To explore the etiological spectrum of diarrhea and its epidemiological characteristics in diarrhea symptoms surveillance cases younger than 5 years from 2009 to 2013 in Gansu province, northwest China. Systematic diarrhea symptoms surveillance were conducted in 27 sentinel sites in Gansu province and outpatients with three or more loose, watery, or sticky pus stools per day were defined as surveillance cases. All stool specimens were tested for Rotavirus, Human calicivirus, Adenovirus, and Astrovirus. Totally, 1,119 cases (51.54%) were identified as any enteric virus. The average isolation rate of Rotavirus was 51.13%, Astrovirus was 10.84%, Adenovirus was 6.94%, and Human calicivirus was 6.60% (P < 0.01). Rotavirus was identified with the highest frequency among these enteric pathogens except in 2011, with a notable downward trend over time (P < 0.01). Rotavirus A was the most proportion in rotavirus, G3P[8] and G9P[8] were the most common combination. Rotavirus mixed Human calicivirus infections was the most common mixed infected patterns. Viral-positive rate was higher among children aged group of 0-12 and 13-24 months (P < 0.01, respectively). The isolation rates of four enteric viral pathogens showed a similar distinct seasonal variation with a higher rate in spring, autumn, and winter months. Rotavirus was the major epidemiological viral pathogen in diarrhea symptom surveillance cases in Gansu province, northwest China, during period 2009-2013. Seasonal and age-related variations were observed in enteric viral pathogen isolation rate. The comprehensive and continuous surveillance is needed to identify the prevalence of different enteric viral pathogens.

The emergence of multidrug resistance (MDR) in Proteus mirabilis clinical isolates is a growing public health concern and has serious implications for wildlife. What is the role of wildlife has been become one of the hot issues in disseminating antimicrobial resistance. Here, 54 P. mirabilis isolates from 12 different species were identified. Among them, 25 isolates were determined to be MDR by profile of antimicrobial susceptibility; 10 MDR P. mirabilis isolates were subjected to comparative genomic analysis by whole genome sequencing. Comprehensive analysis showed that chromosome of P. mirabilis isolates mainly carries multidrug-resistance complex elements harboring resistance to carbapenem genes bla OXA-1 , bla NDM-1 , and bla TEM-1 . Class I integron is the insertion hotspot of IS26; it can be inserted into type I integron at different sites, thus forming a variety of multiple drug resistance decision sites. At the same time, Tn21, Tn7, and SXT/R391 mobile elements cause widespread spread of these drug resistance genes. In conclusion, P. mirabilis isolates from wildlife showed higher resistance to commonly used clinic drugs comparing to those from human. Therefore, wild animals carrying MDR clinical isolates should be paid attention to by the public health.

Due to its drug resistant nature, β-lactamase represents a serious challenge for public health. Extended-spectrum β-lactamase (ESBL) producing Klebsiella pneumoniae clones are increasingly reported worldwide. Little is known about the prevalence and biological characteristics of drug-resistant strains in zoos. During routine surveillance at the Zhengzhou Zoo of China, we found Klebsiella pneumoniae isolate in healthy Red Kangaroos ( Macropus Rufus ) with severe MDR. The Klebsiella pneumoniae were especially resistant to Cefuroxime Sodium (MIC, > 64 μg/mL), Ceftriaxone (MIC, >8 μg/mL) and Cefepime (MIC, >64 μg/mL), and belonged to ST290. Subsequently, whole genome sequencing (WGS) showed that the Chrome Chr-M297-1 harbored bla DHA–3 , bla SHV–1 , bla CTX–M–14 , fosA5 , dfrA3 , sul3 , etc., and pM297-1.1 [222,864 bp, IncFIB(K)], which carried nine antimicrobial genes including bla CTX–M–14 , bla TEM–191 , aph(3″)-Ib , aph(6)-Id and qnrS1 , etc., and pM297-1.2 [225,763 bp, IncFII(K)] carried 22 antimicrobial genes including bla TEM–1 , bla CTX–M–3 , aph(3′)-Ia , aac(3)-IIa , aac(6′)-Ib-cr , aadA16 , qnrB2 , qnrS1 , qacEΔ1 , mphA , sul1 , and dfrA27 , etc. A traceability analysis then revealed that these two plasmids were highly similar to those recovered from human clinical samples in some southern cities in Sichuan Province, China (>99%), suggesting that these plasmids are spreading in China. Furthermore, two plasmids harboring conjugal transfer genes facilitated the transmission of antimicrobial genes by conjugation with E. coli J53. Our research shows that the transmission and adaptation of Klebsiella pneumoniae producing ESBLs is occurring in zoo environments, suggesting that zoos may be becoming important potential reservoirs for clinically important drug-resistant genes. It is therefore necessary to monitor the emergence and spread of drug-resistant gene strains in captive wild animals held in zoo environments.

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β-lactamase represents a serious challenge for treatment and public health, extended-spectrum β-lactamase (ESBL) producing Klebsiella pneumoniae clones have been increasingly reported worldwide.However, little is known about the prevalence and biological characteristics of drug-resistant strains in zoos.During a routine surveillance at in Zhengzhou zoo of China, we reported firstly that the Klebsiella pneumoniae isolate from healthy Red Kangaroos (Macropus Rufus) showed severe MDR, especially resistant to Cefuroxime Sodium (MIC, >64 μg/ml), Ceftriaxone (MIC, >8 μg/ml) and Cefepime (MIC, >64 μg/ml) and belonged to ST290. The whole genome sequencing showed that Chrome Chr-M297-1 harbored blaDHA-3, blaSHV-1, blaCTX-M-14, FosA5, dfrA3, sul3 etc., pM297-1.1(222,864bp, IncFIB(K)) carried 9 antimicrobial genes including blaCTX-M-14 , blaTEM-191, APH(3'')-Ib, APH(6)-Id and QnrS1 etc., and pM297-1.2 (225,763bp, IncFII(K)) carried 22 antimicrobial genes including blaTEM-1, blaCTX-M-3, APH(3')-Ia, AAC(3)-IIa, AAC(6')-Ib-cr, aadA16, QnrB2, QnrS1, QacEΔ1, mphA, sul1, dfrA27, etc. Traceability analysis revealed that these two plasmids are highly similar to those recovered from human clinical samples in some southern cities in Sichuan Province, China(> 99%), suggesting the spread and distribution of these plasmids in China. Furthermore, two plasmids harboring conjugal transfer genes facilitate the transmission of antimicrobial genes by conjugation with E.coli J53. Our research shows that the transmission and adaptation of Klebsiella pneumoniae producing ESBLs in zoo environment, suggesting that the zoo is gradually becoming an important potential reservoir of clinically important drug-resistant genes.Therefore, it is necessary to strengthen the monitoring of the emergence and spread of drug-resistant strains in zoo environment in captive wild animals.