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INTRODUCTION: Ceftazidime-avibactam (CAZ-AVI) is a new option to treat KPC- and OXA-48 carbapenem-resistant Klebsiella pneumoniae (CRKP) infections. However, clinical evidence is limited regarding its use in treating CRKP infections, especially in solid organ transplantation (SOT) recipients. In this study, we assessed the efficacy of CAZ-AVI in treating CRKP infections in both the general population and the SOT recipients in comparison with other antibiotic regimens. METHODS: This is a single-centre retrospective cohort study of patients admitted between January 1, 2018 and June 30, 2021 with the diagnosis of CRKP infections receiving either CAZ-AVI or other regimens ≥ 72 hours and clinical outcomes were analysed. RESULTS: Of 200 patients with CRKP infections, 67 received CAZ-AVI, 133 received other regimens, and 50 were SOT recipients. In the SOT cohort, 30 patients received CAZ-AVI, and 20 received other regimens. The overall 30-day mortality was 38% in the SOT cohort. Compared with patients receiving other regimens, CAZ-AVI therapy resulted in lower 30-day mortality (23.3% vs. 60%, P = 0.014) and 90-day mortality (35.7% vs. 86.7%, P = 0.003), higher clinical cure (93.3% vs. 40%, P < 0.001) and microbiological clearance. Similar promising results of CAZ-AVI were also shown in the whole population cohort. Moreover, clinical outcomes of SOT recipients receiving CAZ-AVI were not inferior to those without SOT. CONCLUSIONS: CAZ-AVI therapy was associated with better clinical outcomes in CRKP infections in both the general population and SOT recipients. Considering the limitations of the present study, well-conducted RCTs are still warranted to confirm these findings.

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Taxonomic notes on the Talaus species from China are provided. Two new species, T.yuyang Yao & Liu, sp. nov. and T.zhangjiangkou Yao & Liu, sp. nov. are described and illustrated, and a further three species are redescribed based on their genitalic characters: T.dulongjiang Tang, Yin, Ubick & Peng, 2008, T.niger Tang, Yin, Ubick & Peng, 2008, and T.sulcus Tang & Li, 2010. The species T.xiphosus Zhu & Ono, 2007 is considered a junior synonym of T.triangulifer Simon, 1886 based on an examination of many recently collected female and male specimens from Guangxi Province, China. Diagnoses, detailed illustrations and a map of distributional records of the six treated species of Talaus in China are provided.

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Eleven leptonetid species belonging to four genera collected in Jiangxi and Fujian Provinces, China are presented. Ten new species of midget cave spiders from southern China are diagnosed, described, and illustrated: Leptoneteladawu Yao & Liu, sp. nov., L.yuanhaoi Yao & Liu, sp. nov. and L.zuojiashanensis Yao & Liu, sp. nov. from Jiangxi; Longileptonetaguadunensis Yao & Liu, sp. nov., L.huboliao Yao & Liu, sp. nov., L.jiaxiani Yao & Liu, sp. nov., L.letuensis Yao & Liu, sp. nov., L.renzhouensis Yao & Liu, sp. nov., L.tianmenensis Yao & Liu, sp. nov., and Pararanamingxuani Yao & Liu, sp. nov. from Fujian. Furthermore, Falcileptonetamonodactyla (Yin, Wang & Wang, 1984) is recorded from Jiangxi province for the first time. Distributions records are given for all investigated species.

