Objective:To evaluate the application of metagenomic next-generation sequencing（mNGS）in the identification of non-tuberculous mycobacteria（NTM）.Methods:A retrospective analysis was conducted on mNGS results of 358 bronchoalveolar lavage fluid（BALF）samples positive for NTM collected at the First Affiliated Hospital of Zhejiang University School of Medicine from February 2021 to January 2024. The analysis included the distribution of NTM species，the detection of mixed pathogens，and the performance of conventional mycobacterial detection methods.Results:The results showed that 362 strains of 15 NTM species were identified from 350 specimens，8 specimens were not precise to the species level. The most frequently detected species were Mycobacterium intracellulare（37.3%，135/362）， Mycobacterium abscessus（26.8%，97/362），followed by Mycobacterium avium（11.0%，40/362）， Mycobacterium kansasii（8.0%，29/362）and Mycobacterium chelonae（7.7%，28/362）. Single NTM species were detected in 339 specimens，while two or three NTM species were simultaneously detected in 11 specimens（3.1%，11/358）. Non-NTM microorganisms co-infected were detected in 53.4%（191/358）of NTM-positive BALF samples，including common pathogens such as Pseudomonas aeruginosa， Staphylococcus aureus，and Aspergillus fumigatus；and difficult-to-identify pathogens such as Legionella pneumophila and Talaromyces marneffei. In NTM-positive patients detected by mNGS，the results supported the diagnosis of NTM infection in 298 cases（298/358，83.2%）and 105 cases（105/358，29.3%）initiated anti-NTM treatment accordingly；while in 60 cases（60/358，16.8%）the positive results were considered as colonization or unrelated to clinical infection. For samples tested with acid-fast staining，mycobacterial liquid culture，and DNA microarray，the positivity rates for NTM were 31.5%（73/232），48.7%（57/117），and 43.0%（46/107），respectively. Conclusions:mNGS demonstrates advantages in identification of NTM. However，the test may detect multiple microorganisms，in that case，the interpretation with clinical and radiological results is requried to determine the main pathogens.

People living with HIV（PLWH）experiencing low-level viremia（LLV）face increased risks of virologic failure，abnormal immune activation，HIV drug resistance mutations，AIDS-related and non-AIDS-related comorbidities，and mortality. Currently，standardized management guidelines specifically addressing LLV in the context of HIV care are lacking in China. To address this gap，the AIDS Committee，Chinese Society of Tropical Disease and Parasitology，Infectious Diseases Professional Committee of Zhejiang Society for Mathematical Medicine，and Committee of AIDS Diagnosis and Treatment Quality Control Management，Zhejiang Provincial STD/AIDS Prevention Association jointly formulated the Expert Consensus on the Management ofLow- Level Viremia in People Living withHIV（2025 Edition）. This consensus synthesizes domestic clinical practices，international guidelines，recent research advancements，and expert recommendations. This article provides a critical interpretation of the key recommendations outlined in the consensus.

Hepatitis B virus（HBV）infection is one of the leading causes of hepatocellular carcinoma（HCC）. Although vaccination and antiviral therapy have reduced HBV infection rates in some regions，the incidence of HBV-associated HCC（HBV-HCC）remains high. Therefore，in-depth research into the carcinogenic mechanisms of HBV-HCC not only helps elucidate the key molecular events by which the virus drives tumorigenesis but also provides a theoretical basis for early diagnosis，risk stratification，and targeted therapy. This article explores the carcinogenic mechanisms of HBV-HCC from multiple perspectives，including HBV proteins and genetic variations，gene expression in liver tissue，viral genome integration，cell signaling pathways，malignant transformation and heterogeneity of liver stem cells，host genetic factors，and intra-organ iron metabolism abnormalities，offering insights for clinical and scientific research.

