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  • 2022 Volume 19 Issue 1
    Published: 25 January 2022
      
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  • Progress of Clinical Research in Hypervirulent Klebsiella Pneumoniae
    XU Qin
    2022, 19(1): 1-4. https://doi.org/10.13493/j.issn.1672-7878.2022.01-001
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    Klebsiella pneumoniae (KP) is an important Enterobacteriaceae bacteria, which colonizes in the intestine and respiratory tract. It can cause diseases when the body's resistance is reduced. KP is a common opportunistic pathogen that causes hospital-acquired and community-acquired infection. In recent years, the incidence of liver abscess caused by KP has shown a significant upward trend, so the hypervirulent KP (hvKP) has received widespread attention. hvKP is separated from traditional KP and has the main characteristics of hypervirulence and high viscosity, which can cause invasive infections and life-threatening in severe cases. In this article, the epidemiology, clinical characteristics, main virulence factors, clinical diagnosis and treatment, drug resistance status of hvKP are reviewed, and their research progress is analyzed.
  • Research Progress in Central Inhibitory Effect and Mechanism of Magnoliae Officinalis Cortex and Its Active Ingredients
    ZHANG Ming-fa, SHEN Ya-qin
    2022, 19(1): 5-9. https://doi.org/10.13493/j.issn.1672-7878.2022.01-002
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    Magnoliae Officinalis Cortex and its active ingredients have sedation, hypnotism, anxiolytic and antiepileptic effects, and antipyretic and analgesic effects. Magnolol and honokiol express central inhibition, and antipyretic and analgesic effects chiefly by increasing γ-aminobutyric acid (GABA) binding to its receptor, and enhancing biosynthesis and content of GABA, then by improving the release of β-endorphin, and activating cannabine receptor-1 to antagonize the effects of the excitative neurotransmitter, glutamic acid and N-methyl-D-aspartate (NMDA), and inhibiting biosynthesis of prostaglandin, the release of 5-TH and Na+ current of neural cells. In this paper, the literature on the central inhibition and mechanism of Magnolia Officinalis Cortex and its active components are reviewed, and the research progress is also analyzed.
  • Pharmacokinetic Study of Tigecycline in Hypoproteinemia Rats
    WANG Feng-fei, RU Ren-ping, YU Le
    2022, 19(1): 13-16. https://doi.org/10.13493/j.issn.1672-7878.2022.01-004
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    Objective: To investigate and compare the pharmacokinetic parameters of tigecycline between normal rats and hypoproteinemia rats after tail vein injection. Methods: A total of 90 healthy male SD rats were randomly divided into 2 groups. The rats in the experimental group were injected with doxorubicin (7.5 mg/kg) through tail vein. After 4 mg/kg tigecycline was injected into the tail vein of the experimental group and control group, 5 rats were sacrificed 10 min, 0.5 h, 1.0 h, 2.0 h, 3.0 h, 4.0 h, 6.0 h, 8.0 h and 12.0 h after administration, respectively. Blood samples were collected for serum separation and blood concentration determination. Results: AUC0~t, Vd and CL in the control group were (4.29±0.42) μg/(mL·min), (1 370.94±512.69) mL and (234.78±23.45) mL/min. AUC0~t was (1.73±0.26) μg/(mL·min), Vd was (4 071.64±1 192.51) mL, CL was (453.19±71.34) mL/h in the experimental group; The serum concentration of tigecycline and AUC0~t were significantly decreased in the experimental group, and the clearance rate and Vd were significantly increased in the experimental group. Conclusion: Hypoproteinemia can reduce the blood concentration of tigecycline and AUC0~t in rats, and lead to reducing efficacy.
