Chikungunya fever is widely distributed in tropical and subtropical regions around the world. In the past 20 years, this disease been seriously epidemic in the Indian Ocean Region, South Asia and Southeast Asia, and has led to the occurrence of imported cases at least 16 provinces (municipalities and autonomous regions) in China. Among them, indigenous epidemics have occurred in Guangdong, Zhejiang and Yunnan provinces. Chikungunya virus (CHIKV) gene sequences have been detected in serum samples from fever of unknown origin cases and mosquito specimens collected from Yunnan Province, mosquitoes from Zhejiang Province and midges from Guangxi Zhuang Autonomous Region. The epidemic strains of CHIKV in China were mainly the Indian Ocean clade lineage of the East/Central/South African genotype, and the Asian genotype. Aedes albopictus is widely distributed in central, eastern and southern China, and Ae. aegypti is distributed in some parts of Hainan, Guangdong, Yunnan and Taiwan. These two kinds of Aedes mosquitoes in China are highly susceptibility and transmissibility to CHIKV. There is still a risk of outbreak or pandemic of chikungunya fever in the distribution areas of Ae. albopictus and Ae. aegypti in China. The monitoring and management of imported cases and the control of the vector Aedes mosquitoes is an important focus of prevention and control work that needs to strengthened at present. This article reviews the epidemiology and pathogenic biology on chikungunya fever in China, which can provide a reference for the prevention and control of this disease.

Objective To analyse the crude detection rate and trends of newly detected HIV/AIDS cases in medical institutions in China from 2017 to 2023, and to provide a reference for optimizing HIV testing strategies in medical institutions. Methods Data on HIV testing and newly reported HIV/AIDS cases were analysed using data from the Comprehensive AIDS Prevention and Control Information System of the China Information System for Disease Control and Prevention for the period from 2017 to 2023. HIV testing in medical institutions includes patients tested preoperatively, those tested before transfusion, those tested in sexually transmitted disease (STD) clinics, prenatal care clinics, and other types of patients. Descriptive statistical analysis and χ² test were performed using SAS 9.4 software. Joinpoint regression was performed using Joinpoint 4.9.0 software to analyse trends of the crude detection rates over time. Results From 2017 to 2023, the person-times of HIV tests in medical institutions increased from 143 million to 255 million, with an increase of 78.07%. The number of newly detected HIV/AIDS cases increased from 74 000 to 88 000 and then declined to 69 000. The crude detection rate of new HIV/AIDS cases declined from 5.18/10 000 to 2.71/10 000, showed a declining trend, the mean annual percentage change was -9.99%(P<0.001). The crude detection rate of new HIV/AIDS cases in STD clinics was the highest among all types of clinic visits (12.79/10 000-24.47/10 000), and the crude detection rate of new cases among all types of clinic visits showed a decreasing trend(P<0.05). Among different medical institutions, general hospitals were the most important source of the number of tests and the number of newly detected HIV/AIDS cases, accounting for more than 62.93% and 62.68%, respectively. Specialised medical institutions had the highest crude detection rate of new cases, which was maintained at more than 5.13/10 000. The crude detection rate of new cases for all four types of medical institutions, except for primary medical institutions, showed a decreasing trend (P<0.05). Conclusions The detection rate of new cases in medical institutions showed a decreasing trend in 2017-2023, and the efficiency of STD clinics testing and detection was higher among all types of attendees. General hospitals are the main source of new cases detection, and testing in specialised medical institutions is more efficient. Testing should be strengthened in key groups of patients and in key medical institutions.

Chronic hepatitis B (CHB) caused by the hepatitis B virus (HBV), constitutes a significant public health issue, with approximately 254 million individuals affected globally, of which 75 million are in China. HBV infection not only severely impacts individual health, leading to conditions such as liver cirrhosis, hepatocellular carcinoma, and liver failure, but also imposes considerable economic burdens on society. This review provides an overview of the current epidemiological characteristics and disease burden of CHB, along with the progress towards, and challenges faced in achieving the World Health Organization's (WHO) goal of eliminating viral hepatitis as a public health threat by 2030. It delves into strategies aimed at reducing new infections, enhancing diagnosis rates, and improving treatment coverage. These strategies include universal screening, expanding the scope of antiviral therapy, and implementing specific measures for treating patients with end-stage liver disease. The review underscores critical actions necessary to accelerate the elimination of hepatitis B-related harms, proposing an integrated control and prevention strategy that incorporates new technologies and approaches. Achieving WHO's 2030 target requires concerted efforts from governments, healthcare institutions, and the broader community, alongside active public participation and support.

Echinococcosis is a parasitic disease caused by the larval stage of Echinococcus tapeworms, posing a severe threat to patients' health. Its diagnostic techniques play a vital role in clinical diagnosis and treatment, surgical planning, and prognostic evaluation. Currently, the diagnostic methods for echinococcosis mainly include etiological, immunological, imaging, and molecular biological diagnostic techniques. This article comprehensively reviews existing diagnostic techniques for echinococcosis, analyzes the advantages and limitations of various methods, and explores their application prospects. With continuous advancements in scientific technology, emerging diagnostic approaches are expected to substantially enhance the efficiency and accuracy of echinococcosis diagnosis. These research findings will provide valuable references for the development of rapid clinical diagnostic detection products at the current stage, potentially improving cure rates, alleviating patients' disease burden, and offering robust support for the prevention, control, and treatment of echinococcosis.

Objective The objective of this research is to construct a technical indicator framework for preventing the of re-establishment of imported malaria at the county level in China, excluding border areas, with the aim of guiding specialist agencies to prevent the re-establishment of imported malaria in a scientific, feasible and comprehensive way. Methods The preliminary framework was built based on literature review and on-site research. Two rounds of Delphi consultation were carried out. The positive coefficient, degree of concentration, degree of coordination, and authority of the experts were calculated. The weights and the combined weights for the indicators were determined using the analytic hierarchy process and probability method, respectively. Results Twenty experts were invited in the 1^st round of consultation, and twenty-six in the 2^nd round. The authority coefficients of the experts for two rounds were 0.955 and 0.968, respectively. The P value of the degree of coordination of two rounds were less than 0.05. The final framework included 5 primary indicators, 19 secondary indicators and 42 tertiary indicators. Primary indicators included government-led, joint control and prevention, surveillance and response, capacity building and organization guarantee, whose weights were 20.2%, 2.4%, 20.1%, 44.7% and 12.5%, respectively. Among the secondary indicators, the highest combined weight was medical institutions (25.0%) of capacity building, and the lowest was cross-sectoral cooperation (0.3%) of joint control and prevention. The three tertiary indicators with higher combined weights were: "1.2.1 There is a comprehensive plan for preventing the re-establishment of imported malaria, and the responsibilities of relevant departments are clearly defined" accounting for 14.9%; "4.1.4 Laboratory personnel in medical institutions possess the ability to conduct microscopic examinations for malaria detection" accounting for 10.6%; and "4.2.1 Specialized malaria surveillance laboratories have been established and are fully equipped with the necessary capabilities to conduct effective surveillance" accounting for 7.6%. Conclusions A framework has been created for the prevention of re-establishment of imported malaria at the county level in China, excluding border areas. The framework provides an operational, scientific and comprehensive technical guidance for county-level areas from the perspective of the effectiveness of government-led, joint prevention and control, surveillance and response, capacity building and organizational support. The importance of maintaining the capacity to prevent re-establishment of imported malaria and whole-process case management under medical and preventive cooperation in the post-elimination stage was highlighted.

Objective To analyze the epidemiological characteristics of varicella infectious diseases in Hainan Province from 2014 to 2023, and explore the epidemic patterns of varicella in Hainan Province. Methods Download data related to chickenpox in Hainan Province from the Infectious Disease Reporting Information Management System and the Public Health Emergency Management System of the Chinese Disease Control and Prevention Information System, descriptive epidemiological methods were used to analyze the incidence characteristics of varicella; ARIMA model was used to predict the incidence trend. Results From 2014 to 2023, a total of 65 832 cases of varicella and one death case were reported in Hainan, with an average annual incidence rate of 66.50/100 000, and the incidence rate fluctuated between 47.31/100 000 and 89.01/100 000. A incidence rate peak occurred every other year. The incidence of varicella showed a seasonal bimodal distribution, with peaks in January and April. The incidence of varicella was negatively correlated with temperature (r=-0.349，P<0.05). Children aged 0-14 years were the main incidence group, and the incidence rate reached its peak in the age group of 5-6 years. Students and young children were the main groups affected by the disease. The incidence rate of male (68.15/100 000) was higher than that of female (62.22/100 000)(χ²=16.80, P<0.05). The incidence rate of male (68.15/100 000) was higher than that of female (62.22/100 000). The 1 dose vaccination rate for 1-year-old children was on the rise, reaching a maximum of 43.2%; The two doses vaccination rate for children aged 4-6 years has been increasing year by year, with the highest reaching 9.9%. A total of 65 cases of varicella PHEE were reported, with M(P₂₅, P₇₅) of 24 (18, 32) cases per case, and a total incidence rate of 2.64%. Primary schools were the main places of occurrence. The ARIMA model has a good predictive fitting effect, and the results show that the predicted incidence in 2024 will increase compared to 2023. There may be peaks in incidence in January to June and October to December. Conclusions The incidence rate of varicella is high in Hainan Province; A lower vaccination rate for varicella in children cannot break the natural prevalence of varicella among healthy children.

