogenic to plants and naturally causes soft rot disease and cracking on <italic>Clausena lansium</italic> (wampee) in China (<xref ref-type="bibr" rid="B42">Zhou et&#xa0;al., 2015</xref>).</p>
<p>The study on pathogen genome is conducive to a comprehensive understanding of pathogenicity and molecular epidemiological characteristics of pathogens. However, there is currently a small amount of genomic information available on <italic>P. anthophila</italic>, mainly due to its rarity. He et&#xa0;al. have recently reported a complete genome sequence of <italic>P. anthophila</italic> CL1 that was initially isolated from symptomatic tissues of wampee, using both next- and third-generation sequencing technologies (<xref ref-type="bibr" rid="B21">He et&#xa0;al., 2022</xref>). The genome sequence of <italic>P. anthophila</italic> UI705 in this study represents the first genome of clinical isolate of this microorganism and may&#xa0;provide a better understanding of its pathogenicity in medical practice.</p>
</sec>
<sec id="s2" sec-type="materials|methods">
<title>Materials and methods</title>
<sec id="s2_1">
<title>Case presentation</title>
<p>A 73-year-old male patient with frequent urination after bladder cancer surgery was admitted to our hospital on 4 July 2022. The patient underwent bladder tumor resection and bilateral ureteral stent placement for bladder tumor in the trigone 40 days ago, and postoperative pathology showed high-grade non-invasive urothelial carcinoma. The laboratory tests revealed increased neutrophils and fasting blood glucose, but decreased erythrocyte, hemoglobin, and albumin. Urinalysis revealed a WBC count of 523/&#x3bc;l (normal 0&#x2013;6/&#x3bc;l), an erythrocyte count of 9/&#x3bc;l, urine protein of 1+, and urine glucose of 2+. After isolation of the purified bacterial strain, the patient was diagnosed with urinary tract infection. The details of the case report are presented in the <xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Material</bold>
</xref>.</p>
</sec>
<sec id="s2_2">
<title>Bacterial isolation</title>
<p>After admission, the clean-catch urine of the patient was collected prior to antibiotic therapy and plated onto Columbia blood agar and MacConkey agar plates (Guangzhou Dijing Microbial Technology Co., Ltd., Guangzhou, China) at 35&#xb0;C in the presence of 5% CO<sub>2</sub>. After incubation overnight, bacterial colonies with homogeneous morphology were observed and counted on both agar plates, and the bacterial titer was higher than 10<sup>5</sup> colony-forming units per milliliter (CFUs/ml).</p>
</sec>
<sec id="s2_3">
<title>MALDI-TOF MS identification</title>
<p>The isolated strain UI705 was identified on matrix-assisted laser desorption ionization/time of flight mass spectrometry (MALDI-TOF MS, Bruker Daltonik GmbH, Germany) platform by direct smear of fresh bacterial colony on the target plate in accordance with the manufacturer&#x2019;s instructions. The acquired spectra data from tested bacteria were compared with the existing known spectrum by using the MALDI Biotyper 3.1 software (Bruker Daltonik GmbH, Germany).</p>
</sec>
<sec id="s2_4">
<title>Biochemical and antibiotic susceptibility test</title>
<p>All the reagents used for biochemical characterization of strain UI705 were purchased from Hangzhou Microbial Reagent, Co., Ltd (Hangzhou, China). The catalytic activity of catalase was detected using 3% (v/v) H<sub>2</sub>O<sub>2</sub>. The oxidase activity was measured by filter paper soaked with the reagent tetramethyl-p-phenylenediamine.</p>
<p>Enzymatic activity and acid production from various carbohydrates of the strain were determined by bacterial microbiochemical reaction tubes according to the manufacturer&#x2019;s instructions. Antimicrobial susceptibility test (AST) was performed by the Kirby-Bauer disc diffusion method with antibiotics (Thermo Fisher Scientific, Waltham, MA, USA).</p>
</sec>
<sec id="s2_5">
<title>16S rRNA analysis</title>
<p>The genomic DNA of purified bacteria was extracted using the TIANamp Bacteria DNA Kit (TIANGEN Biotech, Co., Ltd, Beijing, China) according to the instructions of the manufacturer. 16S rRNA gene sequencing was performed with universal primers (27F: 5&#x2032;;-AGTTTGATCMTGGCTCAG-3&#x2032;;; 1492R: 5&#x2032;;-GGTTACCTTGTTACGACTT-3&#x2032;;). The amplification was performed on C1000 Thermal Cycler (Bio-Rad Laboratories, Hercules, CA, USA) with the following procedure: denaturation at 95&#xb0;C for 3&#xa0;min, 30 cycles of denaturation at 95&#xb0;C for 30 s, annealing at 58&#xb0;C for 30 s and elongation at 72&#xb0;C for 1&#xa0;min, and a further 10&#xa0;min of elongation at 72&#xb0;C. The complete 16S rRNA sequence of the strain UI705 was analyzed with the EzBioCloud Database (<xref ref-type="bibr" rid="B40">Yoon et&#xa0;al., 2017a</xref>). A phylogenetic tree was constructed using the neighbor-joining method by MEGA software version 11 (<xref ref-type="bibr" rid="B35">Tamura et&#xa0;al., 2021</xref>).</p>
