Role of Surface Tension on Heat Feedback and Power from Energetic Composites.

Heat feedback to the unburned reaction interface is an important controlling factor of the velocity of the reaction front and power delivery. In this paper, we investigate the effect of agglomerate surface tension and its relationship to surface residence time and heat feedback on the combustion characteristics by Si addition to an Al/KClO4 composite. Macroscopic imaging demonstrates a significant increase in burn rate with the addition of Si despite the fact that Si/KClO4 has a slightly lower energy density than Al/KClO4. Microscopic imaging coupled with three-color pyrometry reveals that molten liquid forms and evolves into spherical droplets on the burning surface, which are subsequently ejected from the surface. We find that the addition of Si results in a small increase in droplet size and a negligible impact on droplet temperature. However, the droplet formation rate on the surface is slower, leading to a significantly longer surface residence time. This leads to enhanced conductive heat feedback to the unburnt materials, thereby increasing the burn rate and energy release rate. We attribute the decreased droplet growth rate to the lowered surface tension of the liquid mixture with Si addition. This study highlights the crucial role of agglomerate physical property (e.g., surface tension) in influencing the combustion behavior of energetic composites.

Controlled Release of Diborane from Alkali Metal Borohydride using Ionic Liquid-Based Lewis Acids.

Alkali metal borohydrides present a rich source of energy dense materials of boron and hydrogen, however their potential in propellants has been hitherto untapped. Potassium borohydride is a promising fuel with high gravimetric energy density and relatively low sensitivity to air and moisture. Problems arise due to the dehydrogenation of the borohydride on heating with minimal energy release. Common methods to extract both boron and hydrogen by means of borane species involve direct reaction of boron trifluoride species with alkali borohydrides. However, these methods face storage and safety issues due to rapid release of diborane on mixing the reactants. We propose a method of diborane release through controlled release of boron trifluoride by means of a tetrafluoroborate based ionic liquid. The trifluoride is released from the ionic liquid at elevated temperatures and enables safe mixture of the reactants at room temperature. It was found that the reaction between borohydride and boron trifluoride proceeds well above room temperature with potassium borohydride releasing diborane and potassium fluoride. The reaction pathway shows a primary reaction releasing diborane and potassium fluoride and a second less energy efficient step leading to the formation of potassium tetrafluoroborate. A 3D printed propellant formulation was also tested.

Hydrothermal synthesis of high crystallinity ZSM-5 zeolite from coal gasification coarse slag and mother liquor circulation for efficient coal chemical wastewater purification.

A hydrothermal synthesis method was developed to produce high crystallinity ZSM-5 zeolite using coal gasification coarse slag (CGCS) as the raw material. Instead of the expensive NaOH(s.), Na2SiO3(s.) was utilized to activate, depolymerize, and recombine Si and Al elements in the CGCS. The mother liquor circulation technology was employed to recover and reuse raw materials and residual reagents (Na2SiO3(aq.) and TPABr), reducing waste emissions and enhancing resource utilization efficiency. The synthesized ZSM-5 had a specific surface area of 455.675 m2 g-1, pore volume of 0.284 cm3 g-1, and pore diameter of 2.496 nm. The influence of various factors on the morphology and crystallinity of ZSM-5 was investigated, resulting in the production of ZSM-5 with higher specific surface area and pore volume. Adsorption experiments showed that WU-ZSM-5 exhibited a removal efficiency of 85% for ammonia nitrogen (NH4+-N(aq.)), validating its effectiveness in coal chemical wastewater purification. The mother liquor recycling technology enabled zero-emission utilization of solid waste resources and improved the utilization rate of alkali and template to 90%. These results demonstrate the potential application of the developed method in the efficient treatment of coal chemical wastewater.

Ultrahigh-Performance Fiber-Supported Iron-Based Ionic Liquid for Synthesizing 3,4-Dihydropyrimidin-2-(1H)-ones in a Cleaner Manner.