Objective To identify the temporal-spatial distribution patterns and changing of hotspot areas of malaria importations, and high-risk importation areas for imported malaria in Jiangsu Province, in order to provide the scientific evidence for prevention of malaria reintroduction in China. Methods Cases with imported malaria in Jiangsu Province from 2016 to 2022 were accessed from the National Notifiable Disease Report System and the Information Management System for Parasitic Disease Control in China. The county-level vector map of Jiangsu Province was obtained from the National Fundamental Geographic Information System, China. ArcGIS 10.7 software was utilized to create a thematic map depicting the distribution of imported malaria cases in Jiangsu Province at the county level. Global and local autocorrelation analysis was then conducted to investigate the spatiotemporal changes in malaria import hotspot counties. Results There were a total of 1 189 cases with imported malaria reported in 77 counties (81.05%, 77/95) of Jiangsu Province from 2016 to 2022. The global spatial autocorrelation analysis showed that a global spatial cluster of imported malaria in Jiangsu was only identified in 2020 ( Moran's I =0.46, Z=4.37, P<0.01), but local spatial autocorrelation analysis found that a total 60 hotspot counties existed from 2016 to 2022. There are 23 counties in central Jiangsu (38.33%), and 20 counties in southern Jiangsu (33.33%), 17 counties in northern Jiangsu (28.33%). The distribution of hotspot counties exhibits continuity. For instance, Chongchuan District, which falls under the jurisdiction of Nantong City, has consistently emerged as a hotspot county for 2016-2021. Since 2020, two recurring hotspot counties emerged in northern Jiangsu and southern Jiangsu. These counties are Ganyu District, under the jurisdiction of Lianyungang City, and Lishui District, under the jurisdiction of Nanjing City. Conclusions The spatial-temporal cluster of cases with imported malaria was identified at the county level in Jiangsu, that hotspot counties were consistently detected. It is essential to maintain the sustainability of malaria surveillance and response in hotspot counties which were new detected, and strengthen the capacity of surveillance and response in hotspot counties which were continually detected based on the spatial-temporal distribution characteristics and changing rules of imported malaria.

Objective To analyze the current epidemic status of soil-transmitted helminthiasis (STHs) in China, providing reference data for the prevention and control of soil-transmitted helminthiasis. Methods Surveillance data on soil-transmitted helminthiasis in China from 2017 to 2022 were collected and statistically analyzed to investigate the infection status, infection trends, and spatial autocorrelation. Results From 2017 to 2022, the average annual infection rate (AAIR) of soil-transmitted helminthiasis was 1.12% (25 123/2 251 632), with hookworm, roundworm, and whipworm having AAIRs of 0.70%, 0.26%, and 0.20% (15 827 cases, 5 836 cases and 4 586 cases), respectively. The infection rate of soil-transmitted helminths decreased annually by an average of 17.16% (AAPC =-17.16, P=0.007), with annual decreases in the infection rates of hookworm, roundworm, and whipworm being 14.70%, 22.13%, and 20.56%, respectively (AAPC=-14.70, P=0.025; AAPC=-22.13, P=0.015; AAPC =-20.56, P=0.029). The spatial distribution of hookworm, roundworm, and whipworm exhibited spatial positive correlation (Moran's I=0.09, P=0.121; Moran's I=0.46, P=0.001; Moran's I=0.23, P=0.013), with roundworm showing the highest spatial aggregation. The AAIRs of males and females were 1.03% (11 308/1 100 016) and 1.20% (13 851/1 149 286), respectively, with statistical significance (χ²=154.19, P<0.001). The highest AAIR was 1.85% (10 949/590 621) in individuals over 60 years old, with statistical significance across different age groups (χ²=4426.44, P<0.001). Hookworm, roundworm, and whipworm were mainly mild infections. The average annual positive rates of soil ascaris eggs and hookworms were 4.06% (649/15 984) and 2.45%(391/15 984), respectively, with statistical significance (χ²=66.16,P<0.001). Conclusions The infection rate of soil-transmitted helminthiasis in China is relatively low and shows a downward trend. Yet, there are local high-prevalence areas, with the elderly and females being the risk-prone populations. Comprehensive measures including expanding the monitoring scope, innovating monitoring technology, and promoting the rural toilet revolution are necessary to block the spread of soil-transmitted helminthiasis further.

Antimicrobial resistance (AMR), is regarded as one of the top 10 global public health threats. Addressing AMR through the One Health strategy has become a global consensus. AMR monitoring plays a crucial role as the cornerstone of AMR response strategies. This study thoroughly analyzed current situation and progress of AMR monitoring based on the One Health concept in China, the United Kingdom, the United States, and the European Union, and comprehensively compared the similarities and differences of AMR monitoring systems across these countries and regions. The research found that cross-national, cross-regional, and cross-sectoral cooperation in AMR monitoring is increasingly strengthening. However, notable discrepancies still exist among different countries and regions. Notably, most AMR monitoring systems prioritize human and animal health, with relatively insufficient monitoring in the environmental sector. Given the current landscape, China still needs to continue to promote standardized AMR monitoring data sharing and integration across the human, animal, food, and environmental fields, striving to construct a comprehensive and systematic "whole-chain" AMR monitoring system to better tackle this global public health challenge effectively.

Objective This study aims to explore the impact of demographic characteristics, sexual behavioral, and epidemiological history on mpox infection among the MSM in Chengdu, providing a theoretical basis for prevention and control of mpox. Methods A case-control study was conducted, including mpox patients in Chengdu from June 2023 March 2024 as the study group and MSM without mpox as controls, we carried out a retrospective investigation. Basic information, sexual history and behavior, and travel history were obtained for both mpox patients and controls. Univariate and multivariate logistic regression analysis were used to explore the risk factors for mpox infection. Results In this study, 128 MPXV cases (including 53 HIV individuals) and 151 controls (including 50 HIV individuals) were investigated. The average age of the cases was (32.48±6.67) years, all of whom were male, 101 were single, 100 had a college degree or higher, 60 were business services and self-owned occupations, 89 were homosexual, and 116 reported history of having homosexual behavior; 109 had an average of four or fewer homosexual behavior per month; 48 used condoms usually. The proportion of unmarried and those with a college degree or higher was lower in the monkeypox case group than the control group, while proportion of those with sexually transmitted diseases other than HIV was higher than the control group (P<0.05). Bisexuals or heterosexuality had a higher risk of MPXV compared to homosexuals (OR=4.65), the ones who never use condoms during homosexual activities were at higher risk for monkeypox (OR=3.25). There were no significant differences in epidemiological history between the two groups. Multivariate logistic regression showed that being unaware of other STD infections was negatively associated with MPXV infection, while having other STDs other than HIV, being bisexual or heterosexual sexual behavior were positively associated with MPXV infection. Conclusion The MSM in Chengdu with concurrent infection with other sexually transmitted diseases other than HIV, bisexual or heterosexual sexual orientation were risk factors for mpox. It is necessary to strengthen health education for the ones at high-risk.Chengdu

Objective To analyze the epidemiological characteristics and infection pathways and virulence factors of one cholera outbreak in Fengxian District, Shanghai, China, in 2024, and to provide scientific basis for epidemic control and prevention. Methods Epidemiologic data of cases of one cholera outbreak in Fengxian District in 2024 were collected using on-site epidemiologic survey methods; RT-PCR nucleic acid testing and bacterial culture were applied to carry out pathogenicity testing of cases, close contacts, environment, and food samples; and the genome sequences of the strains were obtained using second-generation gene sequencing. Results The case was a 62-year-old woman, who presented to the doctor with diarrhea for 4 consecutive days, 4-5 times a day, with watery stools, which was not effectively relieved by self-administered medication. There was no history of traveling away from Shanghai for 5 days before the onset of the disease, and she was engaged in the preparation and delivery of food for rural banquets during the period. Vibrio cholerae O139 was detected in the anal swab sample of the case and the septic tank of the workplace on the 4th day after the onset of the disease; samples of turtle and links in the store selling turtle were cultured for Vibrio cholerae O139. The isolate carried several virulence-related genes such as ctxA, ctxB, HlyA, zot, rtxA, hapA, nanH, tdh, and T3SS. Comparison of the isolate with the O139 strain of cholera cluster within our country through the National Pathogenic Bacteria Recognition Network (NPBN) in recent years suggests that the closest environmental or aquatic animal isolate to the sequence of this strain is the turtle isolate uploaded at a place in Guangdong. Conclusion This outbreak was a disseminated outbreak caused by the case's contact with turtle contaminated with Vibrio cholerae O139, and early detection of enteric infectious diseases such as cholera can be achieved by relying on the outpatient enteric cholera surveillance network.