Objective:To investigate the correlation between rectal colonization of carbapenem resistant Klebsiella pneumoniae（CRKP）and bloodstream infections（BSI）using molecular epidemiological analysis. Methods:Patients admitted to the Intensive Care Unit（ICU），Hematology Department，and Neurosurgery Department of the First Hospital of Jiaxing from January 2022 to December 2024，were enrolled. Rectal CRKP colonization screening was performed for all participants，with concurrent monitoring for BSI.Whole genome sequencing of CRKP strains in the intestine and blood flow of patients with CRKP rectal colonization and CRKP-BSI was performed using the Illumina NovaSeq PE150 sequencing platform，and samples were genotyped based on the PubMLST database. MLST 2.0 was applied for multi site sequence typing，VFDB online database was used to analyze virulence genes，ResFinder was used to analyze resistance genes，and whole genome sequences were imported into BioNumerics software for core genome multi site sequence typing and clustering analysis. Using the BacWGSTdb database to construct a phylogenetic tree based on genomic SNPs，and the homology between CRKP rectal fixed plants and corresponding BSI-CRKP infected plants were analyzed.Results:A total of 772 patients were included，including 78 cases with positive results in rectal CRKP colonization screening（10.1%）and 694 cases without rectal CRKP colonization（89.9%）. The CRKP-BSI rate in rectal CRKP colonization patients was significantly higher than that in non-CRKP colonization patients［19.2%（15/78） vs. 5.5%（38/694）， χ2=20.749， P<0.001］. Analysis of CRKP rectal colonization strains and bloodstream infection strains in 15 patients with CRKP rectal implantation and CRKP-BSI revealed that ST11 type was the main strain（ n=10），followed by ST37 type（ n=3），with all carrying multiple β-lactam and carbapenem producing enzyme resistance genes.The distribution of virulence genes showed that CRKP strains carried multiple virulence genes，with iroE being ubiquitous，followed by iucA/ B/ C/ D， rmpA2，rmpA，and iroN. All ST11-type CRKP strains exhibited hypervirulent characteristics. Capsular serotyping analysis showed that the predominant type of CRKP colonization and infection strains was KL64. The results of cgMLST and SNP clustering analysis showed that CRKP rectal fixed plants exhibited homology with blood flow infected plants. Moreover，two clusters of CRKP rectal colonization strains with significant homology were found to cluster together among 15 patients. Conclusions:Rectal colonization of CRKP is an important risk factor for the occurrence of BSI-CRKP in hospitals，and ST11 hypervirulent CRKP is the main type. It is recommended to screen high-risk patients for CRKP to reduce the risk of BSI-CRKP.

Objective:To evaluate the diagnostic value of metagenomic next-generation sequencing（mNGS）in bone and joint infections caused by non-tuberculous mycobacteria（NTM）.Methods:Clinical data of 175 patients with suspected NTM bone and joint infections admitted in Beijing Chest Hospital，Capital Medical University from January 2019 to January 2023 were retrospectively analyzed. Mycobacterium growth indicator tube（MGIT）method was used for mycobacterial culture on the bone tissue or abscess samples and mNGS test was performed on bone tissue samples in all patients. Taking clinical diagnosis as the gold standard，the sensitivity，specificity，positive predictive value，negative predictive value，positive likelihood ratio，and negative likelihood ratio of the two methods were compared.Results:Twenty-six patients（14.9%）were clinically diagnosed as NTM bone and joint infections. The mNGS showed higher sensitivity（100.0% vs. 57.7%，），specificity（99.3% vs. 86.6%），positive predictive value（96.3% vs. 42.9%），and negative predictive value（100.0% vs. 92.1%），compared to MGIT culture（all P<0.001）. The positive likelihood ratio（149.00 vs. 4.31）and negative likelihood ratio（0 vs. 0.49）of mNGS were also superior to those of MGIT. Conclusion:Compared to MGIT culture，mNGS has high diagnostic value in NTM bone and joint infections and can serve as an efficient and reliable method for clinical diagnosis.

In recent years，the incidence and prevalence of non-tuberculous mycobacterial（NTM）infections have been on the rise，posing a serious threat to public health and presenting significant challenges for disease management. Currently，the treatment outcomes for NTM disease are poor，one of the main reasons being the high resistance of NTM pathogens to various anti-mycobacterial drugs. Novel therapeutic strategies targeting the host rather than the NTM pathogens themselves may help improve cure rates and reduce mortality. This article summarizes the latest research findings on host factors related to the incidence of NTM disease，including age，pulmonary diseases，immune function，genetic factors and lifestyle，which aids in the early identification of high-risk populations and provides a theoretical basis for developing targeted prevention and treatment strategies and optimizing treatment plans.

In recent year，the iatrogenic infections and outbreaks caused by Mycobacterium abscessus complex（MABC）have been increasingly reported. Studies indicate that MABC accounts for 65%-80% of rapidly growing non-tuberculosis Mycobacterium（NTM）-related pulmonary diseases. As a clinically significant NTM pathogen，MABC exhibits rapid proliferation and intrinsic resistance to multiple antimicrobial agents. Notably，the 16S rDNA sequences among MABC subspecies share 100% homology，posing challenges for subspecies-level differentiation. Rapid and precise identification of MABC at the species or subspecies level is therefore critical for effective clinical management and outbreak control. Conventional biochemical methods for NTM identification are time-consuming and prone to inaccuracies，whereas molecular biology techniques offer superior speed and specificity，and have been widely used clinically. This review highlights the clinical implications of molecular biological techniques in MABC identification and its pivotal role in guiding therapeutic strategies.

