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<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Microbiol.</journal-id>
<journal-title>Frontiers in Microbiology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Microbiol.</abbrev-journal-title>
<issn pub-type="epub">1664-302X</issn>
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<publisher-name>Frontiers Media S.A.</publisher-name>
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<article-meta>
<article-id pub-id-type="doi">10.3389/fmicb.2024.1409593</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Microbiology</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Detection and phylogenetic classification of <italic>Neoehrlichia mikurensis</italic> in rodents from the region of Liupan Mountain, China</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>Wang</surname> <given-names>Xiaodong</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
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<contrib contrib-type="author">
<name><surname>Pang</surname> <given-names>Bo</given-names></name>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
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<name><surname>Kou</surname> <given-names>Zengqiang</given-names></name>
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<contrib contrib-type="author">
<name><surname>Zhao</surname> <given-names>Jiaqi</given-names></name>
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<contrib contrib-type="author">
<name><surname>Yan</surname> <given-names>Yi</given-names></name>
<xref ref-type="aff" rid="aff3"><sup>3</sup></xref>
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<contrib contrib-type="author">
<name><surname>Chen</surname> <given-names>Tan</given-names></name>
<xref ref-type="aff" rid="aff3"><sup>3</sup></xref>
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<contrib contrib-type="author" corresp="yes">
<name><surname>Yang</surname> <given-names>Liping</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="corresp" rid="c001"><sup>&#x002A;</sup></xref>
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<aff id="aff1"><sup>1</sup><institution>Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University</institution>, <addr-line>Jinan</addr-line>, <country>China</country></aff>
<aff id="aff2"><sup>2</sup><institution>Shandong Center for Disease Control and Prevention</institution>, <addr-line>Jinan</addr-line>, <country>China</country></aff>
<aff id="aff3"><sup>3</sup><institution>Jingyuan Center for Disease Control and Prevention</institution>, <addr-line>Guyuan</addr-line>, <country>China</country></aff>
<author-notes>
<fn fn-type="edited-by" id="fn0001">
<p>Edited by: Jinyu Shan, University of Leicester, United Kingdom</p>
</fn>
<fn fn-type="edited-by" id="fn0002">
<p>Reviewed by: Qiaoyun Ren, Chinese Academy of Agricultural Sciences, China</p>
<p>Michele Castelli, University of Pavia, Italy</p>
<p>Andrew Jenkins, University of South-Eastern Norway (USN), Norway</p>
</fn>
<corresp id="c001">&#x002A;Correspondence: Liping Yang, <email>yliping@sdu.edu.cn</email></corresp>
</author-notes>
<pub-date pub-type="epub">
<day>04</day>
<month>07</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="collection">
<year>2024</year>
</pub-date>
<volume>15</volume>
<elocation-id>1409593</elocation-id>
<history>
<date date-type="received">
<day>30</day>
<month>03</month>
<year>2024</year>
</date>
<date date-type="accepted">
<day>10</day>
<month>06</month>
<year>2024</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#x00A9; 2024 Wang, Pang, Kou, Zhao, Yan, Chen and Yang.</copyright-statement>
<copyright-year>2024</copyright-year>
<copyright-holder>Wang, Pang, Kou, Zhao, Yan, Chen and Yang</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>
<p><italic>Neoehrlichia mikurensis</italic> (<italic>N. mikurensis</italic>) is an emerging tick-borne pathogen that can cause neoehrlichiosis. Rodents are considered the major host for <italic>N. mikurensis</italic>. Currently, <italic>N. mikurensis</italic> has been detected in rodents in several studies from China and other countries. However, no research on <italic>N. mikurensis</italic> infection in rodents has been reported in the Liupan mountain region. The region of Liupan Mountain, located in northwestern China, is the center of the triangle formed by the cities of Xi&#x2019;an, Yinchuan, and Lanzhou, with multiple tourist sites in the region. To survey whether there is <italic>N. mikurensis</italic> in hosts, rodents were captured in this region in September 2020. A nested polymerase chain reaction was used to detect the DNA of <italic>N. mikurensis</italic>, followed by nucleotide sequencing and phylogenetic analysis. In the region, among 88 rodents, 3 rodents were detected positive for <italic>N. mikurensis</italic>, a detection rate of 3.4%. Based on phylogenetic analysis of the partial <italic>groEL</italic> gene sequences, <italic>N. mikurensis</italic> from rodents in Liupan Mountain clustered in the same evolutionary branch with those found in rodents from Japan, Russia, and northeastern China, and also in ticks and clinical cases from Heilongjiang Province in northeastern China.</p>
</abstract>
<kwd-group>
<kwd><italic>Neoehrlichia mikurensis</italic></kwd>
<kwd>rodents</kwd>
<kwd>detection</kwd>
<kwd>phylogenetic analysis</kwd>
<kwd>Liupan Mountain</kwd>
</kwd-group>
<counts>
<fig-count count="1"/>
<table-count count="0"/>
<equation-count count="0"/>
<ref-count count="32"/>
<page-count count="5"/>
<word-count count="3372"/>
</counts>
<custom-meta-wrap>
<custom-meta>
<meta-name>section-at-acceptance</meta-name>
<meta-value>Infectious Agents and Disease</meta-value>
</custom-meta>
</custom-meta-wrap>
</article-meta>
</front>
<body>
<sec sec-type="intro" id="sec1">
<label>1</label>
<title>Introduction</title>
<p><italic>Neoehrlichia mikurensis</italic> (<italic>N. mikurensis</italic>), an emerging pathogen belonging to the family <italic>Anaplasmataceae</italic> (<xref ref-type="bibr" rid="ref11">Kawahara et al., 2004</xref>), was first detected in <italic>Ixodes ricinus</italic> in the Netherlands in 1999 (<xref ref-type="bibr" rid="ref23">Schouls et al., 1999</xref>). Currently, <italic>N. mikurensis</italic> has been reported among a variety of animals, such as rodents (<xref ref-type="bibr" rid="ref18">Obiegala et al., 2014</xref>), hedgehogs (<xref ref-type="bibr" rid="ref5">F&#x00F6;ldv&#x00E1;ri et al., 2014</xref>), and a dog (<xref ref-type="bibr" rid="ref3">Diniz et al., 2011</xref>). Of these, rodents can be considered to be the major host for <italic>N. mikurensis.</italic></p>
<p><italic>N. mikurensis</italic> in rodents has been reported in several countries, such as South Korea (<xref ref-type="bibr" rid="ref10">Jha et al., 2018</xref>), Germany (<xref ref-type="bibr" rid="ref6">Galfsky et al., 2019</xref>), Sweden (<xref ref-type="bibr" rid="ref1">Andersson and R&#x00E5;berg, 2011</xref>), Japan (<xref ref-type="bibr" rid="ref12">Kenji et al., 2007</xref>), Hungary (<xref ref-type="bibr" rid="ref26">Szekeres et al., 2015</xref>), and Russia (<xref ref-type="bibr" rid="ref22">Rar et al., 2010</xref>). In 2003, <xref ref-type="bibr" rid="ref19">Pan et al. (2003)</xref> found the pathogen in <italic>Rattus norvegicus</italic> from Guangzhou, China. Subsequently, it was also found in rodents from other provinces in China, such as Yunnan (<xref ref-type="bibr" rid="ref4">Du et al., 2018</xref>), Jilin (<xref ref-type="bibr" rid="ref15">Li et al., 2013</xref>) and Liaoning provinces (<xref ref-type="bibr" rid="ref27">Wang et al., 2019</xref>). Since the first human case of neoehrlichiosis was reported in 2010 (<xref ref-type="bibr" rid="ref30">Welinder-Olsson et al., 2010</xref>), more and more human infections with <italic>N. mikurensis</italic> have been reported globally (<xref ref-type="bibr" rid="ref20">Pekova et al., 2011</xref>; <xref ref-type="bibr" rid="ref14">Li et al., 2012</xref>; <xref ref-type="bibr" rid="ref29">Welc-Faleciak et al., 2014</xref>; <xref ref-type="bibr" rid="ref21">Quarsten et al., 2017</xref>; <xref ref-type="bibr" rid="ref2">Boyer et al., 2021</xref>; <xref ref-type="bibr" rid="ref9">Hoper et al., 2021</xref>; <xref ref-type="bibr" rid="ref13">Lenart et al., 2021</xref>; <xref ref-type="bibr" rid="ref17">Markowicz et al., 2021</xref>; <xref ref-type="bibr" rid="ref7">Gonzalez-Carmona et al., 2023</xref>; <xref ref-type="bibr" rid="ref8">Gynthersen et al., 2023</xref>).</p>
<p>However, no research on neoehrlichiosis or <italic>N. mikurensis</italic> infection in hosts has been reported in the region of Liupan Mountain, China. So, detecting whether there is <italic>N. mikurensis</italic> in rodents is of great significance for assessing the risk of <italic>N. mikurensis</italic> infection in residents. <xref ref-type="bibr" rid="ref24">Silaghi et al. (2012)</xref> detected <italic>N. mikurensis</italic> in the liver, spleen, kidney, blood, transudate, and skin tissues of rodents, with the highest detection rate in the kidney. Therefore, in this study, we used nested PCR to detect the presence of <italic>N. mikurensis</italic> in rodent kidney organs in the region.</p>
</sec>
<sec sec-type="materials|methods" id="sec2">
<label>2</label>
<title>Materials and methods</title>
<sec id="sec3">
<label>2.1</label>
<title>Study area and sample collection</title>
<p>The Liupan Mountain Nature Reserve (106&#x00B0;09&#x2032;-106&#x00B0;30&#x2032;E, 35&#x00B0;15&#x2032;-35&#x00B0;41&#x2032;N), located in northwestern China, is the center of the triangle formed by the cities of Xi&#x2019;an, Yinchuan, and Lanzhou, with multiple tourist sites in the region.</p>
<p>In September 2020, rodents were captured by night trapping method at Laolongtan Scenic Spot, Huanghua Town, and Xingsheng Town in the region. After the captured rodents were brought back to the laboratory, they were species-identified based on their morphological characteristics (<xref ref-type="bibr" rid="ref16">Lu, 1982</xref>), and then dissection was performed to obtain the kidney tissues, which were stored in 2&#x2009;mL cryotubes at &#x2212;80&#x00B0;C.</p>
</sec>
<sec id="sec4">
<label>2.2</label>
<title>DNA extraction and detection of <italic>Neoehrlichia mikurensis</italic></title>
<p>Approximately 25&#x2009;mg of kidney tissue was taken under aseptic operation. DNA was extracted according to the instructions of a Tissue DNA Isolation Kit (Magnetic Beads) (Jiangsu Bioperfectus Technologies Co., Ltd., Jiangsu, China) and stored at &#x2212;40&#x00B0;C.</p>
<p>The <italic>groEL</italic> gene of <italic>N. mikurensis</italic> was amplified by nested PCR. The primers were used as reported by <xref ref-type="bibr" rid="ref15">Li et al. (2013)</xref> and synthesized by Shanghai BioGerm Medical Technology Co., Ltd. (Shanghai, China). The final amplification product target fragment size was 891&#x2009;bp. For the first round of the PCR amplification, the reaction mix was prepared as follows: 12.5&#x2009;&#x03BC;L of Premix Taq<sup>&#x2122;</sup> (TaKaRa Taq<sup>&#x2122;</sup> Version 2.0), 0.5&#x2009;&#x03BC;L each of CNM-out 1 and CNM-out 2 (10&#x2009;&#x03BC;mol/L), DNA template 3&#x2009;&#x03BC;L, ultrapure water 8.5&#x2009;&#x03BC;L. The reaction conditions were: 94&#x00B0;C pre-denaturation 5&#x2009;min; 94&#x00B0;C denaturation 30 s, 53&#x00B0;C annealing 30 s, 72&#x00B0;C extension 1&#x2009;min 30 s, for a total of 40&#x2009;cycles; 72&#x00B0;C final extension 5&#x2009;min. For the second round of PCR amplification, the reaction mix was prepared as follows: Premix Taq<sup>&#x2122;</sup> (TaKaRa Taq<sup>&#x2122;</sup> Version 2.0) 12.5&#x2009;&#x03BC;L, 1&#x2009;&#x03BC;L each of CNM-in 1 and CNM-in 2 (10&#x2009;&#x03BC;mol/L), 0.5&#x2009;&#x03BC;L of first-round product, and 10&#x2009;&#x03BC;L of ultrapure water. The reaction conditions were the same as those of the first-round reaction, except for the final extension at 72&#x00B0;C for 1&#x2009;min. The PCR products were separated using electrophoresis on 1.5% agarose gels, with GelRed<sup>&#x2122;</sup> Nucleic Acid Gel Stain (Biotium, America) and visualized under Gel Doc<sup>&#x2122;</sup> XR+ Imaging System (Bio-Rad, United States).</p>
</sec>
<sec id="sec5">
<label>2.3</label>
<title>Homology and phylogenetic analyses</title>
<p>The positive products were sequenced bidirectionally by Shanghai BioGerm Medical Technology Co., Ltd. (Shanghai, China). Sequence assembly and manual correction were performed using SeqMan software (Version 7.1, Lasergene, DNASTAR, Madison, WI, United States). One of the assembled sequences was uploaded to GenBank database, and used for homology and phylogenetic analyses. After performing blast alignment of the selected sequence at the National Center for Biotechnology Information, sequences with high homology were downloaded. In addition, sequences from selected geographical origins and hosts were also downloaded in this study to better analyze the evolutionary information of the <italic>groEL</italic> of <italic>N. mikurensis</italic>. The <italic>groEL</italic> sequences of <italic>Anaplasma phagocytophilum</italic> (AF033101) and <italic>Ehrlichia chaffeensis</italic> (L10917) were used as outgroups. Based on MEGA X (<xref ref-type="bibr" rid="ref9001">Kumar et al., 2018</xref>), model with the lowest BIC scores (Bayesian Information Criterion) was considered as the best-fit substitution model. The phylogenetic tree was constructed by the maximum likelihood method based on the best-fit substitution model (Tamura 3-parameter+G&#x2009;+&#x2009;I) (<xref ref-type="bibr" rid="ref9002">Tamura, 1992</xref>) using MEGA X (<xref ref-type="bibr" rid="ref9001">Kumar et al., 2018</xref>) and tested with 1,000 bootstrap replications. Sequences were aligned with MegAlign software (Version 7.1, Lasergene, DNASTAR, Madison, WI, United States), and the percent identities were calculated with the same software.</p>
</sec>
</sec>
<sec sec-type="results" id="sec6">
<label>3</label>
<title>Results</title>
<sec id="sec7">
<label>3.1</label>
<title>Sampling and PCR detection</title>
<p>Among 88 rodents captured in the region, 42 were form Laolongtan Scenic Spot, 27 from Huanghua Town, and 19 from Xingsheng Town. <italic>Apodemus peninsulae</italic> (36.4%, 32/88), <italic>Cricetus migratorius</italic> (26.1%, 23/88), <italic>Tscherskia triton</italic> (21.6%, 19/88), <italic>Apodemus agrarius</italic> (11.4%, 10/88), <italic>Niviventer confucianus</italic> (2.3%, 2/88), <italic>Eozapus setchuanus</italic> (1.1%, 1/88), and <italic>Mus musculus</italic> (1.1%, 1/88) were identified.</p>
<p>Three samples were positive for <italic>N. mikurensis</italic> positive, including two <italic>A. peninsulae</italic> (LPM-R14 and LPM-R25) and one <italic>T. triton</italic> (LPM-R37).</p>
</sec>
<sec id="sec8">
<label>3.2</label>
<title>Homology and phylogenetic analyses</title>
<p>The similarity of the three <italic>N. mikurensis</italic> sequences obtained in this study was greater than 99%. The sequence of sample LPM-R14 was uploaded to GenBank database (accession number, PP818814). Based on phylogenetic analysis of the partial <italic>groEL</italic> gene sequences, four evolutionary branches of <italic>N. mikurensis</italic> were reconstructed (<xref ref-type="fig" rid="fig1">Figure 1</xref>). The overall tree topology was consistent with <xref ref-type="bibr" rid="ref15">Li et al. (2013)</xref>, in particular the subdivision of <italic>N. mikurensis</italic> into four main clades (Clusters I-IV). The sequence (PP818814) from <italic>A. peninsulae</italic> clustered in Cluster I with those found in rodents from Japan (LC717483, LC717487), Russia (MN701627, FJ966365), and northwestern China, such as Inner Mongolia Autonomous Region (JQ359076), Heilongjiang (JQ359069, JQ359070, JQ359071, KC108717) and Jilin provinces (JQ359072, JQ359073, JQ359074). Moreover, Cluster I also included <italic>N. mikurensis</italic> infection in ticks from Russia (MG182157, KX980039, FJ966359) and Heilongjiang Province (JQ359077, JQ359078), and clinical cases of neoehrlichiosis from Heilongjiang Province (JQ359062). The homologies of PP818814 and sequences of Clusters I-IV in the phylogenetic tree were shown in <xref ref-type="supplementary-material" rid="SM1">Supplementary Tables S1&#x2013;S3</xref>.</p>
<fig position="float" id="fig1">
<label>Figure 1</label>
<caption>
<p>Phylogenetic tree of <italic>N. mikurensis</italic> inferred from partial fragments of the <italic>groEL</italic> gene sequences. &#x2022;, Sequence obtained in the study.</p>
</caption>
<graphic xlink:href="fmicb-15-1409593-g001.tif"/>
</fig>
</sec>
</sec>
<sec sec-type="discussion" id="sec9">
<label>4</label>
<title>Discussion</title>
<p>In this study, <italic>N. mikurensis</italic> was detected for the first time in rodents from the region of Liupan Mountain. The detection rate of <italic>N. mikurensis</italic> was 3.4% in the region, which was similar to Zhejiang (3.7%) and Henan provinces (3.9%), but lower than Jilin Province (13.8%), China (<xref ref-type="bibr" rid="ref15">Li et al., 2013</xref>). Our findings indicate that sequences of <italic>N. mikurensis</italic> from rodents in Liupan Mountain clustered in the same evolutionary branch with those found in rodents, ticks, and human cases from Heilongjiang Province. Liupan Mountain is the center of the triangle formed by the cities of Xi&#x2019;an, Yinchuan, and Lanzhou, and there are multiple tourist attractions in the region. Therefore, they indicate that there is a potential risk of <italic>N. mikurensis</italic> infection to the residents in Liupan Mountain. Currently, <italic>N. mikurensis</italic> is mainly detected by nested PCR or qPCR, and there is a lack of methods for its serologic detection (<xref ref-type="bibr" rid="ref28">Wass et al., 2019</xref>). Due to the few reported human cases in China, limited detection methods, and insufficient understanding of the clinical manifestations of neoehrlichiosis by physicians, misdiagnosis or missed diagnosis may occur.</p>
<p>Based on phylogenetic analysis of the <italic>groEL</italic> and 16S rRNA genes, <xref ref-type="bibr" rid="ref15">Li et al. (2013)</xref> concluded that <italic>N. mikurensis</italic> has four evolutionary branches (Clusters I-IV) that are related to geographic origins, with sequences from northeastern China and the Asian part of Russia clustering in Cluster I. Subsequently, <xref ref-type="bibr" rid="ref25">Sun et al. (2023)</xref> detected sequences in ticks from northeastern China clustered in Cluster IV. The phylogenetic tree inferred in this study showed that the sequence detected in the case from Spain clustered in Cluster I. This further indicate that geographical distribution and genetic variation are not necessarily concordant, and there are at least two genetic lineages of <italic>N. mikurensis</italic> currently in China.</p>
<p>In conclusion, <italic>N. mikurensis</italic> was found in <italic>A. peninsulae</italic> and <italic>T. triton</italic> in Liupan Mountain, and PP818814 sourced from the region clustered into the same evolutionary branch with <italic>N. mikurensis</italic> infection in rodents from Japan, Russia, and northeastern China, also with the pathogen in ticks and human cases from Heilongjiang Province. They indicate that there is a potential risk of <italic>N. mikurensis</italic> infection to residents in the region. Further studies should be conducted to detect the presence and abundance of <italic>N. mikurensis</italic> in ticks from the same area. And the ability of physicians to diagnose and differential diagnose neoehrlichiosis should be improved to identify whether there is the infection of <italic>N. mikurensis</italic> in local residents.</p>
</sec>
<sec sec-type="data-availability" id="sec10">
<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="SM1">Supplementary material</xref>.</p>
</sec>
<sec sec-type="ethics-statement" id="sec11">
<title>Ethics statement</title>
<p>According to <italic>Regulation on the Management of Vector Prevention and Control</italic> issued by National Health Commission of the People&#x2019;s Republic of China and Integrated Strategy for Vector Prevention and Control included in <italic>Healthy China 2030 Planning Framework</italic>, rats trapped is an activity for vector control. Therefore, ethical approval was not required in the study.</p>
</sec>
<sec sec-type="author-contributions" id="sec12">
<title>Author contributions</title>
<p>XW: Conceptualization, Data curation, Formal analysis, Investigation, Visualization, Writing &#x2013; original draft, Writing &#x2013; review &#x0026; editing. BP: Resources, Writing &#x2013; original draft. ZK: Writing &#x2013; review &#x0026; editing, Supervision. JZ: Writing &#x2013; original draft, Investigation. YY: Writing &#x2013; original draft, Resources. TC: Resources, Writing &#x2013; original draft. LY: Writing &#x2013; review &#x0026; editing, Supervision.</p>
</sec>
</body>
<back>
<sec sec-type="funding-information" id="sec13">
<title>Funding</title>
<p>The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.</p>
</sec>
<sec sec-type="COI-statement" id="sec14">
<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 sec-type="disclaimer" id="sec15">
<title>Publisher&#x2019;s note</title>
<p>All claims expressed in this article are solely those of the authors 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 sec-type="supplementary-material" id="sec16">
<title>Supplementary material</title>
<p>The Supplementary material for this article can be found online at: <ext-link xlink:href="https://www.frontiersin.org/articles/10.3389/fmicb.2024.1409593/full#supplementary-material" ext-link-type="uri">https://www.frontiersin.org/articles/10.3389/fmicb.2024.1409593/full#supplementary-material</ext-link></p>
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