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Article ; Online: Moving towards a standardized definition of antimicrobial resistance: a comparison of the antimicrobial susceptibility profile of difficult-to-treat resistance (DTR) versus multidrug-resistant (MDR) Pseudomonas aeruginosa clinical isolates (CANWARD, 2016-2021).

Walkty, A / Karlowsky, J A / Lagacé-Wiens, P R S / Baxter, M R / Adam, H J / Bay, D C / Zhanel, G G

Diagnostic microbiology and infectious disease

2023 Volume 108, Issue 2, Page(s) 116130

Abstract: Pseudomonas aeruginosa clinical isolates demonstrating difficult-to-treat resistance (DTR) and multidrug-resistant (MDR) phenotypes were evaluated by broth microdilution. Susceptibility was lower for all antimicrobials versus DTR relative to MDR isolates. ...

Abstract	Pseudomonas aeruginosa clinical isolates demonstrating difficult-to-treat resistance (DTR) and multidrug-resistant (MDR) phenotypes were evaluated by broth microdilution. Susceptibility was lower for all antimicrobials versus DTR relative to MDR isolates. Ceftazidime-avibactam, ceftolozane-tazobactam, and imipenem-relebactam susceptibility was 35.9%, 64.5%, and 47.0% for DTR isolates and 60.5%, 80.6%, and 71.5% for MDR isolates.
MeSH term(s)	Humans ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Pseudomonas aeruginosa ; Drug Resistance, Bacterial ; Ceftazidime/pharmacology ; Ceftazidime/therapeutic use ; Cephalosporins/pharmacology ; Cephalosporins/therapeutic use ; Pseudomonas Infections/drug therapy ; Anti-Infective Agents/pharmacology ; Azabicyclo Compounds/pharmacology ; Azabicyclo Compounds/therapeutic use ; Drug Combinations ; Microbial Sensitivity Tests ; Drug Resistance, Multiple, Bacterial
Chemical Substances	Anti-Bacterial Agents ; Ceftazidime (9M416Z9QNR) ; Cephalosporins ; Anti-Infective Agents ; Azabicyclo Compounds ; Drug Combinations
Language	English
Publishing date	2023-11-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	604920-5
ISSN	1879-0070 ; 0732-8893
ISSN (online)	1879-0070
ISSN	0732-8893
DOI	10.1016/j.diagmicrobio.2023.116130
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Zs.A 1845: Show issues

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Article ; Online: Presence of the narrow-spectrum OXA-1 β-lactamase enzyme is associated with elevated piperacillin/tazobactam MIC values among ESBL-producing

Walkty, A / Karlowsky, J A / Lagacé-Wiens, P R S / Golden, A R / Baxter, M R / Denisuik, A J / McCracken, M / Mulvey, M R / Adam, H J / Zhanel, G G

JAC-antimicrobial resistance

2022 Volume 4, Issue 2, Page(s) dlac027

Language	English
Publishing date	2022-03-21
Publishing country	England
Document type	Journal Article
ISSN	2632-1823
ISSN (online)	2632-1823
DOI	10.1093/jacamr/dlac027
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Article ; Online: Antimicrobial susceptibility of clinical isolates of Neisseria gonorrhoeae to alternative antimicrobials with therapeutic potential.

Lagacé-Wiens, P R S / Adam, H J / Laing, N M / Baxter, M R / Martin, I / Mulvey, M R / Karlowsky, J A / Hoban, D J / Zhanel, G G

The Journal of antimicrobial chemotherapy

2017 Volume 72, Issue 8, Page(s) 2273–2277

Abstract: Background: The prevalence of MDR Neisseria gonorrhoeae is increasing globally and represents a public health emergency. Development and approval of new anti-gonococcal agents may take years. As a concurrent approach to developing new antimicrobials, ... ...