  • Relevant Research between Single-nucleotide Polymorphism of hURAT-1 Gene and Hyperuricemia Caused by Pyrazinamide in Patients with Tuberculosis in Yunnan*1
    PENG Jiang-li, LIU Hui, ZHU Jiang-chun, LIU Xing, LUO Ji, LI Na, LIU Meng-xing, CHEN Jie
    2022, 19(1): 17-21. https://doi.org/10.13493/j.issn.1672-7878.2022.01-005
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    Objective: To study the correlation between single-nucleotide polymorphism (SNP) of human urate transporter 1 (hURAT-1) gene and hyperuricemia caused by pyrazinamide in patients with tuberculosis in Yunnan. Methods: 294 cases of tuberculosis patients with hyperuricemia caused by pyrazinamide were selected as the case group (from January 2019 to March 2021), and 220 cases of tuberculosis patients without hyperuricemia caused by pyrazinamide were selected (the same year) as the control group. The SNP typing of hURAT1 gene was analyzed by MassArray technique, and the correlation between hURAT1 SNPs and pyrazinamide induced hyperuricemia was analyzed. Results: The frequency distribution of hURAT1 gene rs11231825 genotypes ( TT, CT, CC ) was statistically significant between the two groups (P<0.01). The mutation allele C frequency of rs11231825 in case group was significantly lower than that in control group (P<0.01). The frequencies of genotypes and alleles at rs2022048 locus in the two groups were basically similar, and the difference was not statistically significant (P>0.05). Conclusion: hURAT1 gene rs11231825 in tuberculosis patients may be related to the risk of hyperuricemia caused by pyrazinamide, and mutant allele C may be the protective allele of hyperuricemia caused by pyrazinamide.
  • Study on Method for Determination of Urea in Clobetasol Propionate Urea Cream
    DING Zhi-jun, LI Xiao-lan, FU Zhi-yuan
    2022, 19(1): 22-25. https://doi.org/10.13493/j.issn.1672-7878.2022.01-006
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    Objective: To establish and investigate a high performance liquid chromatography (HPLC) method for the determination of urea content in clobetasol propionate urea cream. Methods: The content of urea in clobetasol propionate urea cream was determined by HPLC (NH2 column and SB-AQ column), and the linearity, precision, stability, repeatability and recovery of the method were investigated. Results: (1)The average recovery was 97.95%, RSD was 0.50% (n=6), and the average urea content was 98.15%. When the concentration of urea in the cream was between 0.202 2 and 5.054 0 μg/mL(r2=0.999 9) by NH2 column, the linear relationship was good. (2)The linear relationship was also good when the concentration of urea in the cream was between 0.590 4 and 5.904 0 μg/mL (r2=0.999 8) by SB-AQ column. The average recovery was 98.66%, RSD was 0.89% (n=6) and the average urea content was 98.97%. Conclusion: There is no significant difference in urea content measured by NH2 column and SB-AQ column, and the methods are simple, accurate and reproducible, which could be used for the quality control of clobetasol propionate urea cream.
  • Correlation Analysis of Serotype and Drug Resistance of Streptococcus Pneumoniae in Hospitalized Children*1
    ZHAO En-li, FANG Pan-pan
    2022, 19(1): 26-29. https://doi.org/10.13493/j.issn.1672-7878.2022.01-007
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    Objective: To explore the serotype distribution and drug resistance of Streptococcus pneumoniae (SP) in hospitalized children. Methods: SP strains isolated from 116 children with SP admitted to the hospital from October 2019 to March 2021 were selected as the research objects, and the culture and identification results of SP strains in the sputum samples of the throat of the children collected after admission were counted. SP serotype and resistance to common antibacterials were analyzed. Results: Serotypes of 116 SP isolates were detected, of which the TOP 5 serotypes were 19F, 6A, 14, 19A and 23F. The coverage rate of serotype vaccine PCV 23 (1 to 5 B, 6B, 7F, 8N, 9N, 9V, 10A, 11A, 12F, 14B, 15B, 17F, 18C, 19A, 19F, 20F, 22F, 23F, 33F) was 67.24%. The coverage rate of SP-PCV13 (1A, 3 to 5 A, 6A, 6B, 7F, 9V, 14C, 18C, 19A, 19F and 23F) was 5.17%. The results of drug sensitivity test showed that the TOP 5 sensitive drugs of 116 SP isolates were penicillin, ceftriaxone, vancomycin, levofloxacin and linezolid, and their drug resistance rates to erythromycin and azithromycin were 98.28% and 96.55%, respectively. Compared with non-PCV13-covered strains, there was statistical difference in the insensitive rate (intermediate and drug resistance) to cefuroxime, erythromycin and azithromycin (P<0.05). Among 116 SP isolates, serotypes 19F, 6A, 14, 19A and 23F were significantly more sensitive to erythromycin and azithromycin than other serotypes, and the insensitivity rates of 19F to erythromycin and azithromycin were 100.00%. Conclusion: The common serotypes of SP in hospitalized children are 19F, 6A, 14, 19A and 23F, among which the coverage rate of PCV13 vaccine is higher. The covered strain of PCV13 is highly insensitive to erythromycin and azithromycin, so erythromycin and azithromycin should be avoided as much as possible in clinical treatment.
