The purpose of this study is to assess the incidence and management of coinfections in hospitalized severe fever with thrombocytopenia syndrome bunyavirus (SFTSV) patients. We retrospectively evaluated the microbiological database records of the SFTS patients in the first affiliated hospital of Anhui Medical University from January 1, 2018, to December 1, 2021. According to the obtained results, coinfections including pulmonary infection, bloodstream infection, biliary tract infection, urinary tract infection, and abdominal infection were observed in SFTS patients. The incidence rate of fungal infections was found to be high in SFTS patients. Furthermore, we suggest that old age people should be evaluated for the risk of fungal infection. In comparison to the non-infection group, patients in the coinfection group were more likely to get mechanical ventilation, antibacterial treatment, antifungal treatment, and blood product therapy (p < 0.001), with a significantly longer length of stay (p < 0.05). In SFTS patients, the most prevalent strains were Aspergillus fumigatus, Aspergillus flavus, Candida, Klebsiella pneumonia, and Escherichia coli. In this investigation, 66.2% (106/160) of patients were given antibiotics, most often Piperacillin/tazobactam or minocycline. 15.6% (25/160) of patients were treated with antifungal drugs: 13.1% (21/160) with voriconazole.Patients with SFTS Associated Pulmonary Aspergillosis (SAPA) received active antifungal treatment, but the mortality rate was still 23.5% (8/34). Only 6 of the 11 patients with SFTS Associated Candidiasis were treated with antifungal drugs with no mortality. Due to the high frequency of fungal pulmonary infection in SFTS patients, more standardized fungal detection program should be strengthened.

Background Klebsiella pneumoniae ( K. pneumoniae ) causes bloodstream infection (BSI), which is responsible for a high rate of morbidity and mortality among different populations. In mainland China, data on the correlation and features of the type VI secretion system (T6SS) gene cluster in K. pneumoniae is currently scarce. As a result, we conducted a prospective investigation to determine the involvement of the T6SS in K. pneumoniae pathogenicity and antibiotic resistance. Methods In this prospective analysis, we enrolled 119 individuals who had been diagnosed with K. pneumoniae bloodstream infection between July 2019 and January 2021 and acquired demographic and clinical data from their medical records. The virulence genes rmpA, rmpA2, aerobactin, iroB, hcp, vgrG, and icmF were tested for K1 and K2, antimicrobial susceptibility. Five T6SS-positive and five T6SS-negative isolates were chosen for the competition, serum resistance, and biofilm formation experiments to further gain insights regarding the microbiological properties of T6SS-positive K. pneumoniae isolates. Results Among 119 isolates obtained from patients with BSIs, 20 (16.8%) were T6SS positive K. pneumoniae . T6SS positive strains had four virulence genes and a greater K1 capsular serotypes rate than T6SS negative bacteria. Among hvKP isolates, the T6SS positive rate was substantially greater than the T6SS negative rate (P = 0.001). T6SS-positive K. pneumoniae strains had a lower rate of antimicrobial resistance in comparison to T6SS-negative bacteria. T6SS-positive isolates may be more competitive with Escherichia coli than T6SS-negative isolates. T6SS-positive isolates, on the other hand, did not show stronger biofilm-forming activity or a higher survival rate in the presence of normal human serum in comparison to T6SS-negative isolates. Conclusion T6SS-positive K. pneumoniae was common in people who had BSIs. In T6SS‐containing K. pneumoniae , the system may play a major role in bacterial competition.

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Background Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne disease resulted from SFTSV. It is found in Japan, South Korea, Central, and Eastern China. With the increasing prevalence of SFTS and the rapid spread of the SFTS virus (SFTSV) vector, it is obvious that this virus has pandemic potential and poses an imminent public health concern. Case Presentation We depict SFTS in a child from Anhui Province and conduct a review of all reported pediatric cases in China, which is an endemic area for SFTS. From 2011 to 2021, ten SFTS pediatric cases confirmed by RT-PCR were reported, with no child dying. Although SFTS cases in adolescents and children are uncommon, the reported literature showed that clinical symptoms in adolescents and children were milder than in adults. Conclusion To better understand this emerging disease, we described the clinical and epidemiological attributes of SFTS. We suggest that the possibility of SFTSV infection in children with seasonal and virus-related acute febrile diseases should be considered in major endemic areas.