Improving ultrasound diagnostic Precision for breast cancer and adenosis with modality-specific enhancement (MSE) - Breast Net.

Adenosis is a benign breast condition whose lesions can mimic breast carcinoma and is evaluated for malignancy with the Breast Imaging-Reporting and Data System (BI-RADS). We construct and validate the performance of modality-specific enhancement (MSE)-Breast Net based on multimodal ultrasound images and compare it to the BI-RADS in differentiating adenosis from breast cancer. A total of 179 patients with breast carcinoma and 229 patients with adenosis were included in this retrospective, two-institution study, then divided into a training cohort (institution I, n = 292) and a validation cohort (institution II, n = 116). In the training cohort, the final model had a significantly greater AUC (0.82; P < 0.05) than B-mode-based model (0.69, 95% CI [0.49-0.90]). In the validation cohort, the AUC of the final model was 0.81, greater than that of the BI-RADS (0.75, P < 0.05). The multimodal model outperformed the individual and bimodal models, reaching a significantly greater AUC of 0.87 (95% CI = 0.69-1.0) (P < 0.05). MSE-Breast Net, based on multimodal ultrasound images, exhibited better diagnostic performance than the BI-RADS in differentiating adenosis from breast cancer and may contribute to clinical diagnosis and treatment.

Epidemiology and drug resistance analysis of bloodstream infections in an intensive care unit from a children's medical center in Eastern China for six consecutive years.

BACKGROUND: Children in the intensive care unit (ICU) who suffer from severe basic diseases and low immunity are usually in critical condition. It is crucial to assist clinicians in selecting the appropriate empirical antibiotic therapies for clinical infection control. METHODS: We retrospectively analyzed data from 281 children with bloodstream infection (BSI). Comparisons of basic data, pathogenic information, and drug resistance of the main bacteria were conducted. RESULTS: We detected 328 strains, including Gram-positive bacteria (223, 68%), mainly coagulase-negative Staphylococci (CoNS); Gram-negative bacteria (91, 27.7%); and fungi (14, 4.3%). The results of the binary logistic regression analysis showed that the main basic disease was an independent risk factor for death. Compared with Escherichia coli, Klebsiella pneumoniae exhibited a higher proportion of extended-spectrum ß-lactamases (ESBLs), and its resistance to some ß-lactamides and quinolones antibiotics were lower. Twenty-seven isolates of multidrug-resistant (MDR) bacteria were detected, of which carbapenem-resistant Acinetobacter baumannii (CRAB) accounted for the highest proportion (13, 48.2%). CONCLUSIONS: CoNS was the principal pathogen causing BSI in children in the ICU of children, and Escherichia coli was the most common Gram-negative pathogen. The main basic disease was an independent risk factor for death. It is necessary to continuously monitor patients with positive blood cultures, pay special attention to detected MDR bacteria, and strengthen the management of antibiotics and prevention and control of nosocomial infections.

Evaluation and analysis of multidrug resistance- and hypervirulence-associated genes in carbapenem-resistant Pseudomonas aeruginosa strains among children in an area of China for five consecutive years.

Introduction: Carbapenem-resistant Pseudomonas aeruginosa (CRPA) is a growing threat. It is urgent to investigate the multidrug resistance and high virulence of CRPA to provide a basis for infection control and rational use of antibiotics. Methods: A retrospective study of 56 nonduplicated CRPA isolates was conducted. Results: CRPA mainly came from the intensive care unit (ICU) and was mostly isolated from sputum samples. The carbapenem resistance rates of P. aeruginosa were 21.37% (2016), 10.62, 5.88, 10 and 13.87% from 2016 to 2020, respectively. Carbapenem-resistant enzymes and aminoglycoside-modifying enzyme-encoding genes were detected in all isolates, and extended-spectrum ß-lactamase and cephalosporin enzyme-encoding genes were present in 96.43 and 80.38% of isolates, respectively. The detection rate of OprM showed a statistically significant difference (p < 0.05) between the ICU and other wards. Genes related to biofilms, membrane channel proteins, I integrons and efflux systems were detected in all isolates, with detection rates greater than 90%. CRPA was strongly virulent, and over 80% of isolates carried hypervirulence-associated genes (exoU, exoS, exoT, and exoY). The drug resistance rates of cefepime and piperacillin/tazobactam showed a statistically significant difference (p < 0.05) between strains with exoU (+) and exoU (-) (p < 0.05). Notably, out of the 7 individuals who died, 4 had extensively drug-resistant P. aeruginosa (57.14%). Discussion: The detection rates of various resistance and virulence genes were high, and the coexistence phenomenon was serious. In clinical practice, antibiotics should be used reasonably based on different drug resistance genes to ensure the rationality and safety of patient medication.

Insight into carbapenem resistance and virulence of Acinetobacter baumannii from a children's medical centre in eastern China.

Carbapenem-resistant Acinetobacter baumannii (CRAB) appeared more frequently in children and caused a great threat to global public health. It is urgent to investigate the carbapenem resistance and virulence of CRAB for clinicians to choose appropriate antibiotics. A retrospective study of 77 nonduplicated CRAB isolates was conducted. The carbapenem resistance and virulence genes were characterized by polymerase chain reaction (PCR) and gel electrophoresis. In the present study, A. baumannii mainly came from the intensive care unit and was mostly isolated from sputum samples. The carbapenem resistant rate of A. baumannii in 2018-2020 increased significantly compared with that in 2016-2017. All isolates had carbapenem resistant genes. They were highly resistant to a variety of antibiotics but were relatively sensitive to fluoroquinolones and tetracyclines. blaVIM and blaOXA-23 were detected in all isolates, whereas blaOXA-51, blaIMP and blaNDM were present in 98.70%, 67.53% and 31.17% of isolates, respectively. Notably, 1 isolate A. baumannii was identified as multidrug-resistant A. baumannii (MDR-AB), and 76 other extensively drug-resistance (XDR) isolates were also detected. Virulence genes were present in 100% of all isolates, including genes in the iron acquisition system (basJ), secretion systems (ompA, plcD), quorum sensing system (abaI) and biofilm formation (csuA). adeH, pgaA, and ptk were present in 98.70%, 98.70% and 94.80% of isolates, respectively. CRAB, which is prevalent in east China, carries a large number of drug resistance and virulence genes. Fluoroquinolones and tetracyclines may be effective antibiotics for the treatment of CRAB infection in children. An in-depth understanding of the resistance and virulence of CRAB is conducive to timely guiding empirical drug use and controlling infection.

The response of three typical freshwater algae to acute acid stress in water.

The effect of acidic pH conditions on the physiological response of three typical freshwater algae, Chlorella vulgaris, Microcystis aeruginosa and Scenedesmus quadricauda, was investigated in this study. The results of the cultivation experiment indicated that the mortality of the three algae in the logarithmic growth phase increased with increasing exposure time and acidity under acute acidic conditions. The tolerance of S. quadricauda was stronger than that of the other two species under long-term (6 h) exposure to the same acidity; in contrast, C. vulgaris exhibited the greatest tolerance under short-term exposure conditions. The decrease in chlorophyll a (Chl a) content indicated that the photosynthesis of algae was inhibited under acid stress and that the algae could not continue to grow normally. This was consistent with the changes in lipid peroxidation and antioxidant enzyme activity, which were reflected by the malondialdehyde (MDA) content and superoxide dismutase (SOD) activity under acid stress, respectively. The results of this study demonstrated that when exposed to acute acidic conditions, the tolerance of three typical freshwater algae to acidity was significantly different. These findings provide valuable information for poorly mixed acidification operations designed to adjust the pH in lakes, reservoirs, or intake pipes of purification plants.

Unprecedented and Readily Tunable Photoluminescence from Aliphatic Quaternary Ammonium Salts.

Compounds bearing aliphatic amines can be emissive under appropriate conditions. However, their ionized counterparts, namely, quaternary ammonium salts (QASs), which are widely used as phase-transfer catalysts, ionic liquids, disinfectants, and surfactants, are known as luminescence quenchers and considered nonemissive. Herein, unprecedented intrinsic fluorescence/phosphorescence dual emissions from various QASs are reported, which can be finely regulated by changing the excitation wavelength, alkyl chain length, counterion, and mechanical stimuli. The bright photoluminescence along with distinct afterglow and tunable multicolor emissions enables the application of QAS solids in advanced multimode anticounterfeiting. This finding refreshes the understanding of QASs and may inspire emerging applications based on the utilization of the intrinsic luminescences of QASs. Furthermore, it opens opportunities for the investigation of QAS-related processes and functions via a photophysical approach and affords strong implications for the fabrication of novel nonconventional luminophores.

Epidemiology and Drug Resistance of Pathogens Isolated from Cerebrospinal Fluids at a Children's Medical Center in Eastern China During 2006-2020.