  • Analysis of Rational Use of Intravenous Proton Pump Inhibitors in Patients with Tumor of a Hospital
    ZOU Yin, ZHANG Gui-fen, ZHANG Min
    2022, 19(1): 30-35. https://doi.org/10.13493/j.issn.1672-7878.2022.01-008
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    Objective: To analyze the usage and rationality of intravenous proton pump inhibitors (PPIs) for inpatients in the tumor ward of a hospital so as to provide reference for rational drug use in clinic. Methods: The medical records of 210 patients with intravenous PPIs in tumor ward from November to December 2020 were collected from hospital information System. According to the relevant laws and regulations, the usage of intravenous PPIs and its rationality were analyzed statistically. Results: Among the 210 patients, the main purpose of use was postoperative chemotherapy for malignant tumors (27.62%), and 62.08% and 10.77% were treated with antitumor drugs and hematological drugs, respectively. In intravenous PPIs, the use frequency of lansoprazole accounted for 46.69%, the number of cases using a single variety accounted for 78.10%, the average course of treatment was (4.35±4.41) d, the course of treatment was less than or equal to 2 d accounted for 40.48%; The main types of irrational drug use were over-course of drug use (31.34%), over-dose (22.39%) and irrational drug selection (14.93%). PPIs have potential drug interactions with dihydropyridine calcium antagonists, capecitabine tablets and antibacterials. Conclusion: The structure of drug use in the tumor ward of the hospital is basically consistent with the treatment of disease, and the use of intravenous PPIs is acceptable overall, but some unreasonable uses still exist. The administrative department of a hospital should constantly improve the management system and standardize drug use in order to ensure the rationality and safety of clinical drug use.
  • Correlation Analysis of Serum 25-Hydroxy-vitamin D Level and Glucose Metabolism in Pregnant Women with Gestational Diabetes Mellitus*1
    ZHANG Jing, SHI Xiang-kui, JIANG Ying-feng, HUANG Ting, LIU Yuan, CAO Zheng, HUANG Hui, TANG Wen-ming
    2022, 19(1): 36-39. https://doi.org/10.13493/j.issn.1672-7878.2022.01-009
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    Objective: To analyze the correlation between serum 25-hydroxyvitamin D level and glucose metabolism in pregnant women with gestational diabetes mellitus (GDM). Methods: From September 2018 to August 2019, 230 pregnant women with gestational diabetes mellitus (GDM group) and 353 pregnant women with normal pregnancy (NGP group) were selected to compare the difference of serum 25-hydroxyvitamin D levels detected by immunochromatography. The effect of 25-hydroxyvitamin D level on glucose metabolism was analyzed. Results: The serum 25-hydroxyvitamin D level was (46.277±9.839) mmol/L in pregnant women younger than 35 years old, and was (47.394±10.540) mmol/L in pregnant women with age greater than or equal to 35 years, all of them were deficient. The metabolism of 25-hydroxyvitamin D fluctuated seasonally during pregnancy. The average levels of serum 25-hydroxyvitamin D in spring, summer, autumn and winter were (44.203±7.917) mmol/L, (49.065±11.029) mmol/L, (49.171±11.142) mmol/L and (44.652±8.854) mmol/L, respectively. The 25-hydroxyvitamin D levels in summer and autumn were higher than those in spring and winter. The level of 25-hydroxyvitamin D in GDM group was significantly lower than that in NGP group, but the difference was not statistically significant (P>0.05). The proportion of pregnant women with vitamin 25-hydroxyvitamin D deficiency was higher in the GDM group, and the risk of GDM was significantly increased when the 25-hydroxyvitamin D level was lower than 50 mmol/L. The risk of GDM decreased significantly when the 25-hydroxyvitamin D level was higher than 75 mmol/L. Conclusion: Apart from seasonal factors, glucose metabolism is affected by serum 25-hydroxyvitamin D level which is associated with the risk of GDM. When serum 25-hydroxyvitamin D level is greater than 75 mmol/L, the risk of GDM decreases significantly. Therefore, understanding the changes of serum 25-hydroxyvitamin D level in pregnant women is conducive to reasonable supplementation of vitamin D during pregnancy and prevention of gestational diabetes.