Objective To investigate the serotype distribution, antibiotic resistance profiles, and evolutionary relationship of foodborne Salmonella isolates in Changzhou, Jiangsu Province, thereby providing the scientific foundation for the prevention and control of Salmonella related foodborne illnesses. Methods Serotyping, antimicrobial susceptibility testing, and whole-genome sequencing (WGS) were performed on 117 strains of Salmonella isolated from stool specimens of diarrhea patients at the foodborne disease surveillance sentinel hospitals in Changzhou from 2021 to 2023. The Comprehensive Antibiotic Resistance Database (CARD) was used for annotation and analysis of antibiotic resistance genes, and the PubMLST database was used for multilocus sequence typing (MLST). Heatmaps of antibiotic resistance genes were generated using GraphPad Prism 9.5, and phylogenetic trees were constructed using Figtree v1.4.4. Results A total of 21 serotypes of Salmonella were identified from 117 strains of Salmonella, with Salmonella typhimurium and Salmonella enteritidis being the predominant types. The resistance results showed the highest resistance rate to ampicillin (77.78%), followed by tetracycline (58.97%), ampicillin/sulbactam (55.55%), and nalidixic acid (51.28%), with resistance rates exceeding 50%. The most common resistance pattern was CT-AMP-AMS-NAL. Whole-genome sequencing data analysis identified 61 resistance genes, encompassing aminoglycoside, β-lactam, tetracycline, sulfonamide, quinolone, and other resistance determinants. MLST analysis identified 23 sequence types (STs), with ST34 and ST11 being the most prevalent. The phylogenetic analysis revealed high homology among Salmonella strains of the same serotype. Conclusions The dominant serotype of foodborne Salmonella in Changzhou is Salmonella typhimurium, primarily ST34, with strains carrying multiple antibiotic resistance genes, indicating a multidrug-resistant phenotype that warrants attention in future surveillance efforts. The implementation of WGS technology enhances the monitoring of antibiotic resistance trends, providing valuable insights for guiding rational antibiotic use and developing effective prevention and control strategies.

Objective To conduct an epidemiological investigation and analysis on one imported cholera case in Shenzhen in 2024, providing a reference for cholera prevention and control. Methods A cholera case and 86 close contacts in 2024 were investigated using methods of field epidemiological investigation. Real-time RT-PCR was employed for Vibrio cholerae nucleic acid detection and typing of collected specimens, followed by isolation culture, whole genome sequencing and analysis. Results One severe cholera case was confirmed in an Indian businessman, who recovered and was discharged after rescue and rehabilitation. The pathogen was identified as the toxigenic strain of Vibrio cholerae O1 serotype Ogawa, and genetic evolution analysis showed that it had a very close genetic relationship with Vibrio cholerae isolated from multiple countries such as Bangladesh and Pakistan. Among the 86 close contacts under medical observation, no abnormalities were found. A total of 75 close contact specimens and 38 environment smear specimens from epidemic sites were collected, all testing negative. Conclusion This is an imported cholera epidemic originating from India. The sensitivity of medical institutions to monitoring key infectious diseases such as cholera needs to be improved.

A 32-year-old female patient experienced a foreign body sensation in her esophagus on the evening of September 22, 2024, after consuming undercooked grass carp at a restaurant in Wuhan. Esophagoscopy conducted at the hospital revealed no abnormalities. Three days later, she had a stabbing pain in the pharynx. On October 8, upon self-examination, she noticed a red brown worm exhibiting stretching and contracting movements attached near the uvula in her pharynx and then went to the hospital. During the removal of the worm, the doctor observed the ulcers on the mucous membrane. Serological antibody tests for seven common human parasitic worms, including Schistosoma japonicum, Paragonimus westermani, Clonorchis sinensis, cysticercus of Taenia solium, sparganum, hydatid cyst, and Trichinella spiralis, were all negative. The isolated worm was reddish brown, measuring 4 mm in length and 2 mm in width. Staining with hydrochloric carmine dye revealed a morphology consistent with Clinostomum complanatum (Rud., 1819), characterized by an oral sucker at the anterior end, a pharynx connecting to intestinal branches, and two intestinal branches extending to the posterior end of the body with small sub-branches. The ventral sucker, larger than the oral sucker, was located at the front 1/4 of the body. A pair of testes were arranged longitudinally in the mid-posterior part, with an ovary located between the two testes and a uterus located above the upper testis. A comprehensive search of 188 databases comprising more than 460 million full-text articles through the library of Huazhong University of Science and Technology confirmed the first reported case of Clinostomum complanatum infection in humans in China.

Objective To investigate the distribution characteristics of genetic subtypes among newly reported human immunodeficiency virus type 1 (HIV-1) cases in Tongzhou District, Beijing, from 2021 to 2022, and to analyze the molecular epidemiological characteristics and drug resistance patterns of HIV-1 in the area. Methods Newly reported HIV-1 cases in Tongzhou District, Beijing, from 2021 to 2022, were taken as the study population. Nested PCR was used to amplify the HIV-1 pol region gene, and the gene sequences were obtained through first-generation sequencing. A phylogenetic tree was constructed to analyze the HIV-1 genetic subtypes and drug resistance. Results There were 308 new HIV-1 cases reported in Tongzhou District, Beijing from 2021 to 2022. A total of 230 HIV-1 pol region gene sequences were obtained, with a case coverage rate of 74.68%. Seven HIV-1 genotypes were identified, with CRF07_BC (42.17%) and CRF01_AE (36.09%) being the main prevalent strains. Furthermore, new epidemic types such as CRF55_01B, CRF01_AE, and BC recombinants were detected. There were statistically significant differences (χ²=17.845, P<0.05; χ²=7.731, P<0.05) in the genotype composition ratio among newly reported HIV-1 cases across different age groups and detection routes, while no significant differences (P>0.05) were observed concerning gender, transmission route, marital status, and others. A total of 64 cases (27.83%) showed drug-resistant mutations, with 27 mutation sites identified in total. There were significant differences (χ²=53.674, P<0.05) in the mutation rates among different HIV-1 genotypes, with the highest mutation rate (100.0%) observed in CRF55_01B. Drug resistance to PIs, NRTIs, and NNRTIs was observed in 18 cases (7.83%), with resistance rates of 3.04%, 0.87%, and 4.35%, respectively. High-level drug resistance was observed in eight cases, including one case of NRTI resistance (mutation site M184V) and the remainder exhibiting NNRTI resistance, involving sites such as M184V, K103N, Y188L, and Y188C. Conclusions The genotype of HIV-1 in Tongzhou District is diverse, with CRF07_BC and CRF01_AE as the predominant strains. The total drug resistance rate reached a moderate level. We should strengthen the analysis of HIV-1 genotypes and drug resistance monitoring, focusing unique recombinants and resistance-related gene mutations.

In May 2024, the World Health Organization (WHO) issued a position paper on the dengue vaccines, focusing on the newly licensed TAK-003 vaccine. WHO recommends that this vaccine be included in routine immunization schedules in areas of high-intensity dengue transmission, targeting children aged 6-16 years 1-2 years before the peak age of onset of dengue-related hospitalized cases, using a vaccination regimen with a two-dose interval of at least 3 months. Due to limited safety data, the vaccine is not recommended for specific populations such as pregnant women, lactating women, immunocompromised individuals, and symptomatic HIV-infected persons. The document also notes that the TAK-003 vaccine shows good safety and effectiveness in seropositive persons, but may not confer protection against DENV3 and DENV4 in seronegative vaccine recipients. The potential risk of severe dengue cannot be ruled out if seronegative persons are exposed to DENV3 and DENV4 based on currently available data. Additionally, the document mentions that the cost-effectiveness of the TAK-003 vaccine may vary with transmission intensity and age at vaccination, necessitating evaluation in different transmission settings. Currently, there is no data on the use of booster doses, therefore a booster dose is not recommended. Finally, the document notes that the TAK-003 vaccine can be given concurrently with yellow fever and hepatitis A vaccines, and that studies of concurrent vaccination with HPV vaccine are ongoing, which opens up more possibilities for future dengue vaccination strategies.

Objective To understand the serotypes and sources of dengue virus (DENV) in Yunnan Province in 2023, providing a scientific basis for dengue fever prevention and control. Methods DENV nucleic acid testing and virus isolation were performed on the serum samples of dengue fever cases diagnosed at three national monitoring sites in Yunnan Province (Longchuan County, Menghai County, Hekou County) in 2023. Dengue virus envelope (E) gene sequencing was performed on positive serum samples and dengue virus isolates, and phylogenetic analysis was conducted using molecular biology software. Results A total of 1 006 dengue fever cases were reported at three monitoring sites in 2023, including 838 imported cases, 161 cases imported from other counties and cities in Yunnan, and 7 autochthonous cases. Among 371 serum samples, 351 were found DENV-positive, including 305 DENV-1 positive samples (174 imported from Myanmar, 1 imported from Laos, 1 imported from Vietnam, 99 imported from Jinghong, 26 imported from Ruili, and 4 local cases), 43 DENV-2 positive samples (8 imported from Myanmar, 6 imported from Jinghong, 26 imported from Ruili, and 3 local cases), 1 DENV-3 positive sample (imported from Myanmar), 1 DENV-4 positive sample (introduced from Ruili), and 1 untyped case. A total of 23 DENV strains were isolated, including 9 strains of DENV-1, 12 strains of DENV-2, 1 strain of DENV-3, and 1 strain of DENV-4. All DENV-1 strains from three monitoring sites belong to genotype I but were located on different evolutionary branches. The DENV-2 strains from Menghai County and Longchuan County belonged to the Cosmopolitan genotype and Asian I genotype, respectively. The DENV-3 strain from Longchuan County belonged to genotype I, and the DENV-4 strain from Longchuan County belonged to genotype I. Conclusions During the dengue fever epidemic season, the border regions of Yunnan Province face dual pressures from both international and domestic imported dengue cases. Imported or introduced cases carried DENVs of serotypes 1-4 (with five genotypes in total), leading to local outbreaks caused by these cases. Imported and local DENVs originated from Southeast Asian countries and exhibited distinct geographic distribution characteristics.