Herein, a fiber-supported iron-based ionic liquid as a type of fibrous catalyst has been developed for the synthesis of bioactive 3,4-dihydropyrimidin-2-(1H)-ones (DHPMs) via three-component Biginelli reactions in a cleaner manner. The described fibrous catalyst was obtained from the commercially available polyetheretherketone (PEEK) fiber by postfunctionalization processes and was characterized and analyzed in detail by means of diversified technologies. Furthermore, the fiber-supported iron-based ionic liquids could mediate the classical three-component Biginelli reactions to proceed smoothly to gain a variety of substituted DHPMs with yields of up to 99%. The superior catalytic activities of the fibrous catalyst were ascribed to the quasi-homogeneous medium by ionic liquids generated in the surface layer of the PEEK fiber, which could afford an appropriate reaction zone and could further be available for the aggregation of substrates to facilitate the three-component reaction. Notably, the fibrous catalyst is available for recycling over 10 runs just by a pair of tweezers, and the operational procedure was capable of enlarging the catalytic system to the gram-scale without any performance degradation, which provided a cleaner manner to take advantage of the iron-based catalyst in organic synthesis with potential industrialization prospects.

Vancomycin heteroresistance caused by unstable tandem amplifications of the vanM gene cluster on linear conjugative plasmids in a clinical Enterococcus faecium.

Vancomycin heteroresistance is prone to missed detection and poses a risk of clinical treatment failure. We encountered one clinical Enterococcus faecium strain, SRR12, that carried a complete vanM gene cluster but was determined as susceptible to vancomycin using the broth microdilution method. However, distinct subcolonies appeared within the clear zone of inhibition in the E-test assay, one of which, named SRR12-v1, showed high-level resistance to vancomycin. SRR12 was confirmed as heteroresistant to vancomycin using population analysis profiling and displayed "revive" growth curves with a lengthy lag phase of over 13 hours when exposed to 2-32 mg/L vancomycin. The resistant subcolony SRR12-v1 was found to carry an identical vanM gene cluster to that of SRR12 but a significantly increased vanM copy number in the genome. Long-read whole genome sequencing revealed that a one-copy vanM gene cluster was located on a pELF1-like linear plasmid in SRR12. In comparison, tandem amplification of the vanM gene cluster jointed with IS1216E was seated on a linear plasmid in the genome of SRR12-v1. These amplifications of the vanM gene cluster were demonstrated as unstable and would decrease accompanied by fitness reversion after serial passaging for 50 generations under increasing vancomycin pressure or without antibiotic pressure but were relatively stable under constant vancomycin pressure. Further, vanM resistance in resistant variants was verified to be carried by conjugative plasmids with variable sizes using conjugation assays and S1-pulsed field gel electrophoresis blotting, suggesting the instability/flexibility of vanM cluster amplification in the genome and an increased risk of vanM resistance dissemination.

Enhanced performance of acridine degradation and power generation by microbial fuel cell with g-C3N4/PANI-DA/CF anode.

Microbial fuel cell (MFC) has attracted much attention in treating organic wastewater due to its double functions of degrading organics and generating electricity with microorganisms as biocatalysts. Unfortunately, some organics with biological toxicity such as acridine could inhibit the growth and activity of the microorganisms on the anode so that the double functions of MFC would recede. Enhancing microbial activity by using new biocompatible materials as anodes is prospective to solve problem. A novel anode was achieved by electrodepositing g-C3N4 sheets to the carbon felt (CF) modified with polyaniline-dopamine composite film, and used to treat wastewater containing acridine for the first time. After the operation of 13 d, MFC loading with the composite anode showed a degradation efficiency of 98.3% in 150 mg L-1 acridine, while that of CF-MFC was 55.8%. Moreover, MFC loading the modified anode obtained a maximum power density of 1976 ± 47 mW m-2, 140.1% higher than that of CF-MFC. Further analysis revealed that the functional microorganisms associated with acridine degradation such as Achromobacter and Alcaligenes were enriched on the g-C3N4/PANI-DA/CF anode. Moreover, the composite anode could improve the activity of microorganisms and elicit them to generate conductive nanowires, which was beneficial to transferring electrons from microbes to anode over long distances, suggesting a promising prospect application in MFC.

