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OBJECTIVE To conduct data mining on drugs causing liver failure in underage populations based on the FDA Adverse Event Reporting System （FAERS） database， so as to provide reference for clinical use of related drugs. METHODS The data on reported adverse drug event （ADE） of liver failure in this population （under 18 years old） from the first quarter of 2013 to the third quarter of 2022 were retrieved from the FAERS database for mining and analysis； they were divided into infants（≤1 year old）， young children（＞1-＜6 years old）， children（6-＜12 years old） and adolescents（12-＜18 years old） according to the age. The reporting odds ratio （ROR）， proportional reporting ratio and Bayesian confidence propagation neural network of the proportional imbalance method were used to screen ADE signals. RESULTS A total of 1 051 ADE reports of liver failure were collected from the underage population involving 60 drugs. The highest incidence was found in adolescents （410 cases， 39.01%）， followed by young children （297 cases， 28.26%）. The instructions of 14 drugs did not mention hepatobiliary system injury and liver failure risk， including 31 cases of levetiracetam （2.95%），18 cases of metronidazole （1.71%）， 16 cases of each of topiramate and methylprednisolone （1.52% each）， 12 cases of dexamethasone （1.14%）， 11 cases of tisagenlecleucel （1.05%）， 10 cases of each of ferrous sulfate， metformin and busulfan （0.95% each）， 9 cases of propofol （0.86%）， 8 cases of onasemnogene abeparvovec （0.76%）， 5 cases of each of diphenhydramine and omeprazole （0.48% each）， 4 cases of sebeliesterase α （0.38%）， totaling 165 cases， accounting for 15.70% of the total reported cases. Metformin was contrary to the known liver safety， and E-mail：libingchemical@163.com metronidazole and levetiracetam were new risk signals， which caused more serious clinical outcomes. CONCLUSIONS Fourteen new pharmacovigilance signals which cause liver failure in the underage population are found in this study； the liver function of patients should be closely monitored when using these drugs. Among those drugs， metformin neither undergoes liver metabolism nor has been reported in the relevant literature， and the liver-related ADE caused by metformin deserves further attention. The clinical outcomes caused by metronidazole and levetiracetam are relatively serious and need to be given sufficient attention.
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ObjectiveTo investigate the serotype and virulence genes of Klebsiella pneumoniae capsule for in-hospital liver abscess, as well as the homology of these strains. MethodsA total of 26 non-repetitive strains of Klebsiella pneumoniae isolated from the patients with liver abscess in The First Affiliated Hospital of Jiamusi University from October 2018 to October 2019 were collected. These strains were identified to be Klebsiella pneumonia by Vitek-2 Compact automatic microbiological analyzer. The string test was performed for these strains; PCR was used to determine the major capsular serotypes and related virulence genes; multi-locus sequence typing was used to analyze the homology of the strains. The Fisher’s exact test was used for comparison of categorical data between groups. ResultsThe positive rate of all 26 strains of Klebsiella pneumoniae was 100% in the string test, with 17 strains of K1 type, 5 strains of K2 type, 1 strain of K5 type, 1 strain of K57 type, and 2 strains with unknown serotype. The virulence genes rmpA, aero, and ureA had a positive rate of 100% (26/26); uge and mrkD had a positive rate of 96.2% (25/26); fimH had a positive rate of 80.8% (21/26); iucB had a positive rate of 73.1% (19/26); wcaG, magA, and kfu had a positive rate of 65.4% (17/26); allS had a positive rate of 61.5% (16/26); kpn had a positive rate of 30.8% (8/26); iroNB had a positive rate of 7.7% (2/26). The cf29a gene was not detected; wcaG, magA, and allS were only detected in K1 serotype; uge was not detected in K57 serotype. Multi-locus sequence typing found 17 trains with ST23 type, 3 strains with ST86 type, 2 strains with ST65 type, 2 strains with ST1934 type, 1 strain with ST485 type, and 1 strain with ST592 type. ConclusionK1 and K2 serotypes are the main serotypes in the strains in this experiment, and ST23 type is the main sequence type for infection in our hospital.
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Objective To understand the clinical distribution and drug resistance of Acinetobacter baumannii during 2012-2013 to provides the theoretical basis for clinical rational drug uses and the prevention and control of hospital infection.Methods To un-derstand the clinical distribution and drug resistance of Acinetobacter baumannii during 2012-2013 to provides the theoretical basis for clinical rational drug uses and the prevention and control of hospital infection.Results The main sources of specimens were sputum(88.7%),followed by secretions (4.6%).Acinetobacter baumannii infection occurred mainly in emergency ICU,surgical ICU,nerve internal medicine department,etc.Acinetobacter baumannii had the high sensitivity to carbapenem.Multiple drug resist-ance was decreased from 47.2% in 2012 to 46.4% in 2013,pan-drug resistance was decreased from 33.3% in 2012 to 27.8% in 2013.Conclusion Multiple drug resistance of Acinetobacter baumannii is serious,there is an upward trend in resistance to common-ly used antibacterial drugs,clinic should reasonably use antibacterial drugs based on the results of drug susceptibility test.