Group B Streptococcus (GBS) is widely colonized in the human gastrointestinal and urogenital tracts. As one of the major pathogens during the perinatal period, GBS is an important pathogen that endangers the health of pregnant women and newborns and is also one of the important factors leading to neonatal mortality. GBS can cause invasive maternal infections such as chorioamnionitis, puerperal infections, and premature rupture of membranes. During delivery, GBS can also be transmitted to the fetus or newborn through ascending or vertical infections, causing serious complications such as neonatal meningitis, sepsis, and pneumonia, which pose serious threats to the life and health of newborns. GBS possesses numerous virulence factors related to adhesion, immune evasion, and invasive damage, which can promote bacterial adhesion and damage ability, ultimately leading to invasive diseases. To reduce the risk of GBS infection, many countries have established universal prenatal screening and prenatal antibiotic prophylaxis strategies, though there are still certain limitations at present. This article systematically and comprehensively explores the clinical characteristics, virulence factors, laboratory testing methods, and vaccine status of GBS infection, providing reference for improving prevention strategies for GBS infection.

Objective This study conducted a series of biochemical and genetic analyses on three strains of Comamonas kerstersii isolated, aiming to enhance understanding of the bacterium and provide a reference for preventing and controlling infections and diseases associated with it. Methods The fecal samples of patients from three patients from September to October 2023 in Sanya People's Hospital were inoculated on Columbia blood agar plates, and after sufficient incubation, the target strains were isolated and purified using oxidase reagent. Subsequently, the target colonies were subjected to biochemical identification and antibiotic susceptibility testing using the VITEK2-Compact analysis system, while the VITEK MS mass spectrometer was used to identify the bacterial genus. Meanwhile, bacterial DNA was extracted for 16S rRNA sequencing and bacterial genome framework sequencing, with sequencing analysis performed using various bioinformatics analysis tools. Results Three strains of oxidase-positive single colonies were cultured, and the mass spectrometer could not identify the specific strain. The drug susceptibility test showed that all three strains were sensitive to most drugs, but some were resistant to ciprofloxacin and Compound Sulfamethoxazole. 16S rRNA sequencing identified the bacteria to Comamonas genus, and bacterial genome framework sequencing analysis indicated that all bacteria were Comamonas kerstersii. Bioinformatics analysis showed that all three bacterial strains contained virulence factors related to oxidase-positive enteric pathogenic bacteria, including the flmH gene of Aeromonas, vctC gene and rmlB gene of Vibrio, and the flgG gene and flhC gene of Yersinia. Pathogen-host interaction (PHI) analysis results suggested pathogenic genes in the target bacterial genomes that may cause intestinal infection. Conclusions Comamonas kerstersii cannot be identified by conventional mass spectrometer and requires sequencing for analysis. This bacterium is sensitive to most antibiotics, but individual strains are resistant to ciprofloxacin and Compound Sulfamethoxazole. Comamonas kerstersii is associated with infections, especially gastrointestinal infections, though its pathogenesis remains to be further studied.

To analyze the investigation and disposal of an H5N6 human infection with animal derived influenza epidemic in Quanzhou City in 2024, and provide reference for the control and prevention of animal derived influenza epidemics in future.According to Technical Guidelines for Control and Prevention of Human infected with Zoonotic Influenza Viruses (Trial), we investigated the diagnosis and treatment of the case, suspected exposure, infection sources and routes, by the method of field epidemiological investigation. The case, close contacts, and relevant environmental samples were collected for nucleic acid testing and gene sequencing. A nasopharyngeal carcinoma patient who rapidly progressed to severe pneumonia and died of multiple organ failure after being diagnosed with H5N6. The H5N6 virus nucleic acid test results of 5 close contacts and 37 suspected exposed individuals were all negative, and no second-generation cases occurred. Through on-site investigation and genetic sequencing analysis, it is highly likely that the source of infection is the outdoor environment of free range poultry contaminated with H5N6 virus in the vicinity of the patient's home.Patients with nasopharyngeal carcinoma or other immune restricted diseases should take personal protective measures, stay away from poultry and livestock breeding and trading places, and avoid close contact with poultry or other animals as much as possible. We should strengthen the training of management personnel of third-party testing institutions, enhance the work of thematic risk assessment and the application of risk assessment results,and expand the scope of monitoring human infected with zoonotic influenza viruses in breeding farms, live poultry markets, and migratory bird habitats.

Objective To analyze the epidemiological characteristics, trends, risk factors, and pathogenic spectrum of adult diarrheal diseases in Xuhui District, Shanghai from 2017 to 2023, so as to provide scientific reference for pathogen monitoring and disease prevention and control of diarrheal diseases. Methods Samples of adult patients with diarrhea in sentinel hospitals of Xuhui District from 2017 to 2023 were collected, and nucleic acid detection of intestinal pathogens was conducted using real-time quantitative PCR. Thirty specimens were subjected to shotgun metagenomic next-generation sequencing (mNGS), with species identified as metagenomic positive pathogens at the level of genus or species by a threshold that at least one read per million of total reads identified by METAMIC. Pathogenic spectrum detected by qPCR and mNGS was listed and compared. Results A total of 1 265 adult diarrheal specimens were collected, showing a significant upward trend in pathogen positivity rates (χ²=23.493, P<0.05), peaking in 2023 at 64.9% (100/154). A higher incidence was found among males (52.9%, 669/1 265), with the primary affected age group being 26-45 years (51.8%, 655/1 265), and summer and autumn being peak seasons for infection (67.7%, 857/1 265). Most patients (72.3%, 914/1 265) sought medical attention within one day of onset. Before onset, 67.8% (858/1 265) of patients had eaten suspicious meat, eggs, dairy, or seafood products. qPCR results revealed the top three dominant pathogens as Norovirus GII (22.6%, 132/584), Campylobacter jejuni (20.0%, 117/584 ), and enterotoxigenic Escherichia coli (13.0%, 76/584). There were significant differences in pathogenic spectrum across different years (χ²=79.578, P<0.05), with enteroaggregative E. coli, Campylobacter jejuni, and Norovirus GII showing the most variation in prevalence. The difference in pathogenic spectrum detected by mNGS and qPCR was also significant (P<0.05), with the top three most abundant pathogens being Rotavirus (93.3%, 28/30), Vesiculovirus (83.3%, 25/30), and Herpesvirus (80.0%, 24/30). Factor analysis indicated that age, suspicious food, and fever were statistically significant related factors to the detection rates (P<0.05). Conclusions From 2017 to 2023, the overall positive rate of adults with diarrhea in Xuhui District exhibited an increasing trend. Summer and autumn were the peak infection seasons, with viruses predominantly detected in summer and bacteria in both summer and autumn. In addition, mNGS could be used as a complementary technology for conventional detection techniques to provide a scientific basis for the effective prevention and control of diarrhea.

Objective To analyze the antibiotic resistance of clinical isolates from Western China in 2021, providing a reference for guiding the rational use of antibiotics in clinical practices and controlling nosocomial infections. Methods Bacterial samples were collected from nine hospitals in 5 autonomous regions and provinces in Northwest China (690 strains in Ningxia, 141 strains in Gansu, 133 strains in Xinjiang, 179 strains in Qinghai, and 151 strains in Shaanxi) in 2021. MALDI-TOF mass spectrometry was used to confirm bacterial identification, and bacterial susceptibility testing was performed using automated susceptibility testing systems. The results of the susceptibility tests were interpreted according to the 2021 CLSI standards. Results A total of 1 294 clinical strains (non-duplicates) were collected, primarily sourced from sputum specimens 312 strains (24.11%), urine specimens 235 strains (18.16%), pus specimens 147 strains (11.36%), and blood specimens 128 strains (9.89%). Among the 1 294 pathogenic strains, Gram-negative bacteria accounted for 69.47%, whereas Gram-positive bacteria accounted for 30.53%. From the Gram-negative organisms, the most common Enterobacterales strains included E.coli 258 strains (19.94%), K.pneumoniae 166 strains (12.83%), E.cloacae 39 strains (3.01%), and K.oxytoca 36 strains (2.78%). Non-fermentative Gram-negative bacilli constituted 20.63% of all isolates, mainly including P.aeruginosa 129 strains (9.97%) and A.baumannii 87 strains (6.72%). Among Gram-positive bacteria, S.aureus 267 strains (20.63%), E. faecium 68 strains (5.26%), and E.faecalis 48 strains (3.71%) were predominant. Enterobacteriaceae remained highly sensitive to carbapenem antibiotics; however, K.oxytoca had a resistance rate exceeding 15%. P.aeruginosa showed resistance rates of 29.5% and 14% to imipenem and meropenem, respectively; A.baumannii showed resistance rates of 63.2% to both drugs. The detection rate of MRSA was 36.7%, with MRSA showing significantly higher resistance rates than MSSA to most tested drugs. No S.aureus isolates were found resistant to vancomycin, teicoplanin, or linezolid. E.faecium strains demonstrated much higher resistance rates to most of the tested drugs compared to E.faecalis, with a few vancomycin-resistant strains found in both. Conclusions Bacterial resistance to commonly used antibiotics was still severe in Western China. Therefore, medical institutions should continue to enhance the monitoring of bacterial resistance, standardize the management and use of antibiotics, and reduce the transmission and spread of resistant bacteria within hospitals.