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Leprosy and psoriasis rarely coexist, the specific molecular mechanisms underlying their mutual exclusion have not been extensively investigated. This study aimed to reveal the underlying mechanism responsible for the mutual exclusion between psoriasis and leprosy. We obtained leprosy and psoriasis data from ArrayExpress and GEO database. Differential expression analysis was conducted separately on the leprosy and psoriasis using DEseq2. Differentially expressed genes (DEGs) with opposite expression patterns in psoriasis and leprosy were identified, which could potentially involve in their mutual exclusion. Enrichment analysis was performed on these candidate mutually exclusive genes, and a protein-protein interaction (PPI) network was constructed to identify hub genes. The expression of these hub genes was further validated in an external dataset to obtain the critical mutually exclusive genes. Additionally, immune cell infiltration in psoriasis and leprosy was analyzed using single-sample gene set enrichment analysis (ssGSEA), and the correlation between critical mutually exclusive genes and immune cells was also examined. Finally, the expression pattern of critical mutually exclusive genes was evaluated in a single-cell transcriptome dataset. We identified 1098 DEGs in the leprosy dataset and 3839 DEGs in the psoriasis dataset. 48 candidate mutually exclusive genes were identified by taking the intersection. Enrichment analysis revealed that these genes were involved in cholesterol metabolism pathways. Through PPI network analysis, we identified APOE, CYP27A1, FADS1, and SOAT1 as hub genes. APOE, CYP27A1, and SOAT1 were subsequently validated as critical mutually exclusive genes on both internal and external datasets. Analysis of immune cell infiltration indicated higher abundance of 16 immune cell types in psoriasis and leprosy compared to normal controls. The abundance of 6 immune cell types in psoriasis and leprosy positively correlated with the expression levels of APOE and CYP27A1. Single-cell data analysis demonstrated that critical mutually exclusive genes were predominantly expressed in Schwann cells and fibroblasts. This study identified APOE, CYP27A1, and SOAT1 as critical mutually exclusive genes. Cholesterol metabolism pathway illustrated the possible mechanism of the inverse association of psoriasis and leprosy. The findings of this study provide a basis for identifying mechanisms and therapeutic targets for psoriasis.

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Background: Posttransplant lymphoproliferative disorders (PTLDs) are uncommon but serious complications in patients following solid organ transplantation. Primary Epstein-Barr virus (EBV) infection is a risk factor for the development of PTLD, especially early-onset PTLD, in EBV-negative recipients. To date, however, there are no specific guidelines on the threshold of EBV-DNA load for therapeutic intervention, the source for measurement (e.g., blood, bronchoalveolar fluid), or the use of antiviral agents as prophylaxis for early PTLD prevention in EBV-mismatched patients. Methods: The present study describes a 56-year-old male lung transplant recipient diagnosed with EBV-associated PTLD. Results: This patient had a history of invasive fungal disease and Mucor and Aspergillus fumigatus infections in the early post-transplant period, necessitating antifungal therapy throughout the course of the disease. The patient was EBV-positive 15 days after transplantation, with lung CT showing multiple bilateral nodules of varying sizes beginning 98 days after transplantation. A lung biopsy showed PTLD, and next-generation sequencing (NGS) revealed EBV. This patient, however, did not receive any antiviral therapy for early PTLD prevention or any PTLD-related treatment. He died 204 days after lung transplantation. Conclusion: The present study describes a lung transplant recipient who developed EBV-associated PTLD, a non-negligible disease, after solid organ transplantation. Monitoring EBV-DNA load is important, as a sudden increase may be a sensitive indicator of PTLD. An earlier diagnosis may increase the likelihood of successful treatment.

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Two species assigned to Massuria Thorell, 1887 are reviewed. The female of Massuriabandian Tang & Li, 2010 is described for the first time from Jianfengling National Natural Reserve, Hainan Province, China. The species Diaeasimplex Xu, Han & Li, 2008 is described as a synonym of Massuriabellula Xu, Han & Li, 2008 based on female and male specimens from Guangdong Province, China. Massuriaminsp. nov. described as a new species (female, Fujian Province, China). Detailed illustrations and a distribution map are provided for these three species of Massuria.

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Collections of thomisid spiders by amateur and professional arachnologists in China have led to the discovery of some interesting crab spiders (Thomisidae). Two new species in two genera of thomisid spiders are described and illustrated with photographs and SEMs: Phartaxizang Liu & Yao, sp. nov. (♀) and Stephanopisqiong Liu & Yao, sp. nov. (♀). The previously unknown males of Borboropactuslongidens Tang & Li, 2010 and Stephanopisxiangzhouica Liu, 2022 were also collected and are described for the first time. The genus Borboropactus Simon, 1884 is reported for the first time from Vietnam. The new Stephanopis species is also recorded for only the second time from the Asian mainland. Distributions of all these species are mapped.

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Invasive infection caused by hypervirulent Klebsiella pneumoniae (HvKP) has been reported worldwide. Most of the patients are community population, related to diabetes mellitus (DM), chronic liver disease and other basic diseases, which prone to systemic migratory infection. In this study, we collected 377 patients with community acquired Klebsiella pneumoniae liver abscess in our hospital from January 2013 to December 2018, 65.8% of whom were male, and 49.6% had DM. Patients with DM are prone to eye and central nervous system (CNS) infection, which need continuous local abscess drainage during treatment. Among them, patients with poor blood glucose control have a higher rate of blood stream infections (BSI). 219 strains of HvKP were obtained, with K1/K2 Serotype accounted for 81.7%. The incidence of BSI in K2 patients was higher than that in K1 patients. The PCR results indicate that the carrying rate of virulence genes (rmpA、areo、kfu、allS、iroN、magA、uge、wcaG) in K1/K2 type strains is significantly higher than that in non K1/K2 type strains. ST23 and ST65 are the most common multilocus sequence typing (MLST), which belong to K1 and K2 Serotype respectively. All of HvKP strains showed high sensitivity to commonly used clinical antibiotics other than ampicillin, with 54.3% of the strains exhibiting high viscosity characteristics. Meanwhile, 35 classic Klebsiella pneumoniae (cKP) strains were collected, and their serum typing is mainly non K1/K2. The carrying rate of virulence genes and viscosity degree in HvKP are significantly higher than those in cKP. Primary liver abscess caused by HvKP is prone to multiple tissue and organ infections, but it shows higher sensitivity to most commonly used antibiotics in clinical practice except for ampicillin. After effective treatment, the overall prognosis of patients is better. This study analyzes the pathogenic characteristics of HvKP and elaborates on the clinical characteristics of patients, which can provide reference for clinical and scientific research work.

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The disease caused by methicillin-resistant Staphylococcus aureus (MRSA) is a global public health challenge that threatens society and patients seriously. Therefore, the molecular epidemiology and change trend of MRSA is essential for the control and treatment of diseases caused by the pathogen in their regions. To explore molecular epidemiology of MRSA in Hangzhou, we collected 162 MRSA isolates from 2012 to 2018, conducted the antimicrobial susceptibility and used polymerase chain reaction(PCR) to test the molecular typing including multilocus sequence typing (MLST), staphylococcal chromosome cassette mec (SCCmec), staphylococcal protein A (spa A) and Panton-Valentine leucocidin (PVL). All the strains was divided into community-associated MRSA (CA-MRSA) or hospital-associated MRSA (HA-MRSA). 162 MRSA isolates were divided into 16 STs and 30 spa types. The major ST type was ST5 (96/162, 59.3%) and the predominant spa type was t311 (83/162, 51.2%). Five SCCmec types were found and the most common SCCmec type was type II (101/162, 61.7%). ST5-II-t311 was the predominant MRSA clone. And the prevalence of ST5 MRSA gradually declined from 2014 to 2018 but the prevalence of ST59 MRSA significantly increased. At the same time, livestock-associated methicillin-resistant Staphylococcus aureus(LA-MRSA) ST398 and ST9 were detected. Twenty-eight isolates were PVL gene positive (28/162, 17.3%). The most prevalent PVL-positive clone was ST59-IVa-t437. Comparing with HA-MRSA, CA-MRSA had a lower probability of ST5 (9.1% vs 67.1%, P=0.000) but a higher probability of ST59 (63.6% vs 11.4%, P=0.000), not only that, it was more likely to carrying PVL-positive gene (36.4% vs 14.3%, P=0.028). In summary, the molecular types of MRSA were getting complex over time. ST5-II-t311 was the predominant clone of MRSA isolate with a downward incidence from 2014 to 2018. ST59 MRSA strains, which is thought community related strain are spreading into hospitals and has an upward incidence from 2014 to 2018.

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Three new Otacilia species were collected from Jiangxi Provinces, China during a survey of the spider fauna of the region: Otaciliaanfu Liu, sp. nov. (♂♀), O.guanshan Liu, sp. nov. (♂♀), and O.mingyueshan Liu, sp. nov. (♂♀). All species are described and illustrated with photographs and SEM micrographs, and their distribution is also mapped.

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A list of 34 thomisid species belonging to 21 genera collected in Jangxi Province of China is provided. Five new species are described: Angaeusxieluae Liu, sp. nov. (♂♀), Lysitelessubspirellus Liu, sp. nov. (♀), Oxytatemucunica Liu, sp. nov. (♀), Phartalingxiufengica Liu, sp. nov. (♀), Stephanopisxiangzhouica Liu, sp. nov. (♀). A new combination is proposed: Ebelingiaforcipata (Song & Zhu, 1993) comb. nov. (ex. Ebrechtella Dahl, 1907). Previously unknown females of E.forcipata (Song & Zhu, 1993), Oxytatebicornis Liu, Liu & Xu, 2017, and Xysticuslesserti Schenkel, 1963 are described for the first time. Stephanopis O Pickard-Cambridge, 1869, a genus previously known from Australasia and South America, is recorded from the Asian mainland for the first time.

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A list of 26 gnaphosid species belonging to 14 genera collected in Jiangxi Province, China, is provided. Three new species of ground spiders from Jiangxi Province of China are diagnosed, described, and illustrated: Haplodrassusyinae Liu, sp. nov. (♂♀), Hitobiaxiaoxi Liu, sp. nov. (♂), and Zelotesdingnan Liu, sp. nov. (♂♀). Haplodrassusyinae Liu, sp. nov. was previously erroneously recorded in Jiangxi Province as H.montanusYin et al., 2012.

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Five new species of salticids were collected from China: Synagelidesemangou Liu, sp. nov. (♂, ♀) from Gansu province, and S.jinding Liu, sp. nov. (♂), S.serratus Liu, sp. nov. (♂, ♀), S.shuqiang Liu, sp. nov. (♂), and S.triangulatus Liu, sp. nov. (♀) from Jiangxi Province. All species are described and illustrated with photographs and SEM micrographs, and their distributions are also mapped.

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Two new species of Spinirta Jin & Zhang, 2020 (Araneae: Corinnidae) from Jiangxi Province, China are described here: S.sanxiandian sp. nov. (♂♀) and S.sishuishan sp. nov. (♂). Detailed descriptions and photographs of the new species are provided.

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The emergence of high-level tigecycline resistance mediated by plasmid-borne tet(X) genes greatly threatens the clinical effectiveness of tigecycline. However, the dissemination pattern of plasmid-borne tet(X) genes remains unclear. We here recovered tet(X)-positive Acinetobacter isolates from 684 fecal and environmental samples collected at six livestock farms. Fifteen tet(X)-positive Acinetobacter isolates were identified, mainly including 9 tet(X3)- and 5 tet(X6)-positive Acinetobacter towneri isolates. A clonal dissemination of tet(X3)-positive A. towneri was detected in a swine farm, while the tet(X6)-positive A. towneri isolates mainly disseminated sporadically in the same farm. A tet(X3)-carrying plasmid (pAT181) was self-transmissible from a tigecycline-susceptible A. towneri strain to Acinetobacter baumannii strain ATCC 17978, causing 64- to 512-fold increases in the MIC values of tetracyclines (including tigecycline). Worrisomely, pAT181 was stably maintained and increased the growth rate of strain ATCC 17978. Further identification of tet(X) genes in 10,680 Acinetobacter genomes retrieved from GenBank revealed that tet(X3) (n = 249), tet(X5)-like (n = 61), and tet(X6) (n = 53) were the prevalent alleles mainly carried by four species, and most of them were livestock associated. Phylogenetic analysis showed that most of the tet(X3)- and tet(X6)-positive isolates disseminated sporadically. The structures of the tet(X3), and tet(X6) plasmidomes were highly diverse, and no epidemic plasmids were detected. However, cross-species and cross-region transmissions of tet(X3) might have been mediated by several plasmids in a small proportion of strains. Our study implies that horizontal plasmid transfer may be insignificant for the current dissemination of tet(X3) and tet(X6) in Acinetobacter strains. Continuous surveillance for tet(X) genes in the context of One Health is necessary to prevent them from transmitting to humans. IMPORTANCE Recently identified plasmid-borne tet(X) genes have greatly challenged the efficiency of tigecycline, a last-resort antibiotic for severe infection, while the dissemination pattern of the plasmid-borne tet(X) genes remains unclear. In this study, we identified a clonal dissemination of tet(X3)-positive A. towneri isolates on a swine farm, while the tet(X6)-positive A. towneri strains mainly disseminated sporadically on the same farm. Of more concern, a tet(X3)-carrying plasmid was found to be self-transmissible, resulting in enhanced tigecycline resistance and growth rate of the recipient. Further exploration of a global data set of tet(X)-positive Acinetobacter genomes retrieved from GenBank revealed that most of the tet(X3)- and tet(X6)-positive isolates shared a highly distant relationship, and the structures of tet(X3) and tet(X6) plasmidomes exhibited high mosaicism. Notably, some of the isolates belong to Acinetobacter species that are opportunistic pathogens and have been identified as sources of nosocomial infections, raising concerns about transmission to humans in the future. Our study evidenced the sporadic dissemination of tet(X3) and tet(X6) in Acinetobacter strains and the necessity of continuous surveillance for tet(X) genes in the context of One Health.

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The male of Psechrusjinggangensis Wang & Yin, 2001 is described for the first time based on many specimens from its type locality, Jinggang Mountain National Nature Reserve, Ji'an City, Jiangxi province, China. Detailed illustrations, SEM images, and distribution map are given.

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Four new species are described from Jinggang Mountain National Nature Reserve, Jiangxi Province of southern China: Draconarius lingdang sp. nov. (♂♀), D. substrophadatus sp. nov. (♀), Orumcekia cipingensis sp. nov. (♀) and Tonsilla shuikouensis sp. nov. (♀). Additionally, Coelotes septus Wang, Yin, Peng & Xie, 1990 is redescribed and its male is described for the first time.

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Eight new Otacilia species were collected from Ji'an City, Jiangxi Province, China during a survey of the phrurolithid fauna of the region: Otacilia bizhouica Liu, sp. nov. (♂♀), O. gougunao Liu, sp. nov. (♂), O. nanhuashanica Liu, sp. nov. (♂♀), O. subfabiformis Liu, sp. nov. (♂♀), O. wugongshanica Liu, sp. nov. (♂♀), Otacilia yusishanica Liu, sp. nov. (♂♀), O. zaoshiica Liu, sp. nov. (♂♀) and O. ziyaoshanica Liu, sp. nov. (♀). All species are described and illustrated with photographs and SEM micrographs, and their distribution is also mapped.

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Phrurolithidae spiders were collected from Jinggang Mountain National Nature Reserve, Jiangxi Province, China, during the past six years. The new genus Alboculus Liu, gen. nov., with the type species Phrurolithus zhejiangensis Song & Kim, 1991, is described, and its previously unknown male is described for the first time. Furthermore, seven new species of Otacilia are described: O. acutangula Liu, sp. nov. (♂♀), O. bijiashanica Liu, sp. nov. (♂♀), O. longtanica Liu, sp. nov. (♀), O. ovoidea Liu, sp. nov. (♂♀), O. shenshanica Liu, sp. nov. (♂♀), O. subovoidea Liu, sp. nov. (♂♀), and O. xiaoxiica Liu, sp. nov. (♀). All species are illustrated with photographs and their distributions are mapped.