Abstract	Background: The prevalence of MDR Neisseria gonorrhoeae is increasing globally and represents a public health emergency. Development and approval of new anti-gonococcal agents may take years. As a concurrent approach to developing new antimicrobials, the laboratory and clinical evaluation of currently licensed antimicrobials not widely used for the treatment of gonorrhoea may provide new options for the treatment of gonococcal infections. Objectives: To determine the in vitro activity of nine alternative, currently licensed and late-development antimicrobials with the potential to treat gonococcal infections against 112 clinical isolates of N. gonorrhoeae resistant to one or multiple antimicrobials. Methods: The MICs of conventional anti-gonococcal antimicrobials (penicillin, ceftriaxone, cefixime, azithromycin, ciprofloxacin, tetracycline and spectinomycin) and alternative antimicrobials (ertapenem, gentamicin, netilmicin, tigecycline, eravacycline, fosfomycin, linezolid, ceftazidime/avibactam and ceftaroline) were determined by agar dilution. Results: Ertapenem and the novel cephalosporins demonstrated similar MIC values to the third-generation cephalosporins, but increased MICs were observed for isolates with increased cefixime and ceftriaxone MICs. Tigecycline and eravacycline had MIC values below expected serum concentrations for all isolates tested. The aminoglycosides gentamicin and netilmicin were generally more potent than spectinomycin, with netilmicin demonstrating the greatest potency. Fosfomycin MICs were elevated compared with other agents, but remained within the MIC range for susceptible organisms, while linezolid MICs were generally higher than those for organisms considered resistant. Conclusions: Among potentially therapeutically useful alternative agents, the aminoglycosides, eravacycline, tigecycline and fosfomycin had good in vitro activity. The novel cephalosporins and ertapenem had comparable activity to cefixime and ceftriaxone.
MeSH term(s)	Anti-Infective Agents/pharmacology ; Gonorrhea/microbiology ; Humans ; Microbial Sensitivity Tests ; Neisseria gonorrhoeae/drug effects ; Neisseria gonorrhoeae/isolation & purification
Chemical Substances	Anti-Infective Agents
Language	English
Publishing date	2017--01
Publishing country	England
Document type	Journal Article
ZDB-ID	191709-2
ISSN	1460-2091 ; 0305-7453
ISSN (online)	1460-2091
ISSN	0305-7453
DOI	10.1093/jac/dkx147
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Zs.A 1197: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Evaluation of an algorithmic approach in comparison with the Illumigene assay for laboratory diagnosis of Clostridium difficile infection.

Walkty, A / Lagacé-Wiens, P R S / Manickam, K / Adam, H / Pieroni, P / Hoban, D / Karlowsky, J A / Alfa, M

Journal of clinical microbiology

2013 Volume 51, Issue 4, Page(s) 1152–1157

Abstract: The following three diagnostic algorithms were evaluated in comparison with the Illumigene assay as a stand-alone test for Clostridium difficile detection: glutamate dehydrogenase antigen screen (GDH) followed by toxin A/B antigen testing (Tox A/B) with ... ...

Abstract	The following three diagnostic algorithms were evaluated in comparison with the Illumigene assay as a stand-alone test for Clostridium difficile detection: glutamate dehydrogenase antigen screen (GDH) followed by toxin A/B antigen testing (Tox A/B) with the cell cytotoxicity assay for discordant specimens (algorithm 1), GDH followed by the Illumigene (algorithm 2), and GDH followed by Tox A/B with the Illumigene for discordant specimens (algorithm 3). A total of 428 stool specimens submitted to three clinical microbiology laboratories in Manitoba, Canada, for C. difficile detection between June 2011 and April 2012 were included in the study. The prevalence of C. difficile in the stool specimens was 14.7% (63/428) based on toxigenic culture (microbiologic reference standard). The sensitivity and specificity of the Illumigene for C. difficile detection were 73.0% and 99.7%, respectively. The corresponding sensitivities and specificities were 65.1% and 100.0% for algorithm 1, 68.3% and 100.0% for algorithm 2, and 69.8% and 100.0% for algorithm 3. Using algorithm 1, a cell cytotoxicity assay was required for toxin detection in 37% of positive tests, prolonging turnaround time. However, the predictive value of a positive test based on a clinical reference standard (all tests positive or cytotoxigenic culture positive and clinical disease on chart review) was slightly higher with algorithm 1 than with the Illumigene assay as a stand-alone test or as part of an algorithm (algorithms 2 and 3). Based on a reduction in turnaround time, simplicity, and acceptable sensitivity and specificity, we recommend algorithm 2 (screening with the GDH antigen test and confirmatory testing with the Illumigene).
MeSH term(s)	Algorithms ; Bacterial Toxins/analysis ; Clinical Laboratory Techniques/methods ; Clostridioides difficile/isolation & purification ; Clostridium Infections/diagnosis ; Feces/microbiology ; Female ; Glutamate Dehydrogenase/analysis ; Humans ; Male ; Manitoba ; Sensitivity and Specificity
Chemical Substances	Bacterial Toxins ; Glutamate Dehydrogenase (EC 1.4.1.2)
Language	English
Publishing date	2013-01-30
Publishing country	United States
Document type	Comparative Study ; Evaluation Study ; Journal Article
ZDB-ID	390499-4
ISSN	1098-660X ; 0095-1137
ISSN (online)	1098-660X
ISSN	0095-1137
DOI	10.1128/JCM.03203-12
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Zs.A 1188: Show issues

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Article ; Online: Re-evaluation of rejection criteria for endotracheal tube (ETT) specimens from adult patients.

Walkty, A / Lagacé-Wiens, P R S / Manickam, K / Adam, H / Pieroni, P / Alfa, M / Karlowsky, J A

Journal of medical microbiology

2012 Volume 61, Issue Pt 9, Page(s) 1306–1310

Abstract: The purpose of this study was to determine optimal criteria for microbiology laboratory screening of endotracheal tube (ETT) specimens submitted for bacterial culture from adult patients. ETT specimens from adult patients that were received by two ... ...

Abstract	The purpose of this study was to determine optimal criteria for microbiology laboratory screening of endotracheal tube (ETT) specimens submitted for bacterial culture from adult patients. ETT specimens from adult patients that were received by two microbiology laboratories were prospectively evaluated and subdivided into one of three study arms with the following criteria: <10 squamous epithelial cells (SECs) per low-power field with bacteria seen on Gram staining (arm 1), >10 SECs per low-power field with bacteria seen on Gram staining (arm 2) and <10 SECs per low-power field with no bacteria seen on Gram staining (arm 3). A fourth study arm (>10 SECs per low-power field with no bacteria seen on Gram staining) was planned but this arm was terminated due to the paucity of specimens meeting these criteria. Isolate evaluation was performed using standard microbiology protocols. A limited chart review was undertaken at one of the institutions, only reviewing patients from which a potential pathogen was recovered on culture. In total, 141 ETT specimens were evaluated. A potential respiratory pathogen was recovered from 54, 37 and 10 % of specimens in study arms 1, 2, and 3, respectively (P<0.0001, comparing between arm 1 and arm 3). For the 23 patients included in the chart review from whom a potential pathogen was recovered on culture, respiratory infection was considered to be present in 50 % (6/12) of patients in arm 1, 66.6 % (6/9) of patients in arm 2 and 100 % (2/2) of patients in arm 3. Therapy was rarely altered based on culture results. In this study, the ETT specimens submitted for bacterial culture were of limited benefit to clinicians. The data presented here support the use of an absence of bacteria on Gram staining as a rejection criterion for ETT specimens. The criterion of >10 SECs per low-power field should be further evaluated in a prospective study of patients with an unequivocal clinical diagnosis of pneumonia.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Bacteria/isolation & purification ; Bacterial Infections/diagnosis ; Bacteriological Techniques/standards ; Epithelial Cells ; Gentian Violet/standards ; Humans ; Intubation, Intratracheal ; Middle Aged ; Phenazines/standards ; Pneumonia, Bacterial/diagnosis ; Suction ; Trachea ; Young Adult
Chemical Substances	Gram's stain ; Phenazines ; Gentian Violet (J4Z741D6O5)
Language	English
Publishing date	2012-06-14
Publishing country	England
Document type	Evaluation Study ; Journal Article
ZDB-ID	218356-0
ISSN	1473-5644 ; 0022-2615
ISSN (online)	1473-5644
ISSN	0022-2615
DOI	10.1099/jmm.0.042333-0
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Zs.A 634: Show issues

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Article ; Online: Change in antimicrobial susceptibility of Escherichia coli urinary tract isolates at a single institution over a period of 10 years.

Walkty, A / Lagacé-Wiens, P R S / Karlowsky, J A / Hoban, D J / Manickam, K / Adam, H / Pieroni, P / Alfa, M

Canadian journal of microbiology

2012 Volume 58, Issue 3, Page(s) 345–349

Abstract: Urinary tract infections are common. Few published studies have demonstrated the change in Escherichia coli urinary isolate antimicrobial susceptibility over time within a given area and (or) population. The purpose of this study was to evaluate the ... ...

Abstract	Urinary tract infections are common. Few published studies have demonstrated the change in Escherichia coli urinary isolate antimicrobial susceptibility over time within a given area and (or) population. The purpose of this study was to evaluate the change in susceptibility of E. coli clinical isolates obtained from urine specimens at a single institution over a period of 10 years. The microbiology laboratory information system at St. Boniface Hospital (Winnipeg, Manitoba, Canada) was searched retrospectively from 1 January 2000 to 31 December 2009, for all E. coli isolates from either a midstream or catheter urine source that had susceptibility testing performed. Only one isolate per patient was included during the entire study period. Antimicrobial susceptibility testing was carried out with either a Microscan instrument (pre-April 2004) or a Vitek instrument (May 2004 onwards). In total, 7353 E. coli urinary isolates were included for evaluation. Ciprofloxacin susceptibility declined significantly, from 99% in 2000 to 85% in 2009 (p < 0.0001). A small but statistically significant decline in susceptibility was also observed for ampicillin, cefazolin, trimethoprim-sulfamethoxazole, gentamicin, and nitrofurantoin. These data suggest that certain antimicrobials recommended for the treatment of urinary tract infections (ciprofloxacin, trimethoprim-sulfamethoxazole) may no longer be optimal.
MeSH term(s)	Anti-Infective Agents/pharmacology ; Escherichia coli/drug effects ; Escherichia coli/isolation & purification ; Escherichia coli Infections/microbiology ; Humans ; Manitoba ; Microbial Sensitivity Tests ; Retrospective Studies ; Urinary Tract Infections/microbiology ; Urine/microbiology
Chemical Substances	Anti-Infective Agents
Language	English
Publishing date	2012-03
Publishing country	Canada
Document type	Journal Article
ZDB-ID	280534-0
ISSN	1480-3275 ; 0008-4166
ISSN (online)	1480-3275
ISSN	0008-4166
DOI	10.1139/w2012-001
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Article ; Online: In vitro activity of ceftazidime combined with NXL104 versus Pseudomonas aeruginosa isolates obtained from patients in Canadian hospitals (CANWARD 2009 study).

Walkty, A / DeCorby, M / Lagacé-Wiens, P R S / Karlowsky, J A / Hoban, D J / Zhanel, G G

Antimicrobial agents and chemotherapy

2011 Volume 55, Issue 6, Page(s) 2992–2994

Abstract: The in vitro activity of ceftazidime in combination with NXL104 versus 470 Pseudomonas aeruginosa clinical isolates was evaluated using Clinical and Laboratory Standards Institute (CLSI) broth microdilution methods. Ceftazidime had MIC₉₀s of 8 μg/ml and ... ...

Abstract	The in vitro activity of ceftazidime in combination with NXL104 versus 470 Pseudomonas aeruginosa clinical isolates was evaluated using Clinical and Laboratory Standards Institute (CLSI) broth microdilution methods. Ceftazidime had MIC₉₀s of 8 μg/ml and 32 μg/ml in the presence and absence of NXL104, respectively. Of 25 multidrug-resistant P. aeruginosa isolates, the percentages with a ceftazidime MIC of ≤8 μg/ml with and without NXL104 were 60% and 4%, respectively. These data suggest that the ceftazidime-NXL104 combination may prove useful for treating many P. aeruginosa infections.
MeSH term(s)	Anti-Bacterial Agents/pharmacology ; Azabicyclo Compounds/pharmacology ; Ceftazidime/pharmacology ; Humans ; Microbial Sensitivity Tests ; Pseudomonas aeruginosa/drug effects ; beta-Lactamase Inhibitors
Chemical Substances	Anti-Bacterial Agents ; Azabicyclo Compounds ; beta-Lactamase Inhibitors ; avibactam (7352665165) ; Ceftazidime (9M416Z9QNR)
Language	English
Publishing date	2011-03-21
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	217602-6
ISSN	1098-6596 ; 0066-4804
ISSN (online)	1098-6596
ISSN	0066-4804
DOI	10.1128/AAC.01696-10
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Zs.A 809: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Activity of NXL104 in combination with beta-lactams against genetically characterized Escherichia coli and Klebsiella pneumoniae isolates producing class A extended-spectrum beta-lactamases and class C beta-lactamases.

Lagacé-Wiens, P R S / Tailor, F / Simner, P / DeCorby, M / Karlowsky, J A / Walkty, A / Hoban, D J / Zhanel, G G

Antimicrobial agents and chemotherapy

2011 Volume 55, Issue 5, Page(s) 2434–2437

Abstract: The novel non-β-lactam β-lactamase inhibitor NXL104, in combination with cefepime, ceftazidime, ceftriaxone, amdinocillin, and meropenem, was tested against 190 extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae ... ...

Abstract	The novel non-β-lactam β-lactamase inhibitor NXL104, in combination with cefepime, ceftazidime, ceftriaxone, amdinocillin, and meropenem, was tested against 190 extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae isolates, 94 AmpC-hyperproducing E. coli isolates, and 8 AmpC/ESBL-coexpressing E. coli isolates. NXL104 restored 100% susceptibility to the partner cephalosporins for all isolates tested. Amdinocillin and meropenem MICs were modestly improved (2 to 32 times lower) by NXL104. These results suggest that NXL104 may be useful in combination with β-lactams for the treatment of infections caused by ESBL- and AmpC-producing Enterobacteriaceae.
MeSH term(s)	Azabicyclo Compounds/pharmacology ; Escherichia coli/drug effects ; Escherichia coli/enzymology ; Escherichia coli/genetics ; Klebsiella pneumoniae/drug effects ; Klebsiella pneumoniae/enzymology ; Klebsiella pneumoniae/genetics ; beta-Lactamases/genetics ; beta-Lactamases/metabolism ; beta-Lactams/pharmacology
Chemical Substances	Azabicyclo Compounds ; beta-Lactams ; avibactam (7352665165) ; beta-Lactamases (EC 3.5.2.6)
Language	English
Publishing date	2011-02-28
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	217602-6
ISSN	1098-6596 ; 0066-4804
ISSN (online)	1098-6596
ISSN	0066-4804
DOI	10.1128/AAC.01722-10
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Zs.A 809: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article: Change in antimicrobial susceptibility of Escherichia coli urinary tract isolates at a single institution over a period of 10 years

Walkty, A. / Lagacé-Wiens, P.R.S. / Karlowsky, J.A. / Hoban, D.J. / Manickam, K. / Adam, H. / Pieroni, P. / Alfa, M.

Canadian journal of microbiology

Volume v. 58,, Issue no. 3

Abstract	Urinary tract infections are common. Few published studies have demonstrated the change in Escherichia coli urinary isolate antimicrobial susceptibility over time within a given area and (or) population. The purpose of this study was to evaluate the change in susceptibility of E. coli clinical isolates obtained from urine specimens at a single institution over a period of 10 years. The microbiology laboratory information system at St. Boniface Hospital (Winnipeg, Manitoba, Canada) was searched retrospectively from 1 January 2000 to 31 December 2009, for all E. coli isolates from either a midstream or catheter urine source that had susceptibility testing performed. Only one isolate per patient was included during the entire study period. Antimicrobial susceptibility testing was carried out with either a Microscan instrument (pre-April 2004) or a Vitek instrument (May 2004 onwards). In total, 7353 E. coli urinary isolates were included for evaluation. Ciprofloxacin susceptibility declined significantly, from 99% in 2000 to 85% in 2009 (p < 0.0001). A small but statistically significant decline in susceptibility was also observed for ampicillin, cefazolin, trimethoprim–sulfamethoxazole, gentamicin, and nitrofurantoin. These data suggest that certain antimicrobials recommended for the treatment of urinary tract infections (ciprofloxacin, trimethoprim–sulfamethoxazole) may no longer be optimal.
Keywords	gentamicin ; ampicillin ; patients ; urinary tract diseases ; cefazolin ; Escherichia coli ; information systems ; urinary tract ; nitrofurantoin ; urine ; ciprofloxacin ; microbiology ; hospitals
Language	English
Document type	Article
ISSN	1480-3275
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