</sec>
<sec id="s2_6">
<title>Genome sequencing and annotation</title>
<p>The draft genome sequencing of the strain UI705 was performed using the Illumina HiSeq platform by generating paired-end libraries (PE 150 bp). Fragmented genomic DNA with an average size of 300 bp was selected for sequencing. The raw data of sequencing were evaluated by FastQC v0.11.2 and cut by Trimmomatic v0.36 (<xref ref-type="bibr" rid="B8">Bolger et&#xa0;al., 2014</xref>) to obtain relatively accurate and effective data. The filtered reads were assembled into contigs using SPAdes v3.5.0 (<xref ref-type="bibr" rid="B4">Bankevich et&#xa0;al., 2012</xref>), and GapFiller v1.11 (<xref ref-type="bibr" rid="B7">Boetzer and Pirovano, 2012</xref>) is used to fill the gap between contigs. The genetic elements were predicted by Prokka v1.10 (<xref ref-type="bibr" rid="B33">Seemann, 2014</xref>). The average nucleotide identity was calculated using the OrthoANIu algorithm (<xref ref-type="bibr" rid="B41">Yoon et&#xa0;al., 2017b</xref>). The DNA&#x2013;DNA hybridization (DDH) value between UI705 and its related type strain was analyzed by Genome-to-Genome Distance Calculator 3.0 (<xref ref-type="bibr" rid="B31">Meier-Kolthoff et&#xa0;al., 2022</xref>). The prediction of antibiotic resistance, virulence factors, determinants of pathogen&#x2013;host interaction, and carbohydrate-active enzymes was performed by means of the Comprehensive Antibiotic Resistance Database (CARD) (<xref ref-type="bibr" rid="B29">McArthur et&#xa0;al., 2013</xref>), the Virulence Factors of Pathogenic Bacteria (VFDB) (<xref ref-type="bibr" rid="B11">Chen et&#xa0;al., 2016</xref>), the Pathogen&#x2013;Host Interactions (PHI) database (<xref ref-type="bibr" rid="B38">Urban et&#xa0;al., 2015</xref>), and the Carbohydrate-Active enZYmes (CAZy) Database (<xref ref-type="bibr" rid="B26">Lombard et&#xa0;al., 2014</xref>), respectively. The automatic annotation server of protein sequence such as NCBI non-redundant protein sequences (NR) (<ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/">https://www.ncbi.nlm.nih.gov/</ext-link>), Protein family (PFAM) (<xref ref-type="bibr" rid="B18">Finn et&#xa0;al., 2016</xref>), Swiss-Prot (<xref ref-type="bibr" rid="B37">UniProt-Consortium, 2015</xref>), Clusters of Orthologous Groups of proteins (COG) (<xref ref-type="bibr" rid="B36">Tatusov et&#xa0;al., 2000</xref>), Conserved Domain Database (CDD) (<xref ref-type="bibr" rid="B28">Marchler-Bauer et&#xa0;al., 2013</xref>), and Kyoto Encyclopedia of Genes and Genomes (KEGG) (<xref ref-type="bibr" rid="B22">Kanehisa and Goto, 2000</xref>) was applied under the right conditions.</p>
</sec>
</sec>
<sec id="s3" sec-type="results">
<title>Results</title>
<sec id="s3_1">
<title>Physiological, biochemical, and antibiotic susceptibility characteristics</title>
<p>The urine sample developed bacterial colonies on Columbia blood agar after being cultured overnight. The colonies appeared beige to yellow, smooth and circular without apparent hemolytic zones and had diameters between 1 and 2&#xa0;mm (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1A</bold>
</xref>). A spectrogram with protein molecular mass of the strain was acquired by MALDI-TOF MS (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1B</bold>
</xref>) and compared with that of known bacterial species in the database provided by the manufacturer. According to the spectra comparison, the strain UI705 was matched to <italic>P. anthophila</italic> DSM 23080<sup>T</sup> with a high confidence level (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1C</bold>
</xref>). Biochemical tests revealed that the strain UI705 is catalase-positive and oxidase-negative. &#x3b2;-galactosidase is produced. Indole, H<sub>2</sub>S, arginine dihydrolase, and urease are not produced. Acid is produced from glucose, mannose, arabinose, rhamnose, and xylose (<xref ref-type="table" rid="T1">
<bold>Table&#xa0;1</bold>
</xref>). The AST via the Kirby&#x2013;Bauer method showed that the strain is susceptible to almost all tested antibiotics except for ampicillin and cefazolin, which belong to penicillin and first-generation cephalosporin antibiotics, respectively (<xref ref-type="table" rid="T2">
<bold>Table&#xa0;2</bold>
</xref>).</p>
<fig id="f1" position="float">
<label>Figure&#xa0;1</label>
<caption>