Objective:To report the surveillance results of the distribution and antimicrobial resistance profile of clinical isolates in Anhui province.Methods:Surveillance data from 94 members of the Anhui Antimicrobial Resistance Surveillance Network（HuiNet）from October 2023 to September 2024 were collected，the major drug-resistant bacteria and the resistance to commonly used antibiotics were analyzed. WHONET 5.6 and SPSS 25.0 software were used for data analysis.Results:Among 240 339 clinical strains，Gram-negative bacteria accounted for 75.0%（180 153 strains）. The detected bacteria mainly include Escherichia coli（ n=53 587，22.3%）， Klebsiella pneumoniae（ n=39 774，16.5%）， Pseudomonas aeruginosa（ n=25 505，10.6%）， Staphylococus aureus（ n=19 438，8.1%）， Acinetobacter baumannii complex（ n=14 239，5.9%），and so on. The prevalence of methicillin-resistant Staphylococcus aureus（MRSA）and methicillin-resistant coagulase-negative Staphylococcus aureus（MRCNS）were 37.7%（7 112/18 853）and 73.9%（13 221/17 895），respectively. No vancomycin- and teicolanin-resistant Staphylococcus were detected. The prevalence of carbapenem-resistant Escherichia coli（CREC）and Klebsiella pneumoniae（CRKP）were 1.9%（971/51 991）and 12.3%（4 864/39 414），respectively. The resistance rate of CRKP to tigecycline and polycolistin B was 7.7% and 7.9%，respectively. The prevalence of carbapenem-resistant Acinetobacter baumannii（CRAB）complex and Pseudomonas aeruginosa（CRPA）were 57.9%（8 222/14 198）and 18.2%（4 569/25 052），respectively，with low resistance to polycolistin B（2.0% and 7.2%，respectively）. The detection rates of MRSA，MRCNS，CRAB complex，third-generation cephalosporin-resistant Escherichia coli（3GC-R-EC）and quinolone-resistant Escherichia coli（QREC）in northern Anhui were the highest（46.8%，77.1%，65.6%，57.6% and 55.5%，respectively），which were higher than those in central and southern Anhui（ χ2=107.858 and 566.202，5.950 and 142.223，39.254 and 289.137，135.402 and 449.114，39.142 and 185.114， P<0.05 or <0.01），and the detection rates in central Anhui were higher than those in southern Anhui（ χ2=272.031，102.717，162.409，118.891 and 66.889，all P<0.001）. The detection rates of CRKP，CRPA and thirdgeneration cephalosporinresistant Klebsiella pneumoniae（3GC-R-KP）in central Anhui were the highest（16.7%，21.7% and 32.0%，respectively），which were higher than those in northern and southern Anhui（ χ2=229.656 and 439.377，156.599 and 65.818，77.386 and 232.568，all P<0.001）. The detection rates of CREC，3GC-R-EC and QREC were the highest in the elderly（2.2%，54.0% and 56.4%，respectively），which were higher than those in children and adults（ χ2=8.034 and 13.150，17.032 and 103.437，438.353 and 183.099，all P<0.01）. The detection rates of CRKP and 3GC-R-KP in neonates were the highest（20.6% and 56.9%，respectively），which were significantly higher than those in children，adults and the elderly（ χ2=38.869，8.337 and 7.921；65.517，55.525 and 49.214，all P<0.01），and the detection rate of 3GC-R-KP in the elderly was higher than that in children and adults（ χ2=14.122 and 7.501，both P<0.01）. The detection rates of CRAB complex，CRPA，CREC，CRKP and 3GC-R-KP in tertiary hospitals were higher than those in secondary hospitals（ χ2=25.606，16.501，5.820，33.116 and 117.086， P<0.05 or <0.01）. Except for MRSA，vancomycin-resistant Enterococcus faecium and QREC，the detection rates of major drug-resistant bacteria in intensive care unit（ICU）were the highest（all P<0.001）. From 2019 to 2024，the detection rates of MRSA，MRCNS，CRKP，CRAB complex and CRPA all showed a slow decreasing trend（ χ2=42.319，122.779，340.381，83.512 and 81.668，all P<0.001）. Conclusions:The situation of antimicrobial resistance in Anhui province shows a downward trend，but it is still serious，especially in northern and central Anhui. It is necessary to pay attention to the bacterial resistance particularly for the elderly，newborns，children and ICU.

With the use of antiretroviral therapy，the life expectancy of people living with human immunodeficiency virus（HIV）has increased，making metabolic non-infectious diseases major comorbidities. Metabolic dysfunction-associated fatty liver disease（MAFLD）is now the most common cause of non-viral liver disease in HIV-infected individuals. Due to its high prevalence and potential severity，MAFLD imposes a serious health. Understanding its pathogenesis is crucial for developing effective prevention and treatment strategies. This review summarizes recent progress on the mechanisms of HIV-associated MAFLD，focusing on gut-liver axis imbalance，chronic inflammation and immune activation，effects of antiretroviral drugs，and genetic susceptibility.

Long-acting interferons，as one of the recommended drugs for achieving clinical cure in chronic hepatitis B（CHB），exert significant effects through multiple important mechanisms in the treatment of chronic hepatitis B virus infection since their clinical introduction. These mechanisms include inducing antiviral proteins，immune modulation，and regulation of epigenetic modifications. This article systematically elaborates on the antiviral and immune regulatory mechanisms of long-acting interferon，explores clinical cure strategies and influencing factors based on long-acting interferon，and looks forward to the emerging directions of CHB clinical cure in the future，aiming to provide reference for optimizing CHB clinical treatment strategies and improving efficacy.