The human gut constitutes a complex microecosystem comprising bacteria, fungi, archaea, and other microorganisms. Although the gut mycobiome accounts for a minor proportion of this ecosystem, it plays indispensable roles in regulating the host's homeostasis, immunity, and metabolism, and is associated with the occurrence and development of various diseases. In recent years, with the advancements in gut microbiome research, gut mycobiome studies have achieved significant progress, with an expanding repertoire of intestinal fungi being precisely identified. Deciphering the gut mycobiota holds profound implications for human health maintenance. This review synthesizes current knowledge on the human gut mycobiome, focusing on its taxonomic composition, developmental dynamics, interkingdom interactions (fungi-bacteria and fungi-host crosstalk), and multifaceted interactions with host health. Additionally, we critically evaluate methodological innovations in gut mycobiome research, hoping to provide ideas and directions for future gut mycobiome research.

Objective To evaluate the in vitro synergistic antimicrobial effect of allicin combined with imipenem on clinically isolated carbapenem-resistant Klebsiella pneumoniae (CRKP), providing a reference for further in vivo pharmacodynamic studies. Methods Twenty-two strains of CRKP were selected as experimental subjects based on clinical drug sensitivity results. Pulling assay together with carbapenem inhibition enhancement assay were leveraged to identify the high adherence and β-lactamase phenotypes of CRKP. The combined effect of allicin and imipenem was confirmed using the zero interaction potency (ZIP) method. The antimicrobial effects of allicin, imipenem, and their combination against CRKP were tested separately in vitro by agar paper diffusion method. The organic combination of allicin and imipenem was exploited for detecting the diameter of the CRKP inhibitory circle and minimal inhibitory concentration (MIC). The crystal violet semi-quantitative method was utilized to observe the effect of allicin combined with imipenem on CRKP biofilm formation. Results Among the 22 strains of CRKP, 6 strains exhibited high adhesion, accounting for 27.27%. The results of carbapenem inhibition enhancement demonstrated that all strains of CRKP were class A β-lactamase-producing. Allicin had a strong bactericidal effect on CRKP. According to the results of one-way ANOVA, the diameter of the circle of inhibition of allicin combined with imipenem (15.91±2.76)mm was significantly higher than that of the imipenem alone group (8.23±3.46) mm(F=46.39, P<0.001). The ZIP scoring and MIC methods confirmed that the combination of allicin and imipenem primarily exerted an additive effect. One-way ANOVA analysis of crystal violet absorbance values showed that compared to the control group (0.213±0.056), the total CRKP biofilm amount in the allicin combined with imipenem group was reduced (0.134±0.045) (F=3.211, P=0.045). Conclusions The results of bacterial inhibition experiments in vitro show that the combination of allicin and imipenem significantly increases the inhibitory ability of CRKP and inhibits biofilm formation effectively.

Objective To identify the clinical characteristics of a case of abdominal multiple cystic echinococcosis in Shenzhen City, Guangdong Province, and to characterize the molecular biology of pathogen, in order to provide a basis for control and prevention of echinococcosis. Methods Clinical and epidemiological data of 1 case of echinococcosis in Shenzhen City in January 2024 were collected. The pathological sections of the cyst tissue removed by surgery were examined by microscopy after staining. Nucleic acids were extracted from cyst tissue samples, and the ND1 and Cox1 gene sequences were amplified and sequenced by PCR. Sequence comparison and phylogenetic tree analysis were performed using Mega X, BLAST and other software. Results The patient, male, 29 years old, a resident of Nyerong County, Nagqu City, Xizang Autonomous Region, had a history of exposure to domestic dogs and hepatic echinococcosis. Imaging showed abdominal multiple placeholder, consider echinococcosis recurrence; 12 pieces of cystic lesions from different parts of the abdominal cavity were surgically removed, and the pathological sections of cystic tissues showed cuticle layer, germinal layer, protoscolex of echinococcosis. PCR amplification of the specific genes ND1 and Cox1 were positive, and the amplified fragments were about 510 bp and 285 bp, respectively. Sequence comparison and phylogenetic tree analysis results showed that the homology between the sequences in this study and the ND1 gene of Echinococcus granulosus type G1 (JX217890.1, Qinghai), and Cox1 gene (MH050610.1, Xizang) in the GenBank database was 99%. It is closely related to the epidemic strains of Echinococcus granulosus in Xizang, Qinghai and Xinjiang in the phylogenetic tree, and is in the same evolutionary branch (type G1). Conclusion The patient was an imported case of abdominal multiple cystic echinococcosis, and the genotype was G1, with a high probability that the infection originated in Xizang. It is recommended to enhance the surveillance and management of echinococcosis in non-endemic areas, and to strengthen the inspection and quarantine of livestock and agricultural by-products imported from endemic areas to prevent the spread of echinococcosis.

Objective A predictive model should be established during the early stages of dengue progression to evaluate the likelihood of severe dengue and dengue with warning signs, thereby preventing delayed clinical management and reducing dengue-related mortality. Methods Clinical and laboratory examination data of 831 patients admitted to Ruili People's Hospital of Yunnan Province during 2019-2023 were retrospectively collected. The dataset was divided into a training set and a validation set in a 7∶3 ratio. Statistical description and univariate analysis were performed on the training set, with LASSO regression employed to screen variables, followed by logistic regression to develop a risk prediction model for severe dengue. Model performance was validated using ROC curves on both the training set and validation set. Results A total of 831 dengue patients were included in the study, with a mean age of (44.20±15.02) years. Among them, 52.59% were male and 5.42% were Myanmar nationality. In total, 122 cases (14.68%) exhibited severe dengue or dengue with warning signs, predominantly female (58.20%). LASSO regression was used in the training set to screen 11 variables related to the risk of severe dengue and dengue with warning signs: Age, dizziness, vomiting, prothrombin time, partial activated thromboplastin time, hematocrit, platelet, monocyte percentage, absolute value of monocytes, hemoglobin, C-reactive protein (λ_min= 0.011 59); Logistic regression identified statistically significant variables for the risk model of severe dengue and dengue with warning signs as follows: age [OR=1.034 (95%CI: 1.016-1.053)], red blood cells deposited [OR=1.258 (95%CI: 1.143-1.519)], platelet [OR=0.991 (95%CI: 0.985-0.997)], hemoglobin (OR=0.919 (95%CI: 0.873-0.950)], C-reactive protein [OR=1.019 (95%CI:1.004-1.034)]. The model achieved an AUC of 0.894 (95%CI: 0.796-0.867) in the training set and 0.862 (95%CI: 0.709-0.827) in the validation set. At a cut-off threshold of 0.197, sensitivity and specificity were 0.850 and 0.743, respectively. Conclusion This study established a LASSO-logistic regression model, which can predict the risk of severe dengue and dengue with warning signs. The model enhances the capability of hospitals to prevent and manage severe dengue and provides valuable guidance for clinical decision-making.

Objective To analyze the identification of pathogenic bacteria in municipal sewage of Hangzhou City, Zhejiang Province from January to October 2023, to understand the serotype and drug resistance of Vibrio cholerae isolated from sewage, as well as to predict the virulence gene and drug resistance gene carrying situation. Methods From January to October 2023, urban sewage samples from various environments in Hangzhou City, Zhejiang Province, were continuously collected for bacterial isolation and culture. The serotypes of 27 Vibrio cholerae strains were identified by slide agglutination method, and the drug sensitivity test was conducted by micro broth dilution method. Whole genome sequence and bioinformatics software were used to predict drug resistance genes and virulence genes. Results The sewage identification results showed 26 bacteria genera, including Salmonella, Vibrio, Enterobacter, and Aeromonas, among 82 bacterial species. All 27 strains of Vibrio cholerae were non-O1 and non-O139 serogroups. The strains showed high resistance rates to ampicillin, ampicillin/sulbactam and cotrimoxazole at 59.26%, 14.81%, and 14.81%, respectively), exhibited high sensitivity to cefotaxime, tetracycline, chloramphenicol, meropenem, ertapenem, ceftazidime, ceftazidime/avibactam, amikacin, ciprofloxacin, tigecycline, and azithromycin. A total of 21 different drug resistance genes were detected in 11 strains of Vibrio cholerae, among which the highest carriage rate of β-lactam resistance genes reached 63.64%, and 1 strain carried 17 kinds of drug resistance genes. None of the 11 strains of Vibrio cholerae carried ctxA, ctxB, ace, zot, or chxA genes, but all the strains carried rtxB, rtxC, and rtxD genes; 90.91% of the strains carried hlyA, and 36.36% carried rtxA. Conclusions All Vibrio cholerae isolated from sewage in this study are non-O1 and non-O139 serogroups, showing good sensitivity to most antibiotics, but also they carry a certain number of drug-resistance genes and virulence genes. This suggests that future monitoring efforts should focus on these strains, providing certain data support for the study of the characteristics of Vibrio cholerae isolated from sewage.