<p>Isolation and identification of <italic>P. anthophila</italic> strain UI705. <bold>(A)</bold> Bacterial colonies on Columbia blood agar after being cultured at 37&#xb0;C in the presence of 5% CO<sub>2</sub> for 24&#xa0;h. <bold>(B)</bold> The spectrogram with protein molecular mass of the strain acquired by MALDI-TOF MS. <bold>(C)</bold> Spectra comparison of the strain UI705 with that of known strains in a database matched to <italic>P. anthophila</italic> DSM 23080T with a high confidence level.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fcimb-13-1208473-g001.tif"/>
</fig>
<table-wrap id="T1" position="float">
<label>Table&#xa0;1</label>
<caption>
<p>Biochemical characteristics of strain <italic>P. anthophila</italic> UI705.</p>
</caption>
<table frame="hsides">
<thead>
<tr>
<th valign="top" align="left">Characteristic</th>
<th valign="top" align="center">Result</th>
<th valign="top" align="left">Characteristic</th>
<th valign="top" align="center">Result</th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left">Catalase</td>
<td valign="top" align="center">+</td>
<td valign="top" align="left">Sorbitol</td>
<td valign="top" align="center">&#x2212;</td>
</tr>
<tr>
<td valign="top" align="left">Oxidase</td>
<td valign="top" align="center">&#x2212;</td>
<td valign="top" align="left">Adonitol</td>
<td valign="top" align="center">&#x2212;</td>
</tr>
<tr>
<td valign="top" align="left">Glucose</td>
<td valign="top" align="center">+</td>
<td valign="top" align="left">Lysine</td>
<td valign="top" align="center">&#x2212;</td>
</tr>
<tr>
<td valign="top" align="left">Mannose</td>
<td valign="top" align="center">+</td>
<td valign="top" align="left">Ornithine</td>
<td valign="top" align="center">&#x2212;</td>
</tr>
<tr>
<td valign="top" align="left">Arabinose</td>
<td valign="top" align="center">+</td>
<td valign="top" align="left">Arginine</td>
<td valign="top" align="center">&#x2212;</td>
</tr>
<tr>
<td valign="top" align="left">Rhamnose</td>
<td valign="top" align="center">+</td>
<td valign="top" align="left">Citrate utilization</td>
<td valign="top" align="center">+</td>
</tr>
<tr>
<td valign="top" align="left">Sucrose</td>
<td valign="top" align="center">+</td>
<td valign="top" align="left">Nitrate reduction</td>
<td valign="top" align="center">+</td>
</tr>
<tr>
<td valign="top" align="left">Melibiose</td>
<td valign="top" align="center">&#x2212;</td>
<td valign="top" align="left">&#x3b2;-galactosidase</td>
<td valign="top" align="center">+</td>
</tr>
<tr>
<td valign="top" align="left">Maltose</td>
<td valign="top" align="center">+</td>
<td valign="top" align="left">Urease</td>
<td valign="top" align="center">&#x2212;</td>
</tr>
<tr>
<td valign="top" align="left">Raffinose</td>
<td valign="top" align="center">&#x2212;</td>
<td valign="top" align="left">Arginine dihydrolase</td>
<td valign="top" align="center">&#x2212;</td>
</tr>
<tr>
<td valign="top" align="left">Xylose</td>
<td valign="top" align="center">+</td>
<td valign="top" align="left">Motile</td>
<td valign="top" align="center">+</td>
</tr>
<tr>
<td valign="top" align="left">Aesculin</td>
<td valign="top" align="center">+</td>
<td valign="top" align="left">H<sub>2</sub>S production</td>
<td valign="top" align="center">&#x2212;</td>
</tr>
</tbody>
</table>
</table-wrap>
<table-wrap id="T2" position="float">
<label>Table&#xa0;2</label>
<caption>
<p>Antimicrobial susceptibility of <italic>P. anthophila</italic> UI705.</p>
</caption>
<table frame="hsides">
<thead>
<tr>
<th valign="top" align="left">Antibiotics</th>
<th valign="top" align="left">Content (&#x3bc;g/disc)</th>
<th valign="top" align="left">Zone of inhibition (mm)</th>
<th valign="top" align="left">Interpretation</th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left">Amikacin</td>
<td valign="top" align="left">30</td>
<td valign="top" align="left">24</td>
<td valign="top" align="left">S</td>
</tr>
<tr>
<td valign="top" align="left">Cefuroxime</td>
<td valign="top" align="left">30</td>
<td valign="top" align="left">23</td>
<td valign="top" align="left">S</td>
</tr>
<tr>
<td valign="top" align="left">Ceftriaxone</td>
<td valign="top" align="left">30</td>
<td valign="top" align="left">31</td>
<td valign="top" align="left">S</td>
</tr>
<tr>
<td valign="top" align="left">Meropenem</td>
<td valign="top" align="left">10</td>
<td valign="top" align="left">30</td>
<td valign="top" align="left">S</td>
</tr>
<tr>
<td valign="top" align="left">Norfloxacin</td>
<td valign="top" align="left">10</td>
<td valign="top" align="left">28</td>
<td valign="top" align="left">S</td>
</tr>
<tr>
<td valign="top" align="left">Cefepime</td>
<td valign="top" align="left">30</td>
<td valign="top" align="left">30</td>
<td valign="top" align="left">S</td>
</tr>
<tr>
<td valign="top" align="left">Tetracycline</td>
<td valign="top" align="left">30</td>
<td valign="top" align="left">27</td>
<td valign="top" align="left">S</td>
</tr>
<tr>
<td valign="top" align="left">Cefazolin</td>
<td valign="top" align="left">30</td>
<td valign="top" align="left">14</td>
<td valign="top" align="left">R</td>
</tr>
<tr>
<td valign="top" align="left">Levofloxacin</td>
<td valign="top" align="left">5</td>
<td valign="top" align="left">32</td>
<td valign="top" align="left">S</td>
</tr>
<tr>
<td valign="top" align="left">Aztreonam</td>
<td valign="top" align="left">30</td>
<td valign="top" align="left">31</td>
<td valign="top" align="left">S</td>
</tr>
<tr>
<td valign="top" align="left">Ceftazidime</td>
<td valign="top" align="left">30</td>
<td valign="top" align="left">29</td>
<td valign="top" align="left">S</td>
</tr>
<tr>
<td valign="top" align="left">Cefoxitin</td>
<td valign="top" align="left">30</td>
<td valign="top" align="left">24</td>
<td valign="top" align="left">S</td>
</tr>
<tr>
<td valign="top" align="left">Sulfamethoxazole</td>
<td valign="top" align="left">25</td>
<td valign="top" align="left">31</td>
<td valign="top" align="left">S</td>
</tr>
<tr>
<td valign="top" align="left">Cefperazone/Sulbactam</td>
<td valign="top" align="left">105</td>
<td valign="top" align="left">28</td>
<td valign="top" align="left">S</td>
</tr>
<tr>
<td valign="top" align="left">Piperacillin/Tazobactam</td>
<td valign="top" align="left">110</td>
<td valign="top" align="left">29</td>
<td valign="top" align="left">S</td>
</tr>
<tr>
<td valign="top" align="left">Ampicillin</td>
<td valign="top" align="left">10</td>
<td valign="top" align="left">11</td>
<td valign="top" align="left">R</td>
</tr>
<tr>
<td valign="top" align="left">Imipenem</td>
<td valign="top" align="left">10</td>
<td valign="top" align="left">29</td>
<td valign="top" align="left">S</td>
</tr>
<tr>
<td valign="top" align="left">Ciprofloxacin</td>
<td valign="top" align="left">5</td>
<td valign="top" align="left">30</td>
<td valign="top" align="left">S</td>
</tr>
<tr>
<td valign="top" align="left">Gentamicin</td>
<td valign="top" align="left">10</td>
<td valign="top" align="left">22</td>
<td valign="top" align="left">S</td>
</tr>
<tr>
<td valign="top" align="left">Fosfomycin</td>
<td valign="top" align="left">50</td>
<td valign="top" align="left">28</td>
<td valign="top" align="left">S</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>* Drug sensitivity was judged according to EUCAST 2022 standard. S, sensitive; I, intermediate; R, resistant.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</sec>
<sec id="s3_2">
<title>16S rRNA-based phylogenetic tree</title>
<p>To further investigate the phylogenetic features of the isolated strain UI705 in this study, 16S rRNA gene sequencing was performed. The complete 16S rRNA sequence of the strain UI705 was analyzed with the EzBioCloud Database (<xref ref-type="bibr" rid="B40">Yoon et&#xa0;al., 2017a</xref>). The strain UI705 exhibited highest (99.64%) 16S rRNA gene sequence similarity with the type strain of <italic>P. anthophila</italic> LMG 2558<sup>T</sup> (GenBank accession no. EF688010). A total of 1,387 contiguous nucleotides of the strain UI705 were determined and compared with that of <italic>P. anthophila</italic> LMG 2558<sup>T</sup> with a completeness of 98.5%. Among the 1,387 bases, there was only a five-base difference from strain LMG 2558<sup>T</sup>. The 16S rRNA sequencing results were submitted to GenBank (accession no. OQ704296). Multiple alignments with sequences of the related <italic>Pantoea</italic> and the calculations of the levels of sequence similarity were carried out using the MUSCLE algorithm (<xref ref-type="bibr" rid="B17">Edgar, 2004</xref>). A phylogenetic tree was constructed using the neighbor-joining method by MEGA software version 11 (<xref ref-type="bibr" rid="B35">Tamura et&#xa0;al., 2021</xref>). The topology of the phylogenetic tree was evaluated by using the bootstrap resampling method with 1,000 replicates. The phylogenetic tree showed that strain UI705 was clustered with the type strain LMG 2558<sup>T</sup>, and this cluster was strongly supported with a bootstrap value of 82% (<xref ref-type="fig" rid="f2">
<bold>Figure&#xa0;2</bold>
</xref>). The results of the comparative 16S rRNA gene sequence analysis demonstrated that the isolated strain UI705 belongs to the <italic>P. anthophila</italic> species.</p>
<fig id="f2" position="float">
<label>Figure&#xa0;2</label>
<caption>
<p>Phylogenetic tree based on the 16S rRNA gene sequences showing the relationship of isolated strain UI705 (black arrow) and members within genus <italic>Pantoea</italic>. The tree was reconstructed by the neighbor-joining method, and <italic>Enterobacter huaxiensis</italic> 90008<sup>T</sup> (MK049964) was used as an outgroup. Bootstrap values (&gt;50%) based on 1,000 replicates are shown at branch nodes. T, type strain.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fcimb-13-1208473-g002.tif"/>
</fig>
</sec>
<sec id="s3_3">
<title>Whole-genome sequencing of <italic>P. anthophila</italic> UI705</title>
<p>The draft genome sequence of <italic>P. anthophila</italic> UI705 revealed 4,542,010 bp in size and assembled into 15 contigs, with an N50 value of 564,400 bp and 243.23 &#xd7; coverage. The GC content of the assembled genome is 56.95% (<xref ref-type="fig" rid="f3">
<bold>Figure&#xa0;3</bold>
</xref>), which is consistent with that of other reports available. Automatic annotation with the NCBI PGAP revealed 4,288 protein coding genes. The details of gene element prediction were listed in <xref ref-type="table" rid="T3">
<bold>Table&#xa0;3</bold>
</xref>. Genome-based taxonomy classification using OrthoANIu algorithm validated that UI705 belongs to <italic>P. anthophila</italic> as it revealed a high ANI value of 99.88% between UI705 and the <italic>P. anthophila</italic> type strain LMG 2558<sup>T</sup>. Moreover, the DDH value between UI705 and its related type strain was analyzed by GGDC 3.0 with an estimated value of 99.30% (Formula 2). The gene function annotation of the UI705 was performed in a database that is based on NCBI Blast+ and KEGG Automatic Annotation Server, including CDD, COG, NR, and PFAM, and the number of annotated genes is the highest in the NR database (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplement Figure S1</bold>
</xref>). The assembled sequences of <italic>P. anthophila</italic> UI705 were subjected to GO for further annotation and description of the properties of genes and gene products that were divided into molecular function, cellular component, and biological process (<xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4A</bold>
</xref>). The result from KEGG revealed 100 predictive genes involved in human diseases, mainly those related to infectious diseases and drug resistance (<xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4B</bold>
</xref>), indicating that <italic>P. anthophila</italic> may emerge as a human pathogen.</p>
<fig id="f3" position="float">
<label>Figure&#xa0;3</label>
<caption>
<p>Circular display of the draft genome of <italic>P. anthophila</italic> UI705. The circle from outside to inside represent the following: coding sequences (CDS) on the forward strand (green), the contigs (gray), GC content (black), GC-skew (blue and purple indicate values higher and lower than the mean value, respectively), and CDS on the reverse strand (green). The tRNA (yellow) and rRNA (brown) on both forward and reverse strands are indicated.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fcimb-13-1208473-g003.tif"/>
</fig>
<table-wrap id="T3" position="float">
<label>Table&#xa0;3</label>
<caption>
<p>Genome features of <italic>P. anthophila</italic> UI705.</p>
</caption>
<table frame="hsides">
<thead>
<tr>
<th valign="top" align="left">Class</th>
<th valign="top" align="center">Number</th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left">Size (base)</td>
<td valign="top" align="left">4,542,010</td>
</tr>
<tr>
<td valign="top" align="left">G+C content (%)</td>
<td valign="top" align="left">56.95</td>
</tr>
<tr>
<td valign="top" align="left">Contigs</td>
<td valign="top" align="left">15</td>
</tr>
<tr>
<td valign="top" align="left">N50 (base)</td>
<td valign="top" align="left">564,400</td>
</tr>
<tr>
<td valign="top" align="left">Protein coding genes</td>
<td valign="top" align="left">4,288</td>
</tr>
<tr>
<td valign="top" align="left">Coding ratio (%)</td>
<td valign="top" align="left">87.6</td>
</tr>
<tr>
<td valign="top" align="left">tRNAs</td>
<td valign="top" align="left">71</td>
</tr>
<tr>
<td valign="top" align="left">rRNAs</td>
<td valign="top" align="left">10</td>
</tr>
<tr>
<td valign="top" align="left">Repeat region</td>
<td valign="top" align="left">0</td>
</tr>
</tbody>
</table>
</table-wrap>
<fig id="f4" position="float">
<label>Figure&#xa0;4</label>
<caption>
<p>The gene function annotations of the <italic>P. anthophila</italic> strain UI705. <bold>(A)</bold> GO classification describes the properties of genes and gene products as three terms: molecular function (light blue), cellular component (brownish red), and biological process (cyan). The left and right axis indicate percentage of genes and gene numbers, respectively. <bold>(B)</bold> KEGG classification reveals the predicted genes involved in metabolic pathways and human diseases. The numbers on the right of the bar graphs represent predicted genes that are related to correspondent activities.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fcimb-13-1208473-g004.tif"/>
</fig>
</sec>
<sec id="s3_4">
<title>Prediction of pathogenicity</title>
<p>The antibiotic resistance of the isolate U1705 was predicted by the CARD and 81 proteins were predicted, such as those related to antibiotic efflux, antibiotic inactivation, and reduced permeability to antibiotic (<xref ref-type="fig" rid="f5">
<bold>Figure&#xa0;5A</bold>
</xref>). The antibiotic resistance ontology adeF, rsmA, and CRP were annotated with high percentage identity of matching region (61.44%&#x2013;89.66%), and the length ratio of reference sequence ranges from 99.24% to 100%. These AROs belong to the resistance-nodulation-cell division (RND) antibiotic efflux pump family and mediate antibiotic resistance in plenty of Gram-negative bacteria (<xref ref-type="bibr" rid="B6">Blair and Piddock, 2009</xref>). In addition, a total of 126 virulence factor terms were predicted through the core dataset of the VFDB, which contains 368 predicted proteins (<xref ref-type="fig" rid="f5">
<bold>Figure&#xa0;5B</bold>
</xref>). The database predicted the most immune modulation-related proteins, followed by an effector delivery system that includes Type III and VI Secretion Systems (T3SS and T6SS). The T3SS is a needle-like protein complex found in several species of plant or human pathogenic organisms within genus <italic>Pantoea</italic>, contributing to the pathogenicity to their hosts (<xref ref-type="bibr" rid="B13">Correa et&#xa0;al., 2012</xref>; <xref ref-type="bibr" rid="B23">Kirzinger et&#xa0;al., 2015</xref>). Based on PHI database, the U1705 exhibited pathogenicity to both animals and plants, with a total of 198 PHI-related proteins predicted (<xref ref-type="fig" rid="f5">
<bold>Figure&#xa0;5C</bold>
</xref>). There are 11 annotated genes that are related to reduced virulence or loss of pathogenicity in human host. The carbohydrate active enzyme annotation was carried out by CAZy with e-value &lt; 1e&#x2212;5 and glycosyl transferases remain the highest (<xref ref-type="fig" rid="f5">
<bold>Figure&#xa0;5D</bold>
</xref>). The lipopolysaccharide core heptosyltransferase RfaQ and RfaG, and capsular polysaccharide synthesis protein that belong to glycosyl transferases play important roles in the pathogenicity of many bacteria (<xref ref-type="bibr" rid="B2">Aguiniga et&#xa0;al., 2016</xref>; <xref ref-type="bibr" rid="B34">St John et&#xa0;al., 2023</xref>).</p>
<fig id="f5" position="float">
<label>Figure&#xa0;5</label>
<caption>
<p>Prediction of pathogenicity of the strain UI705 through the database. <bold>(A)</bold> The antibiotic resistance was predicted by CARD. <bold>(B)</bold> The virulence factors were predicted through the core dataset of the VFDB. <bold>(C)</bold> The pathogen&#x2013;host interactions were predicted by the PHI database. <bold>(D)</bold> The carbohydrate active enzyme annotation was carried out through the CAZy database. The numbers on the top of the bar graphs represent the predicted proteins in each channel.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fcimb-13-1208473-g005.tif"/>
</fig>
</sec>
</sec>
<sec id="s4" sec-type="discussion">
<title>Discussion</title>
<p>
<italic>Pantoea</italic> is a genus of Gram-negative bacteria derived from Erwiniaceae family that was recently proposed as a novel family on the basis of comprehensive and genome-scale taxonomic analysis by <xref ref-type="bibr" rid="B1">Adeolu et&#xa0;al. (2016)</xref>. The majority of strains within the genus are isolated from plants and the environment, and it is generally considered as a plant pathogen. Among the members of the genus <italic>Pantoea</italic>, only a limited number of species are reported to be associated with human infectious diseases. Currently, the most common causative agent of opportunistic human infections within the genus <italic>Pantoea</italic> is <italic>P. agglomerans</italic>, which can cause infections in different parts of the body, such as bloodstream infections, arthritis or synovitis, periostitis, and endocarditis (<xref ref-type="bibr" rid="B16">Dutkiewicz et&#xa0;al., 2016</xref>). Moreover, <italic>P. agglomerans</italic> has caused several nosocomial outbreaks of septicemia since the great epidemic occurred in 1970 and resulted in 152 cases by this organism alone (<xref ref-type="bibr" rid="B16">Dutkiewicz et&#xa0;al., 2016</xref>). Infections caused by <italic>P. agglomerans</italic> are mainly from wound infection with plant