Purpose Fluoroquinolone-resistant Shigella is considered a serious public health problem and has been put on the WHO global priority list of antibiotic-resistant bacteria. This study was aimed to investigate the fluoroquinolone resistance in Shigella and its relevant genetic mechanisms. Materials and Methods Shigella isolates that were isolated from diarrheal patient’s feces in Ningbo China from 2011 to 2018 were tested for susceptibility to ampicillin, gentamicin, tetracycline, nalidixic acid, ciprofloxacin, and cefotaxime. Genes related to quinolone resistance were amplified by PCR. Results A total of 118 Shigella isolates were collected, including 76 S. flexneri isolates, 40 S. sonnei isolates, and 2 S. boydii isolates. Ciprofloxacin susceptibility test identified 10 (9%) susceptible, 65 (55%) intermediate, and 43 (36%) resistant isolates. Of 76 S. flexneri isolates, 37 were ciprofloxacin resistant, a prevalence significantly higher than 6 of 40 S. sonnei isolates ( P =0.01). The isolates collected during 2014–2018 displayed a significant increase in the prevalence of ciprofloxacin resistance ( P =0.05) than those collected during 2011–2013. All the ciprofloxacin-intermediate and resistant isolates had mutations of gyrA (S83L) and parC (S80I), whereas only the ciprofloxacin-resistant isolates had gyrA (D87N) mutation and qnrB gene. Additionally, 30% of the ciprofloxacin-resistant isolates were positive for aac(6´)-Ib-cr gene. Conclusion This study shows the currently increasing prevalence of ciprofloxacin resistance. The reduced fluoroquinolone susceptibility is highly associated with gyrA (S83L) and parC (S80I) mutations, while the fluoroquinolone resistance is highly associated with gyrA (D87N) mutation, qnrB gene and perhaps aac(6´)-Ib-cr gene.

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Brucellosis, caused by Brucella species, is an infectious disease transmitted through contact with infected animals or their secretions. The clinical disease is characterized by fever and headache. Relative bradycardia is an inappropriate response of heart rate to body temperature, in which the heart rate does not increase proportionally despite a high fever. In this report, we document one case of Brucella melitensis infection demonstrating relative bradycardia. To our knowledge, this is the first report of relative bradycardia in a patient with brucellosis.

To examine the management of bloodborne occupational exposure in a tertiary hospital in China. The prospective study was conducted at Zhejiang Hospital of Traditional Chinese Medicine between January 2016 and December 2019. Data on the blood-borne occupational exposure management was collected. A total of 460 exposures were reported. 40.22% exposures were from hepatitis B virus (HBV)-positive index patients.453 exposures were reported intime, and 371 cases received emergency management. 68/73 received timely prophylaxis. Only 82/113 personnel completed the recommended follow-ups. The outsourcing personnel (P=0.002) and interns (P=0.011) were independent factors of the follow-up. No infections occurred.Although adequate compliance was adhered to with timely reporting and Prophylactic medication, the appropriateness of emergency treatment and compliance with follow-up could be enhanced. Increased availability of HBV vaccination and improved follow-up without sourced personnel are recommended.