  • Analysis of Distribution and Drug Resistance of Pathogenic Bacteria in Patients with Eye Infection of A General Hospital
    LYU Zi-xin
    2022, 19(1): 40-43. https://doi.org/10.13493/j.issn.1672-7878.2022.01-010
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    Objective: To analyze the distribution and drug resistance of pathogenic bacteria in patients with eye infection of a general hospital so as to provide references for rational use of antibacterials. Methods: A total of 86 patients with ophthalmic diseases admitted to Nanyang First People's Hospital from August 2019 to August 2020 were selected as research objects, and their eye tissue samples were collected for bacterial culture and drug sensitivity test. The positive rate and pathogen distribution of 138 eye specimens, Drug resistance rate of main Gram-positive, Gram-negative bacteria were analyzed. Results: 95 (68.84%) of 138 eye specimens were positive for pathogenic bacteria. 154 strains of pathogenic bacteria were isolated and cultured, including 89 (57.79%) Gram-positive bacteria, mostly Staphylococcus epidermidis, Staphylococcus aureus and Streptococcus pneumoniae. There were 58 Gram-negative strains (37.66%), mostly Pseudomonas aeruginosa and Acinetobacter baumannii., and 7 strains of fungi (4.55%). The resistance rates of Gram-positive bacteria to oxacillin, tetracycline, penicillin G, erythromycin, clindamycin and sulfamethoxazole were higher, but the resistance rates to linezolid, vancomycin, amikacin, rifampicin and teicoplanin were lower. The drug resistance rate of Gram-negative bacteria to cefepime, piperacillin-tazobactam sodium, levofloxacin, ceftazidime, ciprofloxacin, cefuroxime, cefazolin, ceftriaxone were higher, but the drug resistance rate to furantoin, imipenem, meropenem was lower. Conclusion: Gram-positive bacteria are the main pathogenic bacteria of ophthalmic infection in general hospitals, and antibacterial drugs have to be rationally selected strictly based on the results of bacterial culture and drug sensitivity test.
  • Analysis of Pathogen Distribution and Drug Resistance of PICC-Related Bloodstream Infections in Patients with NSCLC Undergoing Chemotherapy
    LI Han-bing
    2022, 19(1): 44-47. https://doi.org/10.13493/j.issn.1672-7878.2022.01-011
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    Objective: To analyze the pathogen distribution and drug resistance rate of peripherally inserted central venous catheter (PICC)-related bloodstream infection in patients with non-small cell lung cancer (NSCLC) treated with chemotherapy. Methods: The clinical data of 65 NSCLC patients with PICC-related bloodstream infection during chemotherapy in the hospital from January 2018 to December 2020 were retrospectively analyzed, and the results of bacterial culture and drug sensitivity test of blood samples were analyzed. The distribution and drug resistance of pathogenic bacteria in patient samples were analyzed. Results: A total of 106 strains of pathogenic bacteria were isolated from the samples of 65 NSCLC patients with PICC-related bloodstream infection during chemotherapy, including 67 strains of Gram-negative bacteria (63.21%), 33 strains of Gram-positive bacteria (31.13%) and 6 strains of fungi (5.66%). The main Gram-negative bacteria were Klebsiella pneumoniae, Pseudomonas aeruginosa and Escherichia coli. The main Gram-positive bacteria were Staphylococcus aureus and Staphylococcus epidermidis. The fungi were mainly Candida smooth. The main pathogenic bacteria of PICC related bloodstream infections had different degrees of resistance rate to antimicrobial agents, among which Klebsiella pneumoniae to ciprofloxacin, gentamicin, cefazolin and cefoperazone were higher (less than 70.00%), and its resistance rate to amoxicillin, amikacin, imipenem and meropenem were lower (less than 30.00%). The drug resistance rates of Pseudomonas aeruginosa to gentamicin and ceftazidime were higher, and its drug resistance rates to amoxicillin, amikacin, imipenem, meropenem, piperacillin and cefotaxime were lower. The drug resistance rates of Escherichia coli to ciprofloxacin, gentamicin, ceftazidime and cefoperazone were higher, and its drug resistance rate to amoxicillin, amikacin, imipenem, meropenem, aztreonam, piperacillin and cefotaxime were lower. Conclusion: The main pathogens of PICC-related bloodstream infection in NSCLC chemotherapy patients are Gram-negative bacteria, and the 3 pathogens with the highest proportion are Klebsiella pneumoniae, Pseudomonas aeruginosa and Escherichia coli, which have different degrees of resistance to commonly used antibacterials.
