The emergence and spread of New Delhi metallo-␤-lactamase 1 (NDM-1)-producing carbapenem-resistant Enterobacteriaceae (CRE) present an urgent threat to human health. In China, the bla NDM-1 gene has been reported mostly in Acinetobacter spp. but is rarely found in Enterobacteriaceae. Here, we report a high incidence and endemic spread of NDM-1-producing CRE in Henan Province in China. Sixteen (33.3%) of the 48 CRE isolates obtained from patients during June 2011 to July 2012 were positive for bla NDM-1 , and the gene was found to be carried on plasmids of various sizes (ϳ55 to ϳ360 kb). These plasmids were readily transferrable to recipient Escherichia coli by conjugation, conferred resistance to multiple antibiotics, and belonged to multiple replicon types. The bla NDM-1 -positive CRE isolates were genetically diverse, and six new multilocus sequence typing (MLST) sequence types were linked to the carriage of NDM-1. Five of the isolates were classified as extensively drug-resistant (XDR) isolates, four of which also carried the fosA3 gene conferring resistance to fosfomycin, an alternative drug for treating infections by CRE. In each bla NDM-1 -positive CRE isolate, the bla NDM-1 gene was downstream of an intact ISAba125 element and upstream of the ble MBL gene. Furthermore, gene environment analysis suggested the possible transmission of bla NDM-1 -containing sequences from Acinetobacter spp. to Klebsiella pneumoniae and Klebsiella oxytoca. These findings reveal the emergence and active transmission of NDM-1-positive CRE in China and underscore the need for heightened measures to control their further spread.

Polymerized-dioxolane(P-DOL) is of potential as as olid-polymer-electrolyte(SPE) due to its high Li + -conductivity,g ood compatibility with Li-metal and desired preparation method of in situ polymerization in cells.I nt his study, SnF 2 was demonstrated not only to be an efficient catalyst for the polymerization of DOL at room temperature,b ut also an effective additive for improvingi nterfacial wettability and suppressing dendrite through the reaction with Li-metal and the formation of LiF/Li x Sn based composite solid electrolyte interlayer(SEI). Using the SnF 2 polymerizedP-DOL containing 1M LiTFSI as SPE(P-DOL-SPE), obviously denser Lideposition was obtained, and the all-solid-state(ASS) Li/ LiFePO 4 cell delivered stable cycling over 350 cycles at 45 8 8C. At the same time,t he irreversible decomposition of P-DOL-SPE into formaldehyde and small molecule epoxides are observed at 110 8 8C, whichiseven initiated at lower temperature of 40 8 8Cu nder vacuum. This thermal decomposition of P-DOL-SPE in pouchc ell causes huge volume swell, and therefore putting as trict limitation on the operating temperature window for the P-DOL based electrolytes.

c Acquisition of bla NDM-1 in bacterial species, such as Proteus mirabilis that is intrinsically resistant to tetracycline, tigecycline and colistin, will make clinical treatment extremely difficult. Here, we characterized an NDM-1-producing clinical isolate of P. mirabilis (PM58) that displayed an extensively drug-resistant (XDR) phenotype, susceptible only to aztreonam. Molecular analysis revealed that PM58 harbored both a conjugative NDM-1 plasmid and a novel Salmonella genomic island 1 variant on chromosome.G lobal dissemination of New Delhi metallo-␤-lactamase 1 (NDM-1), an Ambler class B metallo-␤-lactamase (MBL) able to hydrolyze all ␤-lactams except monobactams, in Gramnegative bacteria represents a great threat for public health (1). Transmission of bla NDM-1 is of especial concern with bacterial species of intrinsic antibiotic resistance, such as Proteus mirabilis that is intrinsically resistant to tetracycline, tigecycline and colistin, which will make clinical treatment extremely difficult.Salmonella genomic island 1 (SGI1), consisting of a conserved backbone structure and a multidrug resistance (MDR) region, is integrated into the chromosome specifically at the last 18 bp of the 3=-end of the thdF gene and was initially reported in Salmonella enterica serovar Typhimurium DT104 (2). To date, multiple variants of SGI1 have been discovered, and they are classified from SGI1-A to SGI1-Y, corresponding to various structures of the MDR region. Since several novel variants of SGI1, such as SGI1-L and SGI1-U to SGI1-Y, have been identified in P. mirabilis, this species is considered an acceptor of SGI independent of Salmonella spp. (3-5). Recently, the bla NDM-1 gene was reportedly integrated into a novel SGI1 variant, named PGI1 (Proteus genomic island 1), in a P. mirabilis clinical isolate (6). However, the bla NDM-1 carrying PGI1 was nontransferable in the presence of helper plasmid pR55, and this PGI1-harboring isolate remained susceptible to multiple antibiotics, including meropenem, ertapenem, gentamicin, and fosfomycin (6). Here, we describe a clinical extensively drug resistant (XDR) P. mirabilis isolate that harbors both a conjugative NDM-1 plasmid and a novel SGI1 variant on chromosome.A 3-year-old girl was admitted to the emergency department of The First Affiliated Hospital of Zhengzhou University on August 10, 2013, with a diagnosis of spinal cord injury (SCI) caused by a knife injury. After the surgery operation on August 11, intravenous cefathiamidine was given empirically (1 g administered 2 times/day) for 1 week to prevent bacterial infections. After receiving treatment, the patient was in a stable condition and was transferred to the rehabilitation department for restorative treatment. Unfortunately, the patient developed symptoms of frequent and urgent micturition and urodynia on December 10, 2013, and was treated with gentamicin bladder irrigations via catheter (20 mg administered 2 times/day). On December 15, an XDR P. mirabilis isolate named PM58 in this study was obtained from the uri...

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Compared with individual events, compound weather and climate extremes may impose more serious influences on natural systems and human society, especially in populated areas. In this study, we examine the changes in the compound precipitation events that follow extremely hot weather within several days during 1961–2017 in South China by taking the Guangdong Province as an example. Additionally, we assess the impacts of urbanization on these changes. It is found that extreme precipitation events in Guangdong are often preceded by hot weather, with an average fraction of 28.25%. The fraction of such compound events is even larger in more populated and urbanized areas such as the Pearl River Delta (PRD) region. Moreover, our results reveal significant increases in the frequency and fraction of the compound extreme heat and precipitation events. These increases are especially stronger in more developed areas (e.g., PRD), and their increasing trends tend to accelerate in recent decades. Furthermore, the local urbanization contributes to 40.91 and 49.38% of the increases in the frequency and fraction of the compound events, respectively. Our findings provide scientific references for policy-makers and urban planners to mitigate the influences of the compound heat and precipitation extremes by considering their increasing risks under the context of global climate change and local urbanization.