Objective To investigate the effects of capsaicin on gut microbiota and antimicrobial peptide expression of Anopheles stephensi, providing experimental references for the application of capsaicin in mosquito-borne disease prevention and control. Methods Anopheles stephensi were continuously fed with sugary water containing capsaicin or DMSO for the capsaicin-treated group and the control, respectively. The DNA of the female mosquito's midguts and gut bacteria was extracted. Bacterial 16S rDNA high-throughput sequencing and real-time fluorescence quantitative PCR were used to analyze and compare the bacteria diversity, gut flora composition, relative abundance, and total bacterial load in female mosquitoes’ midgut between the control and capsaicin treatment groups. Total RNA was extracted from the midguts of the two groups of Anopheles mosquitoes, and the transcriptional levels of important antimicrobial peptides were detected and compared by reverse transcription and real-time fluorescence quantitative PCR. Results A total of 10 phyla, 11 classes, 28 orders, 43 families, and 62 genera were identified in the two groups. The capsaicin-treated group had fewer taxa, with significantly reduced bacterial diversity, and different community composition and relative abundance of the flora compared to the control group. At the phylum level, Bacteroidota, Proteobacteria, and Firmicutes predominated in both two groups. At the order level, Flavobacteriales, Acetobacterales, Pseudomonadales, and Lactobacillales were the dominant bacteria, with reduced relative abundance of Pseudomonadales and Acetobacterales and increased relative abundance of Flavobacteriales and Lactobacillales in the capsaicin-treated group. At the genus level, Elizabethkingia was predominantly abundant in both samples, with higher relative abundance of Elizabethkingia, Leuconostoc, and Gluconobacter in the capsaicin-treated group, while Asaia and Acinetobacter had significantly lower relative abundance compared to the control group. In addition to these changes, the total bacterial load was increased and the transcriptional levels of attacin C, cecropin A, and defensin were significantly decreased by capsaicin treatment. Conclusions Capsaicin treatment significantly affects the composition of the gut flora in Anopheles stephensi and increases the total bacterial load while inhibiting the expression of antimicrobial peptides. Based on the analysis, it indicates that capsaicin might affect the fecundity and vector competence of Anopheles by changing the energy metabolism and immune-related bacteria.

Objective To study the interference effects of siRNA and dsRNA in Aedes albopictus and their impact on mosquito survival, providing reference and technical support for the study of mosquito gene function, the research and development of new insecticides, the control of vector mosquitoes, and the interruption of arboviruses transmission. Methods For genes of interest in Ae. albopictus, siRNAs targeting the desired genes were designed and commercially synthesized, while dsRNAs were obtained by amplifying the target gene fragments, followed by in vitro transcription and purification, with verification by agarose gel electrophoresis. The interfering RNA was injected into Ae. albopictus by thoracic microinjection. Then the expression of targeted genes on the 3rd day post-microinjection was detected by quantitative PCR to verify the interfering effect, and the survival curve of the mosquitoes was recorded at the same time. Results In the siRNA interference experiments targeting 10 genes with 22 siRNA pairs, only two siRNA pairs, SR-C-2 siRNA and ENR-1 siRNA, successfully interfered with the target gene expression compared to the control group, with interference rates of 58% and 33%, respectively, while the remaining siRNAs did not show interference effects, with some even causing increased expression of the target gene. In the dsRNA interference experiments, Mesh dsRNA significantly reduced the expression of mesh gene at the concentration of 3×10¹¹ RNA molecules per mosquito, with an interference effect lasting 5 days and an interference rate of 55%-60% on the third day and 34% on the fifth-day post-injection. Mosquito survival within 3 days post-dsRNA injection was significantly higher than in the siRNA injection group. Conclusions Ae. albopictus on the fifth-day post-emergence is the most suitable to receive thoracic microinjection. dsRNA is more stable than siRNA for interference, with higher post-injection survival rates, making it more suitable for in-depth studies of mosquito gene function. Although siRNA-based gene interference is simpler and more feasible, attention should be paid to the purification method of siRNA and its homology with other genes in the mosquito species to avoid non-specific experimental results due to the off-target combinations.

Objective To analyze and investigate a hospital-acquired outbreak of carbapenem-resistant Klebsiella pneumoniae (CRKP) in a hospital's neurosurgical intensive care unit (NSICU), and to implement rectification based on the investigation results, providing valuable insights and recommendations for controlling similar outbreaks caused by multi-drug-resistant strains. Methods The field epidemiological investigation was conducted to investigate five cases of clustered CRKP pulmonary infection in the NICU in Shandong in 2021. Hygienic monitoring of the environment was undertaken. The main occurrence stages were analyzed, effective control measures were taken, and the effectiveness of the control measures was evaluated. Results The study identified an outbreak of CRKP infections that occurred in the neurosurgical intensive care unit, with the beds of infection cases and spatial positions being centrally distributed. Hygienic monitoring was performed on environmental surfaces, as well as the hands and nasal cavities of medical and cleaning staff. In the first sampling, 3 samples from the patient bed units tested positive for CRKP, while no CRKP was detected on other surfaces, or in samples from the hands and nasal passages of the medical staff and air specimens. The CRKP strains found on surfaces had antibiotic resistance profiles consistent with the patient strains. No further related cases occurred after comprehensive control measures were implemented. Conclusions The comprehensive control measures, including enhanced ward disinfection and isolation, strict management of hand hygiene among medical staff, and personnel training, can effectively control the outbreak of CRKP hospital-acquired infections in NSICU.

Objective To analyze the whole genome sequence characteristics of dengue serotype 2 virus (DENV-2) strains isolated from Guangzhou in 2023, providing new foundational data to support local dengue fever prevention and control efforts. Methods Dengue viruses were isolated from serum samples of dengue fever patients using C6/36 cells. Whole genome sequencing of dengue virus was performed using Nanopore sequencing technology (Nanopore platform). The sequencing data were assembled utilizing IPH-NANO v1.0 software, and homology analysis, phylogenetic analysis, and amino acid site variation analysis of the dengue virus genome sequence were conducted using software such as BioEdit7.0.9.0, MEGA11, and iqTree1.6.12. Results A total of 13 DENV-2 isolates were obtained from the serum samples of dengue fever patients in Guangzhou in 2023, all of which were derived from locally infected cases. The whole genome sequences obtained by sequencing and splicing ranged from 10 429-10 439 nt in length. The nucleotide (amino acid) homology among the 13 isolates was 99.7%-99.9% (99.6%-9.9%). A genome-wide phylogenetic analysis showed that the genotypes of all 13 Guangzhou isolates were identified as the Cosmopolitan genotype and were grouped in the same evolutionary clade as isolates from Réunion (French overseas territory), Djibouti, Kenya, and other regions. Compared with the reference sequence (NC001474), a total of 26 amino acid site variations were identified in the C/prM/E protein regions of the 13 isolates, including 4 variations in the C protein region, 8 in the prM protein region, and 14 in the E protein region. Conclusion The DENV-2 strains isolated from Guangzhou in 2023 exhibited high homology, with closely related isolates primarily originating from countries or regions such as Réunion, Djibouti, and Kenya, it highlights the need for further assessment of the risk of dengue fever importation from East Africa, South Asia, and other regions.