  • Analysis of Detection and Drug Resistance of Klebsiella Pneumoniae in ICU Patients of a Hospital
    XU Ting-ting, WEI Guo-shi, SU Sha-sha
    2022, 19(1): 48-50. https://doi.org/10.13493/j.issn.1672-7878.2022.01-012
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    Objective: To investigate the detection and drug resistance of Klebsiella pneumoniae (KP) in ICU Patients of a hospital so as to provide reference for clinical prevention and treatment of KP infection. Methods: A total of 209 strains of KP isolated from ICU patients in a hospital from January 2019 to December 2020 were retrospectively selected as the research subjects. Drug sensitivity test and the phenotype screening and confirmation test of extended-spectrum beta-lactamase (ESBLs) were performed to analyze the source distribution and drug resistance rate of KP specimens. Results: A total of 209 strains of KP were isolated from the patients' specimens, mainly 148 strains (70.81%) isolated from sputum, followed by 23 strains(11.00%) from blood, 17 strains(8.13%) from pus and 11 strains(5.26%) from urine. A total of 155 strains of ESBLs-producing KP were detected in the patients' specimen, and the detection rate was 74.16%(155/209). The drug resistance rates to ampicillin, cefazolin, cefuroxime, ceftazidime, ceftriaxone, cefotaxime and cefepime were higher, and the drug resistance rate to imipenem was the lowest. The drug resistance rate of ESBLs-producing KP was higher than that of non-ESBLs-producing KP, and the difference was statistically significant(P<0.05). Conclusion: KP infection in ICU patients is mainly isolated from sputum specimens, and drug resistance phenotypes of KP are diverse and the drug resistance rate is high. Clinical monitoring of bacterial drug resistance rate should be strengthened, and antibacterials should be used rationally to control hospital infection.
  • Analysis of Distribution and Drug Resistance Rate of Common Pathogenic Bacteria in Clinic from 2019 to 2020
    SONG Guang-bo, LIAO Wei, NAN Li, GE Ting, SUN Zheng-min, SONG Yu-juan
    2022, 19(1): 51-55. https://doi.org/10.13493/j.issn.1672-7878.2022.01-013
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    Objective: To investigate the distribution and drug resistance rate of common pathogenic bacteria in hospitals from 2019 to 2020, and to provide reference for clinical drug usage. Methods: The results of pathogens' identification and drug sensitivity test were collected from the specimens submitted from each ward of the hospital from 2019 to 2020, and the distribution of pathogenic bacteria and drug resistance of main pathogenic bacteria were analyzed. Results: A total of 9 153 strains of pathogenic bacteria were isolated from the specimens collected from each ward from 2019 to 2020, whose main sources were secretion, mid-stream urine and sputum, including 278 strains of fungi, 2 689 strains of Gram-positive bacteria and 6 186 strains of Gram-negative bacteria. The resistance rates of Dung enterococcus to tetracycline, quinuptine/dapurtine were higher than those of Excrement enterococcus. The resistance rates of Excrement enterococcus to streptomycin, levofloxacin, moxifloxacin, ampicillin, penicillin were higher than those of Dung enterococcus. The resistance rates of Staphylococcus aureus to tetracycline, gentamycin and levofloxacin were higher than those of coagulase negative Staphylococcus, Enterococcus faecalis and Enterococcus faecium were 100.00% sensitive to vancomycin and linezolid, coagulase negative Staphylococcus and Staphylococcus aureus were 100.00% sensitive to vancomycin, linezolid and quinuptin/damuputin. The drug resistance rates of Acinetobacter baumannii to furantoin and cefazolin were 100.00%, and its drug resistance rates to gentamicin, imipenem, cefotetan, ceftazidime, ceftriaxone, ampicillin-sulbactam sodium were more than 80.00%. The drug resistance rates of Escherichia coli to cefazolin, ticarcillin and piperacillin were 100.00%, and its drug resistance rates to compound sulfamethoxazole, levofloxacin, ceftriaxone and ampicillin - sulbactam sodium were more than 60.00%. The drug resistance