OBJECTIVE: To investigate the epidemiology and drug resistance of pathogens isolated from cerebrospinal fluid samples at a children's medical center in eastern China and provide the basis for anti-infection treatments. METHODS: In all, 307 non-duplicated strains of pathogens were isolated from cerebrospinal fluid samples in the Children's Hospital of Soochow University from January 2006 to December 2020. Mass spectrometry was used for pathogen identification. The VITEK 2 Compact system and Kirby-Bauer method were applied to determine antimicrobial susceptibility. RESULTS: Among the 307 isolates, gram-positive bacteria, gram-negative bacteria and fungi accounted for 60.26%, 34.53%, and 5.21%, respectively. The most prevalent pathogens were Streptococcus pneumoniae (26.06%), Escherichia coli (20.20%) and Streptococcus agalactiae (17.26%). The number of isolates was highest in winter. The most prevalent gram-positive bacterium in children <6 months old was Streptococcus agalactiae, while Streptococcus pneumoniae was the most in children were >6 months old. The drug resistance of gram-positive bacteria, fungi and Haemophilus influenza were not high. In addition, 35 strains of gram-negative bacteria produced extended-spectrum ß-lactamases (ESBLs) and 6 strains were identified as multidrug-resistant (MDR) bacteria. These strains showed much higher resistance to the antibiotics than other strains. CONCLUSION: Cases of meningitis among children have increased in the past 15 years and MDR bacteria were also identified. The emergence of MDR bacteria is a cause for great concern and requires further investigation.

Time-Dependent Afterglow from a Single Component Organic Luminogen.

Pure organic luminogens with long-persistent luminescence have been extensively studied, on account of their fundamental research significance and diverse utilizations in anticounterfeiting, bioimaging, encryption, organic light-emitting diodes, chemo-sensing, etc. However, time-dependent color-tunable afterglow is rarely reported, especially for single-component materials. In this work, we reported an organic luminogen with time-dependent afterglow, namely, benzoyleneurea (BEU), with multiple persistent room-temperature phosphorescence (p-RTP) and thermally activated delayed fluorescence (TADF) in single crystals. While the lifetime of TADF is relatively short (~1.2 ms), those for p-RTP are as long as around 369~754 ms. The comparable but different decay rates of diversified p-RTP emissions endow BEU crystals with obvious time-dependent afterglow. The existence of multiple emissions can be reasonably illustrated by the clustering-triggered emission (CTE) mechanism. Single-crystal structure illustrates that the combination of benzene ring and nonconventional chromophores of ureide helps facilitate divergent intermolecular interactions, which contribute to the formation of varying emissive species. Moreover, its methyl- and chloro-substituted derivatives show similar multiple p-RTP emissions. However, no time-dependent afterglows are observed in their crystals, due to the highly approaching lifetimes. The afterglow color variation of BEU crystals grants its applications in advanced anticounterfeiting field and information encryption.

Simulation Guided Hand-Driven Portable Triboelectric Nanogenerator: Design, Optimisation, and Evaluation.

Inspired by the fundamental mechanics of an ancient whirligig (or buzzer toy; 3300 BC), a hand-driven rotational triboelectric nanogenerator (HDR-TENG) was designed and optimised, guided by our recently reported mathematical modelling. This modelling indicates that the power generated by HDR-TENG is a function of the number of segments, rotational speed, and tribo-surface spacing with different weighting sensitivities. Based on the simulation results, additive manufacturing technology was combined with commercially available components to cost-effectively fabricate the HDR-TENG. The fabricated HDR-TENG can provide stable and adjustable rotational speed up to 15,000 rpm with a linear hand stretching. The output voltage of HDR-TENG maintains a constant value within 50,000 cycles of testing when using Nylon 66 and PTFE as the triboelectric material. It can charge a 47 µF capacitor to 2.2 V in one minute. This study provides a cost-effective portable HDR-TENG device with adjustable high rotational speed, high power output, and long durable life, creating opportunities to provide a power supply for point-of-care devices in remote or resource-poor settings and applications in science and engineering education.

Hospitalization for Invasive Pneumococcal Diseases in Young Children before Use of 13-Valent Pneumococcal Conjugate Vaccine, Suzhou, China.

A 13-valent pneumococcal conjugate vaccine against invasive pneumococcal disease (IPD) was introduced in China in April 2017. We describe 105 children <5 years of age who were hospitalized for IPD at Soochow University Affiliated Children's Hospital in Suzhou, China, during January 2010-December 2017. We calculated the incidence of hospitalization for IPD as 14.55/100,000 children in Suzhou. We identified 8 different capsular serotypes: 6B (28.4% of cases), 14 (18.9% of cases), 19A (18.9% of cases), 19F (12.2% of cases), 23F (10.8% of cases), 20 (4.1% of cases), 9V (4.1% of cases), and 15B/C (2.7% of cases). These results provide baseline data of IPD before the introduction of this vaccine in China, enabling researchers to better understand its effects on IPD incidence.

Intrinsic Luminescence from Nonaromatic Biomolecules.

Novel emitters that do not contain traditional chromophores but only electron-rich moieties (e. g. amine, C=O, -OH, ether, and imide), which are classified as nonconventional luminophores, have been more frequently reported. Although more and more examples have been demonstrated, their emission mechanism remains unclear. The clustering-triggered emission (CTE) mechanism has previously been proposed to rationalize the luminescence of unconventional chromophores. Moreover, great attention has been paid to the distinctive inherent luminescence from nonaromatic biomolecules such as cellulose, starch, sugars, and nonaromatic amino acids and proteins. In this Review, we summarize these unconventional biomolecular luminophores and apply the CTE mechanism to rationalize such a phenomenon. This Review may shed new light on the understanding of intrinsic emission of nonaromatic biomolecules and decipher the intrinsic fluorescence from cells and tissues.

Accessing Tunable Afterglows from Highly Twisted Nonaromatic Organic AIEgens via Effective Through-Space Conjugation.

Nonaromatic, cross-conjugated, and highly twisted luminogens consisting of acylated succinimides demonstrate aggregation-induced emission characteristics along with tunable multicolor photoluminescence and afterglows in their single crystals. Effective through-space conjugation among different moieties bearing n/π electrons promote the spin-orbit coupling and intersystem crossing and lead to diverse emissive clusters with concurrently rigidified conformations, thus allowing readily tunable emissions. Derived from it, the proof-of-concept application for advanced anti-counterfeiting is illustrated. These results should spur the rational design of novel nonaromatic AIEgens, and moreover advance understandings of the non-traditional intrinsic luminescence and the origin of tunable multicolor afterglows.

Clustering-Triggered Efficient Room-Temperature Phosphorescence from Nonconventional Luminophores.

Pure organic room-temperature phosphorescence (RTP) and luminescence from nonconventional luminophores have gained increasing attention. However, it remains challenging to achieve efficient RTP from unorthodox luminophores, on account of the unsophisticated understanding of the emission mechanism. Herein, we propose a strategy to realize efficient RTP in nonconventional luminophores through incorporation of lone pairs together with clustering and effective electronic interactions. The former promotes spin-orbit coupling and boosts the consequent intersystem crossing, whereas the latter narrows energy gaps and stabilizes the triplets, thus synergistically affording remarkable RTP. Experimental and theoretical results of urea and its derivatives verify the design rationale. Remarkably, RTP from thiourea solids with unprecedentedly high efficiency of up to 24.5 % is obtained. Further control experiments testify the crucial role of through-space delocalization on the emission. These results will spur the future fabrication of nonconventional phosphors and advance the understanding of the underlying emission mechanism.

Reevaluating Protein Photoluminescence: Remarkable Visible Luminescence upon Concentration and Insight into the Emission Mechanism.

It is a textbook knowledge that protein photoluminescence stems from the three aromatic amino acid residues of tryptophan(Trp), tyrosine (Tyr), and phenylalanine (Phe), with predominant contributions from Trp. Recently, inspired by the intrinsic emission of nonaromatic amino acids and poly(amino acids) in concentrated solutions and solids, we revisited protein light emission using bovine serum albumin (BSA) as a model. BSA is virtually nonemissive in dilute solutions (≤0.1 mg mL-1 ), but highly luminescent upon concentration or aggregation, showing unique concentration-enhanced emission and aggregation-induced emission (AIE) characteristics. Notably, apart from well-documented UV luminescence, bright blue emission is clearly observed. Furthermore, persistent room-temperature phosphorescence (p-RTP) is achieved even in the amorphous solids under ambient conditions. This visible emission can be rationalized by the clustering-triggered emission (CTE) mechanism. These findings not only provide an in-depth understanding of the emissive properties of proteins, but also hold strong implications for further elucidating the basis of tissue autofluorescence.

Achieving Persistent, Efficient, and Robust Room-Temperature Phosphorescence from Pure Organics for Versatile Applications.

Pure organic persistent room-temperature phosphorescence (p-RTP) under ambient conditions is attractive but challenging due to the slow intersystem crossing process and susceptibility of triplet excitons. Fabrication of pure organic RTP luminogens with simultaneously high efficiency and ultralong lifetime still remains a daunting job, owing to their conflicting requirements for the T1 nature of (n,π*) and (π,π*) characteristics, respectively. Herein, a group of amide-based derivatives with efficient p-RTP is developed through the incorporation of spin-orbital-coupling-promoting groups of carbonyl and aromatic π units, giving impressive p-RTP with lifetime and efficiency of up to 710.6 ms and 10.2%, respectively. Furthermore, two of the luminogens demonstrate intense p-RTP after vigorous mechanical stimulation, indicating their robust nature, which is rarely encountered. Efficient and robust p-RTP even in the amorphous state endows them promising potential for encryption and bioimaging with facile fabrication processes. A bioimaging study with live mice indicates that such highly robust p-RTP is tremendously beneficial for in vivo afterglow imaging with an ultrahigh signal-to-background ratio of 428. These results strongly imply the possibility of realizing efficient and robust p-RTP from pure organics even without meticulous protection, thus paving the way to their promising and versatile applications.

Emission and Emissive Mechanism of Nonaromatic Oxygen Clusters.

Nonaromatic luminophores without remarkable conjugates have aroused great attention. Their emission mechanism, however, remains an open question. Meanwhile, previous studies generally focus on aliphatic amine and/or carbonyl-containing systems; those with merely oxygen moieties (i.e., ether, hydroxyl) are scarcely touched. Recently, the clustering-triggered emission (CTE) mechanism is proposed to rationalize the emission of nonconventional luminophores, according to which compounds bearing purely oxygen moieties can also be emissive. To check this conjecture, herein, both nonaromatic compound of xylitol and polymers of PEG and F127 are studied, which are found to be emissive in concentrated solutions and solids. Furthermore, cryogenic-persistent phosphorescence of the compounds and even persistent room temperature phosphorescence of xylitol crystals are observed. Additionally, their potential application as Fe3+ sensors is demonstrated. These results not only verify the rationality of the CTE mechanism but also suggest the possibility to discover and design new luminophores according to it.

Genetic effects of released swimming crab (Portunus trituberculatus) on wild populations inferred from mitochondrial control region sequences.

Along the coast of Shandong Province in China, an extensive hatchery-release programme has been conducted for more than 10 years. However, no information has been reported concerning the long-term effects on the wild population resulting from the release of large numbers of juveniles in Portunus trituberculatus. In this study, sequence variation of swimming crab P. trituberculatus based on the mitochondrial control region was investigated for 946 swimming crabs at the releasing sites from 2012 to 2014. The result showed that the wild P. trituberculatus was characterized by high genetic diversity indices, and not significantly different from the previous study. Low FST values were estimated among the groups of different years and different sites, which suggested no genetic differentiation found in the wild population after the stock enhancement programme. Hence, the long-term extensive hatchery release programme has not affected the genetic structure of wild P. trituberculatus populations along the coast of Shandong Province.

Prevalence and characterization of hepatitis B and C virus infections in a needle-sharing population in Northern China.

BACKGROUND: The epidemiologies of hepatitis C virus (HCV) and hepatitis B virus (HBV) infections in specific populations in certain areas of China are poorly understood. A pilot survey of HCV/HBV infections was carried out in villages in Kuancheng County, Heben Province, where injection of sodium benzoate or amphetamines using shared needles has been a common practice. The aims of this study were to analyze the endemicity and characterize HCV/HBV infections in this population. METHODS: Data on demographic characteristics and drug abuse were collected from individuals who signed informed consent forms. Serum HCV antibody (anti-HCV), hepatitis B surface antigen (HBsAg), and hepatitis B core antibody (anti-HBc) were measured in all participants. HCV RNA was measured in samples positive for anti-HCV using real-time polymerase chain reaction. RESULTS: Among 852 participants from 11 villages, 49.9% had used sodium benzoate or amphetamine at least once, by intravenous injection. The overall prevalence of anti-HCV, HCV RNA, anti-HBc, HBsAg, and HCV/HBV co-infection was 37.1%, 26.6%, 67.7%, 10.7%, and 30.0%, respectively. Two-hundred-twenty-three of 227 (98.2%) participants positive for HCV RNA were aged >40 years. Co-infection was related to sex, age, number of injections, and time from first injection. The rate of spontaneous HCV RNA clearance was 28.2% (89/316), and was related to the number of injections, time from first injection, and HBsAg positivity. However, HBsAg was related to the anti-HBc signal/cut-off ratio rather than to the above parameters. Trend tests demonstrated that the prevalence of anti-HCV, HCV RNA, and anti-HBc was related to the number of injections (P < 0.001), while HBsAg prevalence was not (P = 0.347). CONCLUSIONS: The prevalence of HCV and HBV infection is likely to be high among individuals older than 40 years in areas of needle sharing, and one-time screening for HCV infection should be offered to these populations.

[Leukotriene receptor antagonist as add-on therapy to intranasal corticosteroids in the treatment of allergic rhinitis: a systematic review].

OBJECTIVE: To systematically evaluate the efficacy and safety of leukotriene receptor antagonist (LTRA) combined intranasal corticosteroids in the treatment of allergic rhinitis (AR). METHOD: The randomized controlled trials (RCT) about the combined therapy of LTRA and nasal corticosteroids from January 1985 to May 2014 were searched in OVID, PubMed, EMBASE, CNKI, WanFang Data, and Cochrane Library. Two reviewers independently screened the literatures, extracted the data, and evaluated the methodological quality. Then meta-ana- lyses were conducted by using RevMan 5.1 software. RESULT: A total of 5 RCTs were included upon literature search. The results of meta-analyses showed that the efficacy of nasal corticosteroids plus LTRA was superior to nasal corticosteroids alone in total nasal symptom scores and individual nasal symptom scores (rhinorrhea, sneezing) [WMD = -4.49, 95% CI (-4.95(-)-4.03)-, P < 0.01; WMD = -0.43, 95% CI (-0.78(-)-0.07), P < 0.05; WMD = -0.10, 95% CI (-0.6(-)-0. 04), P < 0.01], with significant differences. However, compa- ring the subgroup treated with nasal corticosteroids combined LTRA against the subgroup treated with nasal corti- costeroids alone, we found no significant differences for RQLQ score and for individual nasal symptom scores (nasal blockage, nasal itching) [WMD = -15.19, 95% CI (-55.37(-)-25. 00), P > 0.05; WMD = 0.01, 95% CI(-) 0.06-0.08), P > 0. 05; WMD = -0.15,95% CI (-0.43(-)-0.13), P > 0.05]. CONCLUSION: Based on limited evidence, we preliminary concluded the combined therapy of nasal corticosteroids and LTRA was more effective than nasal corticosteroids alone in the management of AR. Further large-scale, well-designed RCTs were still required to validate the add-on efficacy of LTRA for AR patients.

Etiology and epidemiology of children with acute otitis media and spontaneous otorrhea in Suzhou, China.

BACKGROUND: There are scare data about bacterial etiology and the antibiotic susceptibility, serotype distribution and molecular characteristics of pneumococci in children with acute otitis media (AOM) in China. METHODS: A prospective study was conducted in Suzhou University Affiliated Children's Hospital. All children under 18 years of age diagnosed as AOM and with spontaneous otorrhea were offered enrollment, and collection of middle ear fluid was then cultured for bacterial pathogens. The antibiotic susceptibility, serotypes, macrolide resistance genes and sequence types of Streptococcus pneumoniae strains were identified. RESULTS: From January 2011 to December 2013, a total of 229 cases of AOM with spontaneous otorrhea were identified; of these, 159 (69.4%) middle ear fluid specimens were tested positive for bacterial pathogens. The leading cause was S. pneumoniae (47.2%), followed by Staphylococcus aureus (18.8%) and Haemophilus influenzae (7.4%). The antibiotic resistance rates of S. pneumoniae isolates to erythromycin were 99.1%, and the nonsusceptible rate to penicillin was 54.6%. The most common serotypes identified were 19A (45.1%) and 19F (35.4%). The coverage against PCV7 serotypes for this outcome was 56.1% and of PCV13 was 97.6%. The macrolide resistance was mainly mediated by both ermB and mefA/E genes (88.6%). The CC271 was the major clonal complex identified. CONCLUSIONS: S. pneumoniae was a leading cause for AOM in children in Suzhou, China. Antibiotics resistance rates of S. pneumoniae were high and mainly due to the spread of CC271 clonal complex.