Immobilization of two dendritic organic phases onto silica and their molecular shape recognition for polycyclic aromatic hydrocarbons, tocopherols and carotenoid isomers.

BACKGROUND: Molecular shape selectivity, based on the size and shape parameters of the molecule, such as length and planarity, is a separation process that can be used for compounds with restricted shapes, such as isomers. The separation of geometric isomers is challenging because these compounds have similar physicochemical properties but differ slightly in molecular shape. The ability to separate and quantify these isomers is important in high performance liquid chromatography (HPLC), which is one of the most widely used techniques in separation science today, because the shape of the molecule has a strong influence on biological processes. RESULTS: We prepared symmetrical discoidal dendrimeric organomolecule gelators (GSDM) and o-phenylenediamine-derived low-molecular-weight dendrimeric organomolecule gelators (G1) and bonded them to silica surfaces. The dendritic organic compound-grafted silica (SiO2@GSDM and SiO2@G1) was used as HPLC stationary phases for the separation of shape-restricted isomers of polycyclic aromatic hydrocarbons (PAHs), carotenoids and tocopherols. The two phases exhibit a very high molecular shape selectivity compared to the commercially available alkyl phases. There are differences in molecular shape selectivity between the two stationary phases. Changes in the chemical structure of dendritic organic compounds can alter the orientation of the molecules, as well as changes in the molecular recognition ability. It was found that SiO2@GSDM has high molecular linear selectivity for PAHs at different temperatures, even at 50 °C. The planar selectivity of SiO2@GSDM was better for triphenylene and o-terphenyl benzenes compared to SiO2@G1. SIGNIFICANCE: This separation behavior may be attributed to the combined effect of weak interaction centers, which allowed the effective separation of bioactive and shape-restricted isomers through multiple interactions. Furthermore, SiO2@GSDM showed better separation of tocopherols and carotenoids, suggesting that the backbone and ordered structure of organic molecular gelators is an effective way to improve the shape selectivity of the molecules, whereas the molecular orientation of the functional groups influences the separation mechanism of the shape-restricted isomers.

Characterisation of a Novel Hybrid IncFIIpHN7A8:IncR:IncN Plasmid Co-Harboring blaNDM-5 and blaKPC-2 from a Clinical ST11 Carbapenem-Resistant Klebsiella pneumoniae Strain.

Purpose: We aimed to characterize a novel blaNDM-5 and blaKPC-2 co-carrying hybrid plasmid from a clinical carbapenem-resistant Klebsiella pneumoniae (CRKP) strain. Methods: Antimicrobial susceptibility was determined by the broth microdilution method. Plasmid size and localization were estimated using S1 nuclease pulsed-field gel electrophoresis (S1-PFGE) and Southern blotting. Plasmid transfer ability was evaluated by conjugation experiments. Whole genome sequencing (WGS) was performed using Illumina NovaSeq6000 and Oxford Nanopore MinION platforms. Genomic characteristics were analyzed using bioinformatics methods. Results: Strain ZY27320 was a multidrug-resistant (MDR) clinical ST11 K. pneumoniae strain that confers high-level resistance to carbapenems (meropenem, MIC 128 mg/L; imipenem, MIC 64 mg/L) and ceftazidime/avibactam (MIC >128/4 mg/L). Both S1-PFGE-Southern blotting and whole genome sequencing revealed that the carbapenemase genes blaKPC-2 and blaNDM-5 were carried by the same IncFIIpHN7A8:IncR:IncN hybrid plasmid (pKPC2_NDM5). Conjugation experiments indicated that pKPC2_NDM5 was a non-conjugative plasmid. Conclusion: This is the first report of a hybrid plasmid carrying both carbapenemase genes blaNDM-5 and blaKPC-2 in a clinical K. pneumoniae ST11 isolate that confers resistance to both ceftazidime/avibactam and carbapenems, thereby presenting a serious threat to treatment in clinical practice.

Single-atom nanozymes: classification, regulation strategy, and safety concerns.