material and hospital-acquired infection in immunocompromised individuals. Recently, a couple of studies report that <italic>P. dispersa</italic> can cause bacteremia and neonatal sepsis, especially in immunocompromised patients (<xref ref-type="bibr" rid="B30">Mehar et&#xa0;al., 2013</xref>; <xref ref-type="bibr" rid="B20">Hagiya and Otsuka, 2014</xref>; <xref ref-type="bibr" rid="B3">Asai et&#xa0;al., 2019</xref>). Rare cases of bacteriuria are described in <italic>P. ananatis</italic> and <italic>P. stewartii</italic> (<xref ref-type="bibr" rid="B15">De Baere et&#xa0;al., 2004</xref>; <xref ref-type="bibr" rid="B12">Cobo et&#xa0;al., 2022</xref>). An increasing number of <italic>Pantoea</italic> species related to human infections are described, but the pathogenic mechanisms underlying these species remain unclear.</p>
<p>
<italic>P. anthophila</italic> has been characterized with non-pathogenic organism and initially isolated from <italic>I. balsamina</italic> and <italic>Tagetes erecta</italic>, showing no external sign of infection or any negative effect&#xa0;on its hosts (<xref ref-type="bibr" rid="B10">Brady et&#xa0;al., 2009</xref>). Wan et&#xa0;al. reported the draft genome sequence of <italic>P. anthophila</italic> strain 11-2 isolated from&#xa0;hypersaline water from the lake on Laysan, Hawaii and numerous virulence-related components were identified based on bioinformatic analysis (<xref ref-type="bibr" rid="B39">Wan et&#xa0;al., 2015</xref>). Only one study by Zhou et&#xa0;al. reported for the first time that <italic>P. anthophila</italic> naturally caused soft rot disease and cracking on <italic>C. lansium</italic> (<xref ref-type="bibr" rid="B42">Zhou et&#xa0;al., 2015</xref>), indicating that <italic>P. anthophila</italic> is pathogenic to plant.</p>
<p>We encountered the first case of urinary tract infection caused by <italic>P. anthophila</italic> in a 73-year-old man with bladder cancer. The patient denied having been in contact with or being injured by plants or other materials, so the exact source of the isolate from our patient remains unknown. The elderly patient has undergone chemotherapy after surgical treatment of bladder cancer and belongs to the immunocompromised population, which may contribute to the infection of <italic>P. anthophila</italic>. Infections by <italic>Pantoea</italic> species may not present with the conventional symptoms such as fever and leukocytosis, which mainly result from the low virulence of the bacteria. The main symptom of the patient in this study is frequent urination, without fever or other clinical manifestations, and the leukocyte count remained normal with a high percentage of neutrophils (85.6%). Therefore, it is difficult to determine the presence of infection through hematological indicators, and the isolation of pathogenic bacteria from urine confirms the existence of infection. The isolate was susceptible to all antibiotics tested, except for ampicillin and cefazolin, which is consistent with the reported drug sensitivity of <italic>P. stewartia</italic> (<xref ref-type="bibr" rid="B12">Cobo et&#xa0;al., 2022</xref>). The patient&#x2019;s condition improved rapidly due to appropriate antibiotic treatment.</p>
<p>The isolated strain was identified as <italic>P. anthophila</italic> by MALDI-TOF MS, an emerging technology developed in recent years for rapid identification of bacterial pathogens. MALDI-TOF MS can accurately identify commonly isolated micro-organisms due to high coverage rate in the comparison database, but it has limited ability in identification of novel or rare pathogenic species (<xref ref-type="bibr" rid="B19">Ha et&#xa0;al., 2019</xref>). Mass spectrometry may be misidentified in the identification of some <italic>Pantoea</italic> species, such as <italic>P. dispersa</italic>, which was initially mistaken as <italic>Klebsiella ozaenae</italic> (<xref ref-type="bibr" rid="B3">Asai et&#xa0;al., 2019</xref>). 16S rRNA gene sequencing has been frequently used for molecular classification and phylogeny of bacterial isolates. The 16S rRNA sequence of strain UI705 was found to have a five-base difference from the type strain LMG 2588<sup>T</sup> within a total of 1,387 nucleotides. A phylogenetic tree also revealed a cluster within the previously reported <italic>P. anthophila</italic> strains and our isolate UI705, indicating that our strain is most closely related to the type strain. Owing to the diversity of microbial species, multi-dimensional analysis, including MALDI-TOF MS and 16S rRNA gene sequencing, will be valuable in accurately distinguishing the large amounts of species from their closest phylogenetic neighbors.</p>