Objective To investigate the application value of nucleic acid mass spectrometry (MassARRAY) in the detection of drug resistance genes of Mycobacterium tuberculosis (MTB). Methods Pulmonary samples (sputum, bronchoalveolar lavage fluid) from suspected pulmonary tuberculosis patients and tissue and pus samples from suspected extrapulmonary tuberculosis patients were collected from Xi'an Chest Hospital from September 2022 to May 2023. Two samples from the same patient were subjected to both the melt curve method and the MassARRAY method to detect common drug resistance genes in patient samples, alongside mycobacterial culture and microplate drug susceptibility test. The efficacy of the Melt curve method and MassARRAY method for the detection of various drugs was evaluated using the microporous plate method as the standard. Results A total of 72 pulmonary specimens (40 sputa, 32 bronchoalveolar lavage fluids) and 36 extrapulmonary (18 tissues and 18 pus) were collected. The positive rate of mycobacterial culture was 32.4% (35/108). The detection rate of drug resistance genes by nucleic acid mass spectrometry was 52.8% (57/108). The resistance detection rates for rifampicin by nucleic acid mass spectrometry, melting curve, and microplate method were 14.0% (8/57), 13.0% (6/46), and 20.0% (7/35) respectively, with no significant difference among the three methods(F=0.851, P>0.05). There was no significant difference in the detection rates of isoniazid, ethambutol, streptomycin, and fluoroquinolones among the three methods. Using phenotypic drug susceptibility results of culture-positive samples as the reference standard, the Kappa values of rifampicin, isoniazid, ethambutol, and streptomycin detected by nucleic acid mass spectrometry were 1.000, 1.000, 0.635, and 0.821, respectively. Conclusions Nucleic acid mass spectrometry is a highly sensitive and specific method for detecting drug-resistance genes in Mycobacterium tuberculosis samples. It is a rapid, sensitive, accurate, and flexible molecular detection method with a promising application prospect in diagnosing drug-resistant tuberculosis.

Objective To investigate the level of pertussis antibody in 344 healthy population in Hebei Province in 2023, and to understand the infection status and estimate the potential infection of pertussis. Methods A total of 344 healthy people of all ages from 7 cities (counties) in Hebei Province in 2023 were stratified by random sampling method. The demographic characteristics, vaccination history and pertussis history of the subjects were collected. Serum IgG antibody against pertussis toxin (PT-IgG) were determined by enzyme-linked immunosorbent assay (ELISA). Results The geometric mean concentration (GMC) of PT-IgG in 344 healthy people was 5.28 IU/mL, and the antibody positive rate (PT-IgG concentration ≥ 40 IU/mL) was 6.10% (21/344). There was no significant difference in proportion of antibody levels and antibody concentration ≥40 IU/mL between males and females. The top three regions with the highest antibody positive rate were Xinhe County in Xingtai (20.00%), Lianchi District in Baoding (11.43%), and Shijiazhuang (9.37%). There was a significant difference in pertussis antibody levels among different regions (P=0.007), but no significant difference in pertussis antibody concentration ≥40 IU/mL among different regions (P=0.100). The GMC of antibody was the highest in the 1~<3 years old group (11.45 IU/mL), followed by the <1 year old group (8.15 IU/mL). There was a significant difference in the pertussis antibody levels among different age groups (P=0.001). The proportion of antibody concentration ≥40 IU/mL was the highest in the 1~<3 years old group (20.83%), followed by the <1 year old group (12.77%). There was a significant difference in the proportion of antibody concentration ≥40 IU/mL among different age groups (P=0.028). And 303 (88.08%) cases of the 344 healthy people had a history of DTaP, 4.62%, 46.86% and 48.52% of healthy people had completed 1-2, 3 and 4 doses of DTaP, respectively. Among the healthy people who had completed 1-2 doses of DTaP, there was no significant difference in the level of pertussis antibody among different age groups (P=0.47). Among the healthy people who had completed 3 doses of basic immunization and 4 doses of complete immunization, there was a significant difference in the level of pertussis antibody among different age groups (P=0.04, P=0.01). There was no significant difference in the proportion of PT-IgG concentration ≥40 IU/mL among different age groups and different immunization doses (P=0.72). Conclusion The overall antibody level and proportion of PT-IgG concentration ≥40 IU/mL in the healthy population of Hebei Province in 2023 were both low, indicating the inadequacy of the protective effect of the current immunization program for children, although vaccinated people could still infect with pertussis disease, we need to further monitoring and optimization of immune strategies indicating.

Objective To investigate the epidemiological characteristics and molecular transmission mechanism of the colistin resistance gene mcr-1 in food animal-derived Escherichia coli in Hanzhong, Shaanxi Province, and to grasp the prevalence of mcr-1 positive Escherichia coli in Hanzhong, in order to offer the empirical evidence for the prevention and management of disseminating the mcr-1 colistin resistance gene in both community and hospital settings. Methods From November 2019 to May 2020, frozen whole chicken carcasses and frozen raw ground pork were randomly sampled from seven major supermarkets in Hanzhong, Shaanxi Province, for the isolation and identification of Escherichia coli. The mcr-1 gene was detected using PCR analysis, and the drug susceptibility of mcr-1-positive strains was assessed using the broth dilution method. Whole genome sequencing, S1-pulsed field gel electrophoresis (PFGE), and Southern blot were used to locate the mcr-1 gene. Results Out of 159 samples randomly collected from seven different supermarkets, 77 Escherichia coli strains were isolated, and 11 strains carrying the mcr-1 gene were detected, with a positive rate of 14.29%. All 11 mcr-1-positive strains were multidrug-resistant, with a minimum inhibitory concentration (MIC) for colistin ≥2 mg/L (11/11). They exhibited a 100.00% resistance rate to ampicillin, streptomycin, tetracycline, and chloramphenicol (11/11), and all produced extended-spectrum beta-lactamases (ESBLs). The strains exhibited susceptibility to carbapenems and cefoxitin but had a 90.91% resistance rate to quinolones ciprofloxacin and levofloxacin. The mcr-1 gene was located on plasmids in 10 of the mcr-1-positive strains, with plasmid sizes approximately 60 kb and 220 kb. The 11 mcr-1-positive Escherichia coli strains belonged to 9 different sequence types (STs), including one previously unidentified ST. Besides carrying the colistin resistance gene mcr-1, all isolates possessed at least one ESBLs gene, predominantly bla_CTX-M-55 (8/11, 72.73%). The plasmid types harboring mcr-1 were predominantly IncI2 (5/11, 45.45%) and IncHI2 (5/11, 45.45%), with one strain having mcr-1 located on the chromosome. Conclusions The mcr-1-positive Escherichia coli detected in this study are all multidrug-resistant and produce ESBLs, predominantly bla_CTX-M-55. The mcr-1 gene can be transmitted through plasmid and chromosome.

Objective To analyze the clinical characteristics and prognostic factors for clinical cure in chronic hepatitis B virus (HBV) infected patients with pegylated interferon-α-2b (PEG-IFN-α-2b) based therapy. Methods This is a retrospective study. Chronic HBV infected patients receiving PEG-IFN-α-2b therapy were enrolled in Yuncheng Central Hospital affiliated to Shanxi Medical University between August 2020 and November 2023. Treatment-naïve patients received PEG-IFN-α-2b monotherapy, while nucleoside (acid) analogs (NAs)-experienced patients received PEG-IFN-α-2b add-on therapy. The study endpoint was hepatitis B surface antigen (HBsAg) negative in accompany with HBV DNA below the detection limit (course of treatment < 48 weeks) or treatment for 48 weeks. The general characteristics, virological variables, blood routine test, and liver function of patients were collected at baseline and study endpoint. Student’s t test or Mann-Whitney U test was used for comparison. The prognostic factors of clinical cure were examined using univariate and multivariate stepwise logistic regression models. Results A total of 61 chronic HBV infected patients were enrolled, including 39 males and 22 females. The age were (39.13±7.53) years. Twenty-one cases were treatment-naïve, while 40 patients were NAs-experienced. Nineteen cases were positive for HBV DNA at baseline. The baseline HBsAg levels were 211.30(50.93, 2 110.00) IU/mL. Thirty-four patients achieved clinical cure at the study endpoint with 25.50 weeks of median course of PEG-IFN-α-2b treatment. Twenty-seven patients did not achieve clinical cure at the study endpoint, and the course of treatment was 48 weeks. Clinical cure group had significant lower baseline HBsAg level when compared with non-clinical cure group [78.66(19.54, 204.60) IU/mL vs 2 078.00(442.20, 4 237.00) IU/mL, P<0.001]. At the study endpoint, the white blood cell, platelet, red blood cell, hemoglobin levels were lower than those in baseline (P<0.05), while alanine aminotransferase and asparatate aminotransferase levels were higher than those in baseline (P<0.05). There were no remarkable differences in blood routine tests or liver function between clinical cure and non-clinical cure group at either baseline or study endpoint (P>0.05). Baseline low HBsAg level was a predictor for clinical cure in patients receiving PEG-IFN-α-2b therapy (OR=0.998, 95%CI: 0.998-0.999). No severe adverse events were happened during therapy. Conclusion PEG-IFN-α-2b-based therapy was well-tolerant, and could achieve high rate of clinical cure in chronic HBV-infected patients who had low baseline HBsAg level.