Nanozymes, nanomaterials possessing enzymatic activity, have been studied extensively by researchers. However, their complex composition, low density of active sites, and inadequate substrate selectivity have hindered the maturation and widespread acceptance of nanozymes. Single-atom nanozymes (SAzymes) with atomically dispersed active sites are leading the field of catalysis due to their exceptional performance. The maximum utilization rate of atoms, low cost, well-defined coordination structure, and active sites are the most prominent advantages of SAzymes that researchers favor. This review systematically categorizes SAzymes based on their support type and describes their specific applications. Additionally, we discuss regulation strategies for SAzyme activity and provide a comprehensive summary of biosafety challenges associated with these enzymes.

[Sn2S6]4- Anion-Intercalated Layered Double Hydroxides for Highly Efficient Capture of Iodine.

The development of low-cost and high-efficiency iodine sorbents is of great significance for the control of nuclear pollution. In this work, we intercalate the tin sulfide cluster of [Sn2S6]4- to Mg/Al-type layered double hydroxides to obtain Sn2S6-LDH, which exhibits highly efficient capture performance of iodine vapor and iodine in solutions. The dispersion effect of the positively charged LDH layers contributes to the adequate exposure of [Sn2S6]4- anions, providing plentiful adsorption sites. For iodine vapor, Sn2S6-LDH showed an extremely large iodine capture capacity of 2954 mg/g with a large contribution from physisorption. For iodine in solutions, a significantly large sorption capacity of 1308 mg/g was achieved. During iodine capture, I2 molecules were reduced to I- ions (by S2- in [Sn2S6]4-), which then reacted with Sn4+ to form SnI4, where the molar amount of captured iodine is 4-fold that of Sn. Besides, the as-reduced I- combined with I2 again to generate [I3]-, which then entered the LDH interlayers to maintain electric neutrality. While reducing iodine, S2- itself in [Sn2S6]4- was oxidized to S8, which further combined with SnI4 to form a novel compound of SnI4(S8)2. The excellent iodine capture capability endows Sn2S6-LDH with a promising application in trapping radioactive iodine.

Stretchable ultrasonic arrays for the three-dimensional mapping of the modulus of deep tissue.

Serial assessment of the biomechanical properties of tissues can be used to aid the early detection and management of pathophysiological conditions, to track the evolution of lesions and to evaluate the progress of rehabilitation. However, current methods are invasive, can be used only for short-term measurements, or have insufficient penetration depth or spatial resolution. Here we describe a stretchable ultrasonic array for performing serial non-invasive elastographic measurements of tissues up to 4 cm beneath the skin at a spatial resolution of 0.5 mm. The array conforms to human skin and acoustically couples with it, allowing for accurate elastographic imaging, which we validated via magnetic resonance elastography. We used the device to map three-dimensional distributions of the Young's modulus of tissues ex vivo, to detect microstructural damage in the muscles of volunteers before the onset of soreness and to monitor the dynamic recovery process of muscle injuries during physiotherapies. The technology may facilitate the diagnosis and treatment of diseases affecting tissue biomechanics.

Recent advances in g-C3N4-based photo-enzyme catalysts for degrading organic pollutants.

In recent years, photocatalytic reactions have shown great potential in degrading organic pollutants because of their simple operation and no secondary pollution. Graphitic carbon nitride (g-C3N4) is one of the most frequently used photocatalyst materials in the field of photocatalysis because it is a form of photocatalytic material with facile synthesis, no metal, visible light response, and strong stability. Enzyme-catalyzed degradation has received extensive attention due to its broad selectivity, high efficiency, and environmental friendliness. Horseradish peroxidase (HRP), one of several oxidoreductases utilized for pollutant degradation, has a wide range of applications due to its mild reaction conditions and high stability. Exploring efficient platforms for immobilizing g-C3N4 and HRP to develop photo-enzyme-coupled catalysis is an attractive practical topic. The coupling effect of g-C3N4 and HRP improves the carrier separation efficiency and generates more active species, which finally realize the solar-driven non-selective destruction of organic pollutants. We describe the alteration of g-C3N4 and the immobilization of HRP in detail in this study, and we outline recent developments in the photo-enzyme coupling of g-C3N4 and HRP.

A wearable cardiac ultrasound imager.