<p>The draft genome sequencing of the clinical isolate UI705 reveals plenty of virulence factors that are involved in human diseases, such as adherence/invasion, toxin, and stress survival. The chaperone protein fimbriae, Myf/pH6 antigen, outer membrane protein OmpU, and multivalent adhesion molecule MAM7 are important adhesins or invasins that mediate the initiation of host&#x2013;pathogen interactions (<xref ref-type="bibr" rid="B24">Krachler et&#xa0;al., 2011</xref>; <xref ref-type="bibr" rid="B25">Liu et&#xa0;al., 2015</xref>; <xref ref-type="bibr" rid="B32">Pakharukova et&#xa0;al., 2016</xref>). Moreover, there are a number of predicted proteins related to host&#x2013;pathogen interactions, such as TyrR, yfeAB, Crp, and RelA, and most of the genes are annotated from the reservoirs of <italic>Yersinia pestis</italic> and <italic>Vibrio cholerae</italic>. These results indicate that <italic>P. anthophila</italic> is a potential pathogen in both animal and plant hosts, and further experimental investigations are necessary to determine its pathogenicity. In this case, the <italic>P. anthophila</italic> caused urinary tract infection, which was cured by appropriate treatment with fosfomycin. The antibiotic resistance of the isolate UI705 was characterized by analysis through the CARD database based on the genome with kinds of multidrug resistance proteins. However, the AST results of this study show that the UI705 is only resistant to first-generation cephalosporin antibiotics, which may be due to the poor concordance between bacterial resistance genotypes and phenotypes.</p>
<p>In conclusion, we report the first case of urinary tract infection caused by <italic>P. anthophila</italic> in an elder man with bladder cancer. The clinical isolate was identified and analyzed by means of MALDI-TOF MS, 16S rRNA gene sequencing, and genome sequence. It should be noted that <italic>P. anthophila</italic> may lead to asymptomatic infection in an immunocompromised patient, which deserves the attention of clinicians. Although the pathogenicity of <italic>P. anthophila</italic> is unclear, the present case may indicate an emerging pathogen in medical practice. More cases of infections by this organism should be collected and integrated to explore the potential pathogenicity as well as epidemiology of <italic>P. anthophila</italic> infections.</p>
</sec>
<sec id="s5" sec-type="data-availability">
<title>Data availability statement</title>
<p>The datasets presented in this study can be found in online repositories. The names of the repository/repositories and accession number(s) can be found in the article/<xref ref-type="supplementary-material" rid="s11">
<bold>Supplementary Material</bold>
</xref>.</p>
</sec>
<sec id="s6" sec-type="ethics-statement">
<title>Ethics statement</title>
<p>The studies involving human participants were reviewed and approved by Medical Ethics Committee of the Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology. The patients/participants provided their written informed consent to participate in this study.</p>
</sec>
<sec id="s7" sec-type="author-contributions">
<title>Author contributions</title>
<p>YZhang, YF, and ZL designed the research. YZhang, YF, YZhan, and XL performed the experiments. HaW, TF, LS, HaW and JW analyzed the data. YZhang, YF, and HuW wrote the initial draft of the manuscript. All authors contributed to the article and approved the submitted version.</p>
</sec>
</body>
<back>
<sec id="s8" sec-type="funding-information">
<title>Funding</title>
<p>This work was supported by a grant from the Wuhan Municipal Health Commission (Project no. WX21Q42) and by one local grant from The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology to YMZ.</p>
</sec>
<sec id="s9" sec-type="COI-statement">
<title>Conflict of interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec id="s10" sec-type="disclaimer">
<title>Publisher&#x2019;s note</title>
<p>All claims expressed in this article are solely those of the authors&#xa0;and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
<sec id="s11" sec-type="supplementary-material">
<title>Supplementary material</title>
<p>The Supplementary Material for this article can be found online at: <ext-link ext-link-type="uri" xlink:href="https://www.frontiersin.org/articles/10.3389/fcimb.2023.1208473/full#supplementary-material">https://www.frontiersin.org/articles/10.3389/fcimb.2023.1208473/full#supplementary-material</ext-link>
</p>
<supplementary-material xlink:href="DataSheet_1.docx" id="SM1" mimetype="application/vnd.openxmlformats-officedocument.wordprocessingml.document"/>
</sec>
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