Objective To explore the clinical characteristics of acute Q fever to improve the understanding of the disease. Methods The clinical data of 10 patients with acute Q fever admitted to the Affiliated Hospital of Nantong University from November 2020 to December 2023 were collected, and the general data, epidemiological characteristics, clinical manifestations, laboratory test results, imaging manifestations, treatment plans, and outcomes were retrospectively analyzed. Results Among the 10 patients, there were 7 males and 3 females, with an average age of (58.30±6.41) years. Three patients had contact history with sheep, one with poultry, and six without clear epidemiological history. The main clinical manifestations were fever, chills, fatigue, cough, headache, nausea, etc. Laboratory tests showed slight leukocytosis in one case, leukopenia in two cases, elevated neutrophil ratio in three cases, and lymphopenia in two cases; procalcitonin was elevated in six cases; C-reactive protein, D-dimer, alanine aminotransferase, aspartate aminotransferase, and lactate dehydrogenase were elevated in all cases; Coxiella burnetii was detected in all 10 patients by metagenomic next-generation sequencing (mNGS). Upon diagnosis, treatment regimens were adjusted for all patients, using doxycycline or minocycline either alone or in combination, and all patients recovered and were discharged from the hospital. Conclusions Acute Q fever patients often have no clear epidemiological history and lack characteristic clinical manifestations, making conventional laboratory tests insufficient for diagnosis. mNGS examination can provide a basis for etiological diagnosis of suspected cases, and comprehensive treatment based on doxycycline or minocycline shows good efficacy.

Objective To analyze the epidemic characteristics of plague epidemics, host and vector community structure, and abundance in plague focus of wild rodents in Yunnan Province, 2017-2023, providing a scientific basis for formulating plague prevention strategies and forecasting warning for this epidemic foci. Methods Following the requirements of the "National Plague Surveillance Plan" and the "Yunnan Provincial Plague Surveillance Plan", host-vector surveillance, etiology, and serological testing were carried out, and plague epidemic data and host-vector surveillance data in plague focus of wild rodents in Yunnan Province, 2017-2023 were collected and sorted using Excel 2019 software to create a database for descriptive analysis. Results From 2017 to 2023, 11 animal plague epidemics were discovered in the wild plague foci of Yunnan Province, with 18 epidemic spots. From the altitude distribution point of view, 7 epidemic spots were distributed at an altitude of 2 800-3 000 meters, another seven at 3 000 and 3 200 meters, and four spots were located in areas with an altitude of ≥3 200 meters; a total of 36 samples of host and vector animals were detected positive, including 28 positive samples of host animals and 8 positive samples of vector animals, and 29 strains of Yersinia pestis were isolated; in terms of species composition, Eothenomys miletus accounted for the largest proportion of 41.67%, followed by Apodemus chevrieri at 22.22%; Ctenophthalmus quadratus at 11.11%; Rattus tanezumi and Neopsylla specialis each at 8.33%, and Dremomys pernyi, rat carcass, and Frontopsyllas padix each accounted for 2.78%; the epidemic peaked in April, and no human cases were found. A total of 453 220 rat cages (traps) were placed, capturing 27 677 rodents, with an average capture rate of 6.11%. A total of 25 075 main hosts, Apodemus chevrieri and Eothenomys miletus, were captured, accounting for 90.60% of the total capture rate. A total of 14 700 fleas were seized on the surface of small animals, with a total flea infection rate of 23.13% and a flea index of 0.59. The main vectors were Ctenophthalmus quadratus and Neopsylla specialis, with constituting ratios of 45.71% and 22.69%, respectively. Conclusions From 2017 to 2023, the population density of main host animals in Yunnan's wild rodent plague foci was relatively high and showed an upward trend, possibly related to the local planting structures. Plague plays a regulatory role in host population structures. Epidemics among animals showed obvious seasonality, with a trend of expanding epidemic areas. No human cases were found, but Yersinia pestis was detected in Rattus tanezumi in human settlements, raising the possibility that animal plague could spread to humans. It suggests strengthening the monitoring of areas adjacent to the epidemic source, eradicating rats and fleas in spring, improving the accuracy of plague prediction and early warning, providing strong technical support for the early detection of plague among animals, and preventing the spread of the epidemic to humans.

Objective To explore and analyze the epidemiological characteristics of scarlet fever caused by group A Streptococcus (GAS) in Minhang District, Shanghai from 2023 to 2024, providing relevant information for clinical treatment and infection control. Methods Throat swab specimens were collected from children clinically diagnosed with scarlet fever at a sentinel hospital in Shanghai from May 2023 to June 2024. GAS strains were isolated and cultured using blood agar plates, and mass spectrometry performed species identification. The polymerase chain reaction (PCR) method was used to assess emm gene typing and 11 superantigens, while the broth microdilution method was used to determine the resistance of the strains to 14 antibiotics. Whole genome sequencing was performed on 68 GAS strains. The chi-square test and Fisher's exact probability method were conducted for intergroup comparisons. Results A total of 178 GAS strains were isolated from 305 throat swab specimens of scarlet fever cases in children. All GAS strains were sensitive to penicillin, cefotaxime, linezolid, vancomycin, meropenem, chloramphenicol, levofloxacin, teicoplanin, and cefepime, while the resistance rates to erythromycin, clarithromycin, and tetracycline were 99.44%, 99.44%, and 94.94%, respectively. There are two types of emm genes, with emm12 being the main type (89.33%, 159/178), followed by emm1 10.7% (19/178). There were 26 types of superantigen gene spectrums. The speA gene carrying rate of emm1 type GAS (94.74%, 18/19) was significantly higher than emm12(12.00%,32/159) (χ²=46.77, P<0.001). The simultaneous carrying rate of speH and speI genes in emm12 type GAS (59.75%, 95/159) was higher than in emm1 type (0) (χ²=24.35, P<0.001). Whole-genome sequencing revealed that all 68 GAS strains carried the drug resistance gene ermB, with 98.52% (67/68) carrying tetM. Conclusions In Minhang District of Shanghai, non-invasive scarlet fever in children is predominantly caused by emm12 GAS, which shows high resistance to erythromycin, clindamycin, and tetracycline, with higher carriage rates of speH and speI in emm12 types compared to other strains.

Objective To investigate the epidemiology and genomic characterizations of carbapenem-resistant Escherichia coli (CREC) from a tertiary hospital in Guangzhou, Guangdong province, China from January 2021 to December 2023. Methods The non-repetitive CREC isolates identified at the hospital from January 2021 to December 2023 were included and their clinical characteristics were analyzed through the clinical record system. A total of 42 CREC isolates were randomly selected for species identification, antimicrobial susceptibility testing, and multilocus sequence typing. Whole-genome sequencing and bioinformatics analysis were conducted to investigate the antimicrobial resistance genes, virulence-related genes, replicons, and plasmid types carrying the carbapenem resistance genes in CREC. Results A total of 2 887 Escherichia coli (EC) isolates were collected from the hospital between January 2021 to December 2023, including 105 CREC strains. The prevalence rates of CREC over the three years were 1.76%, 2.80%, and 5.69%, respectively, showing a significant upward trend (P<0.001). All 42 CREC isolates showed resistance to multiple antibiotics, with resistance rates for amoxicillin-clavulanate, ceftazidime, and cefepime all at 100.00%, ertapenem and imipenem at 97.62%, levofloxacin at 83.33%, and amikacin at 45.24%. All CREC isolates were susceptible to tigecycline. The 42 CREC strains were classified into 14 ST types, with the main types being ST167 (28.57%), ST410 (26.19%), and ST131 (9.52%). ST410 CREC isolates carried significantly more fim, algA, icsP/sopA, and high-pathogenicity island (HPI) related virulence genes than ST167 isolates (P<0.05), whereas aslA and hcp-2 were significantly lower than ST167 (P<0.05). The carbapenem resistance genes carried by CREC were primarily bla_NDM-5 (n=34), followed by bla_NDM-1 (n=6), with only one isolate carrying bla_KPC-2. These carbapenem resistance genes were mainly located on IncF (n=27) and IncX3 (n=11) type of plasmids. Conclusions The prevalence of CREC significantly increased from 2021 to 2023 in this hospital, with ST167 and ST410 as the dominant types. ST410 CREC is a newly prevalent high-risk clone carrying adhesion, biofilm formation, and HPI-related virulence genes, and there is an urgent need to monitor its epidemiological status and transmission characteristics to provide a basis for the formulation of control measures.

This paper reports the discovery, diagnosis, treatment, and epidemiological survey of an imported confirmed visceral leishmaniasis (kala-azar) case in Wuhan City, providing a reference experience for enhancing awareness of imported visceral leishmaniasis among medical professionals in non-endemic healthcare institutions and reducing misdiagnosis. The patient had worked in Yangquan, Shanxi Province, for more than one year. After returning to his hometown in Hubei Province in 2020, he began to show symptoms such as intermittent fever, pancytopenia, progressive splenomegaly, and significant weight loss. Leishmania amastigotes were found in bone marrow smears. The rapid diagnostic test using the rk39 strip was positive for antibodies. Furthermore, both loop-mediated isothermal amplification (LAMP) and quantitative polymerase chain reaction (qPCR) assays confirmed the presence of Leishmania nucleic acid. Based on a comprehensive analysis of the epidemiological history, clinical manifestations, and laboratory test results, the case was confirmed as an imported visceral leishmaniasis case. This case presented with low parasite density and abnormal autoimmune indicators such as increased rheumatoid factor, leading to its prolonged misdiagnosis as a hematologic or autoimmune disease without effective treatment. It was only diagnosed after having left the endemic area for four years. Non-endemic areas should pay attention to the inquiry of epidemiological history and improve healthcare institutions' diagnostic awareness and treatment capabilities related to visceral leishmaniasis to avoid delays in treatment.