Continuous imaging of cardiac functions is highly desirable for the assessment of long-term cardiovascular health, detection of acute cardiac dysfunction and clinical management of critically ill or surgical patients1-4. However, conventional non-invasive approaches to image the cardiac function cannot provide continuous measurements owing to device bulkiness5-11, and existing wearable cardiac devices can only capture signals on the skin12-16. Here we report a wearable ultrasonic device for continuous, real-time and direct cardiac function assessment. We introduce innovations in device design and material fabrication that improve the mechanical coupling between the device and human skin, allowing the left ventricle to be examined from different views during motion. We also develop a deep learning model that automatically extracts the left ventricular volume from the continuous image recording, yielding waveforms of key cardiac performance indices such as stroke volume, cardiac output and ejection fraction. This technology enables dynamic wearable monitoring of cardiac performance with substantially improved accuracy in various environments.

A photoacoustic patch for three-dimensional imaging of hemoglobin and core temperature.

Electronic patches, based on various mechanisms, allow continuous and noninvasive monitoring of biomolecules on the skin surface. However, to date, such devices are unable to sense biomolecules in deep tissues, which have a stronger and faster correlation with the human physiological status than those on the skin surface. Here, we demonstrate a photoacoustic patch for three-dimensional (3D) mapping of hemoglobin in deep tissues. This photoacoustic patch integrates an array of ultrasonic transducers and vertical-cavity surface-emitting laser (VCSEL) diodes on a common soft substrate. The high-power VCSEL diodes can generate laser pulses that penetrate >2 cm into biological tissues and activate hemoglobin molecules to generate acoustic waves, which can be collected by the transducers for 3D imaging of the hemoglobin with a high spatial resolution. Additionally, the photoacoustic signal amplitude and temperature have a linear relationship, which allows 3D mapping of core temperatures with high accuracy and fast response. With access to biomolecules in deep tissues, this technology adds unprecedented capabilities to wearable electronics and thus holds significant implications for various applications in both basic research and clinical practice.

Co-immobilized bienzyme of horseradish peroxidase and glucose oxidase on dopamine-modified cellulose-chitosan composite beads as a high-efficiency biocatalyst for degradation of acridine.

Co-immobilized bienzyme biocatalysts are attracting increasing interest in the field of wastewater treatment due to their widespread application. In this study, we successfully prepared a co-immobilized bienzyme biocatalyst by immobilizing horseradish peroxidase (HRP) and glucose oxidase (GOD) on dopamine (DA) modified cellulose (Ce)-chitosan (Cs) composite beads via covalent binding, designated as Ce-Cs@DA/HRP-GOD beads, and found that the bienzyme biocatalyst had a good ability to catalytically degrade acridine in wastewater. SEM, EPR, FTIR, and XRD were used to characterise the structure and properties of the Ce-Cs@DA/HRP-GOD beads. The co-immobilized bienzyme biocatalyst with a small amount of HRP exhibited better degradation efficiency for acridine (99.5%, 8 h) in simulated wastewater compared to the Ce-Cs@DA/HRP (93.8%, 8 h) and Ce-Cs@DA/GOD (15.8%, 8 h) beads alone. In addition, a reusability study showed that the co-immobilized bienzyme biocatalyst maintained a degradation rate of 61.2% after six cycles of acridine degradation. The good biodegradability and reusability of the biocatalyst might be due to the synergistic effect of bienzyme HRP-GOD, including the strong covalent bonding. Accordingly, the co-immobilized bienzyme biocatalyst based on the cascade reaction may pave the way for efficient and eco-friendly treatment of industrial wastewater.

The confinement effect of layered double hydroxides on intercalated pyromellitic acidic anions and highly selective uranium extraction from simulated seawater.

Oxygen-rich pyromellitic acidic anions (PMA4-) have been intercalated into MgAl-layered double hydroxides to fabricate the MgAl-PMA-LDH (abbr. PMA-LDH) composite exhibiting excellent adsorption performance toward uranium (U(VI)). Benefiting from the large number of functional groups of -COO-, the PMA-LDH displays an extremely large maximum U adsorption capacity (qUm) of 352 mg g-1 and an ultra-fast sorption rate, reaching uptakes of ∼97% within 30 min and >99% in 1 h at the initial U concentration (CU0) of 113 ppm. Over a very wide pH range of 5-11, high U removals (>93%) are achieved at CU0 = 105 ppm. Moreover, in the presence of highly concentrated competitive ions, ultra-high selectivity of UO22+ is observed, giving a very large distribution coefficient (Kd) of ∼106 mL g-1. Moreover, the PMA-LDH exhibits effective capture of UO22+ in contaminated simulated seawater, showing high uptakes of >93% at CU0 ∼ 10 ppm and >98% at CU0 ∼ 100 ppm. The dispersion effect of LDH layers may contribute to the increase of U adsorption capacity, and the confinement effect of LDH is conducive to the improvement of sorption selectivity toward U. The exploration of the interaction mechanism of UO22+ with PMA4- confined within the LDH gallery offers an important basis for the fabrication of new kinds of organic/inorganic hybrid materials. The PMA-LDH is a highly effective adsorbent which can be applied to uranium extraction from seawater and uranium disposal in nuclear wastewater.

Epidemiology, evolution and cryptic susceptibility of methicillin-resistant Staphylococcus aureus in China: a whole-genome-based survey.

OBJECTIVES: The aim of this study was to investigate the genomic epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) in China to identify predominant lineages and their associations with clinical data and antimicrobial resistance profiles. METHODS: We performed a national prevalence study of patients with S. aureus infections in 22 tertiary hospitals in China from 2015 to 2017. Clinical data from patients and the antimicrobial phenotypes were collected for each isolate. Genome sequencing was performed on a proportion of isolates and a phylogenetic analysis was undertaken. Genotypic and phenotypic ß-lactam susceptibilities were compared. RESULTS: A total of 1900 patients with S. aureus infections were included, of which 40% involved MRSA. Community-associated MRSA (CA-MRSA) infections were 24% of the total isolates. Genomic data showed that more than three-quarters of the MRSA were from three dominant lineages CC239 (25%, 116/471), CC5 (21%, 96/471) and CC59 (33%, 154/471) with CC59 accounting for more than half of the CA-MRSA isolates. Penicillin susceptibility genomic features were observed in 53% (251/470) of MRSA, including almost all of the CC59 (152/154) lineage, and 96% (242/251) of these isolates demonstrated in vitro susceptibility to penicillin or amoxicillin combined with clavulanic acid. Phylogenetic analysis indicated that the CC59 lineage can be divided into six lineages with all Asian CC59 isolates likely arising from an ancestral Mainland China lineage. CONCLUSIONS: This study showed a high prevalence of CA-MRSA in China, largely due to the widespread presence of CC59. As almost all isolates in this lineage possess genetic variants leading to increased ß-lactam susceptibility, we suggest that to improve antibiotic stewardship combinations of penicillins and ß-lactamase inhibitors should be included in the antibiotic susceptibility testing panels used to inform treatment decisions and research undertaken on this combination therapy.

Mo3 S13 2- Intercalated Layered Double Hydroxide: Highly Selective Removal of Heavy Metals and Simultaneous Reduction of Ag+ Ions to Metallic Ag0 Ribbons.

We demonstrate a new material by intercalating Mo3 S13 2- into Mg/Al layered double hydroxide (abbr. Mo3 S13 -LDH), exhibiting excellent capture capability for toxic Hg2+ and noble metal silver (Ag). The as-prepared Mo3 S13 -LDH displays ultra-high selectivity of Ag+ , Hg2+ and Cu2+ in the presence of various competitive ions, with the order of Ag+ >Hg2+ >Cu2+ >Pb2+ ≥Co2+ , Ni2+ , Zn2+ , Cd2+ . For Ag+ and Hg2+ , extremely fast adsorption rates (≈90 % within 10 min, >99 % in 1 h) are observed. Much high selectivity is present for Ag+ and Cu2+ , especially for trace amounts of Ag+ (≈1 ppm), achieving a large separation factor (SFAg/Cu ) of ≈8000 at the large Cu/Ag ratio of 520. The overwhelming adsorption capacities for Ag+ (qm Ag =1073 mg g-1 ) and Hg2+ (qm Hg =594 mg g-1 ) place the Mo3 S13 -LDH at the top of performing sorbent materials. Most importantly, Mo3 S13 -LDH captures Ag+ via two paths: a) formation of Ag2 S due to Ag-S complexation and precipitation, and b) reduction of Ag+ to metallic silver (Ag0 ). The Mo3 S13 -LDH is a promising material to extract low-grade silver from copper-rich minerals and trap highly toxic Hg2+ from polluted water.

Etiology and prevalence of ESBLs in adult community-onset urinary tract infections in East China: A prospective multicenter study.

OBJECTIVES: Community onset urinary tract infections (COUTIs) drew attention recently owing to their increased prevalence and associations with resistant pathogens. The study is aimed at investigating the etiology of COUTIs as well as prevalence and the related risk factors of extended-spectrum ß-lactamase (ESBL) in COUTIs in China. METHODS: The prospective study was performed in nineteen hospitals during November 1, 2017 and August 31, 2019. Non-duplicated isolates from COUTIs were included. The ESBL phenotypic confirmation test was performed and whole genomes were sequenced for all the ESBL-positive bacteria for further analysis. The risk factors for ESBL-producing bacterial infections were analyzed using binary logistic regression. RESULTS: A total of 1760 COUTI cases were included in this study. Escherichia coli (1332, 75.7%), Klebsiella pneumoniae (110, 6.3%) and Enterococcus faecalis (52, 3.0%) were the top three common pathogens of COUTIs in China. The overall positive rate of ESBLs in Enterobacterales was 37.2% (562/1512). The age (OR=1.007, P = 0.041), solid malignant tumor (OR=1.668, P = 0.016), prostate diseases (OR=2.035, P = 0.010), history of lithotripsy for urinary calculi (OR=2.009, P = 0.030), history of urological surgery (OR=1.869, P = 0.009) and cephalosporin use within 3 months (OR=1.503, P = 0.025) were independent risk factors for ESBL-producing organisms causing COUTIs. The predominant ESBL types were CTX-Ms, among which CTX-M-14, CTX-M-55 and CTX-M-27 were the most common subtypes. ST131 and ST1193 were the predominant sequence types of ESBL-producing E. coli (ESBL-EC). Most of the tested antimicrobial agents showed significantly higher non-susceptible rates in the ESBL positive group as compared with ESBL-negative group (P < 0.05). CONCLUSIONS: Enterobacterales, especially E. coli, is the most common pathogen in COUTIs in China and ESBL-producers are highly prevalent. Thus, early prediction depending on risk factors seems to be crucial to determine the appropriate empirical therapy for infections caused by ESBL-producing pathogens.

Novel tigecycline resistance mechanisms in Acinetobacter baumannii mediated by mutations in adeS, rpoB and rrf.

Acinetobacter baumannii is an important pathogen in hospital acquired infections. Although tigecycline currently remains a potent antibiotic for treating infections caused by multidrug resistant A. baumannii (MDRAB) strains, reports of tigecycline resistant isolates have substantially increased. The resistance mechanisms to tigecycline in A. baumannii are far more complicated and diverse than what has been described in the literature so far. Here, we characterize in vitro-selected MDRAB strains obtained by increasing concentrations of tigecycline. We have identified mutations in adeS, rrf and rpoB that result in reduced susceptibility to tigecycline. Using in situ complementation experiments, we confirm that mutations in rrf, rpoB, and two types of mutations in adeS correlate with tigecycline resistance. By Western blot and polysome profile analysis, we demonstrate that the rrf mutation results in decreased expression of RRF, which affects the process of ribosome recycling ultimately leading to increased tigecycline tolerance. A transcriptional analysis shows that the mutated rpoB gene plays a role in regulating the expression of the SAM-dependent methyltransferase (trm) and transcriptional regulators, to confer moderate tigecycline resistance. This study provides direct in vitro evidence that mutations in the adeS, rpoB and rrf are associated with tigecycline resistance in A. baumannii.