rates of Klebsiella pneumoniae to cefazolin and ticarcillin were 100.00%, and its drug resistance rates to minocycline, compound sulfamethoxazole, levofloxacin, furantoin, gentamicin, ceftazidime, ceftriaxone, ampicillin - sulbactam sodium were more than 60.00%. The drug resistance rates of Pseudomonas aeruginosa to compound sulfamethoxazole, tigecycline, cefazolin, amoxicillin-clavulanate potassium, ampicillin/sulbactam, ticarcillin and piperacillin were 100.00%, and its drug resistance rates to minocycline, nitrofurantoin and cefotetan were all more than 90.00%. Conclusion: From 2019 to 2020, the common pathogens with high proportion in hospitals are fungi such as Candida albicans, Gram-positive bacteria such as Enterococcus faecalis, Enterococcus faecium, coagulase negative Staphylococcus and Staphylococcus aureus, Gram-negative bacteria such as Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. Among them, the drug resistance rates of Escherichia coli, Acinetobacter baumannii and Klebsiella pneumoniae show an increasing trend year by year. Therefore, the hospital infection department and microbiology room should regularly monitor the drug resistance rate of various pathogenic bacteria to provide the most reasonable antibacterial treatment plan for clinic.
  • Analysis of Distribution and Drug Resistance of Pathogenic Bacteria in Feces Specimens of 62 Children with Infectious Diarrhea
    ZHANG Kun
    2022, 19(1): 56-58. https://doi.org/10.13493/j.issn.1672-7878.2022.01-014
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    Objective: To analyze the distribution and drug resistance of pathogenic bacteria in feces specimens of 62 children with infective diarrhea. Methods: The data of 62 children with infectious diarrhea who were admitted to the hospital from February 2019 to July 2020 were collected as the research objects. The feces of the children were taken as specimens, and bacteria were cultured on a plate. The microbial dynamic detection system was used to identify the types of bacteria. The distribution and drug resistance rate of pathogenic bacteria in fecal specimens were analyzed. Results: A total of 84 strains of pathogenic bacteria were isolated from fecal specimens of 62 children with infectious diarrhea, mainly were Salmonella, Shigella, Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa, accounting for 32.14%, 28.57%, 15.48%, 13.10% and 10.71%, respectively. The main Salmonella groups were Salmonella 04, 02 and 07, accounting for 13.09%, 10.71% and 8.33%, respectively. The main Shigella were Shigella flexneri, Shigella sonnei, Shigella baumannii and Shigella dysentery, accounting for 10.71%, 9.52%, 7.14% and 1.19%, respectively. The resistance rates of Salmonella to imipenem and amikacin were 0.00% and 3.70%, respectively. The drug resistance rates of Shigella to imipenem, compound sulfamethoxazole and amikacin were 0.00%, 0.00% and 4.17%, respectively. The resistance rate of pathogenic Escherichia coli to imipenem was 0.00%. Staphylococcus aureus had the lowest resistance rate to imipenem, which was 0.00%. The resistance rates of Pseudomonas aeruginosa to imipenem and amikacin were 0.00% and 0.00%, respectively. Conclusion: Salmonella and Shigella are the main pathogenic bacteria causing infectious diarrhea in children, and the main strains have different resistance rates to commonly used antibiotics. In clinical treatment, relevant measures can be formulated, and prevention and control measures should be taken actively to effectively reduce the incidence of infective diarrhea in children and promote their recovery.
  • Analysis of Pathogen Distribution and Drug Resistance in Vaginal Secretions of Women with Vaginal Infection at Childbearing Age in a Hospital and Related Factors
    WANG Feng-yan, WANG Yan-hong
    2022, 19(1): 59-62. https://doi.org/10.13493/j.issn.1672-7878.2022.01-015
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    Objective: To analyze the distribution and drug resistance of pathogenic bacteria in vaginal secretions of women with vaginal infection at childbearing age in a hospital and the infection-related factors. