Detection of SARS-CoV-2 can be difficult and patients can be co-infected with influenza A virus and COVID-19.

The genus Nocardia has the potential to cause nocardiosis, which might be underrecognized and underdiagnosed. Herein, the demographical features of 441 nonrepetitive nocardiosis cases and species distribution of their Nocardia strains in China, 2009 to 2021, are summarized.

Streptococcus pyogenes, or group A Streptococcus, is a pathogen responsible for a wide range of clinical manifestations, from mild skin and soft tissue infections and pharyngitis to severe diseases. Its epidemiological characteristics should be comprehensively under surveillance for regulating the national prevention and treatment practice. Herein, a total of 140 S. pyogenes, including 38 invasive and 102 noninvasive isolates, were collected from infected patients in 10 tertiary general hospitals from 7 cities/provinces in China during the years 2009 to 2016. All strains were characterized by classical and molecular techniques for its emm types/subtypes, virulent factors and antibiotic resistance profiling. Of 140 isolates, 15 distinct emm types and 31 subtypes were detected, dominated by emm12 (60 isolates, 42.9%), emm1(43, 30.7%) and emm89 (10, 7.1%), and 8 new emm variant subtypes were identified. All strains, invasive or not, harboured the superantigenic genes, speB and slo. The other virulence genes, smeZ, speF and speC accounted for 96.4%, 91.4% and 87.1% of collected isolates, respectively. Further multilocus sequence typing (MLST) placed all strains into 22 individual sequence types (STs), including 4 newly-identified STs (11, 7.9%). All isolates were phenotypically susceptible to penicillin, ampicillin, cefotaxime, and vancomycin, whereas 131(93.5%), 132(94.2%), and 121(86.4%) were resistant to erythromycin, clindamycin, and tetracycline, respectively. Our study highlights high genotypic diversity and high prevalence of macrolide resistance of S. pyogenes among clinical isolates circulating in China.

KPC and NDM co-producing carbapenem-resistant Klebsiella pneumoniae (KN-CRKP) showed an upward trend; nevertheless, global systematic and comprehensive analyses profiling remain lacking. 968 local CRKP were collected from 6 provinces in China, and 64,354 genomes were retrieved from GenBank. All 413 genomes of KN-CRKP were obtained from 32 countries, including 16 subtypes of KN-CRKP. The top three CRKP subtypes, K2N1-CRKP, K2N5-CRKP and K3N1-CRKP, exhibited distinct geographic distributions, with K2N1-CRKP and K2N5-CRKP primarily circulating in China while K3N1-CRKP showed predominant prevalence in USA. Meanwhile, ST11-KL64, ST11-KL47, and ST258-KL107, were the three most prevalent ST and KL, and 64.3% of ST11-KL64 KN-CRKP belonged to hypervirulent strains. Genomes revealed Clone Group 1, accounting for 55.0% of KN-CRKP, shifting from KL47 to KL64 and carrying more hypervirulence genes, has a significant advantage in adhesion, invasion, and proliferation, and its dispersal was the primary driver contributing to the worldwide spread of KN-CRKP. Furthermore, ST11 KN-CRKP was generally formed by KPC-producing CRKP acquiring bla_NDM-carrying plasmid and novel hybrid plasmids co-encoding KPC and NDM have occurred. Aztreonam/avibactam and cefiderocol were promising antimicrobial agents against KN-CRKP. The global KN-CRKP research, spanning from 2005 to 2024, provides valuable insights into the global transmission, dynamics, and treatment of KN-CRKP.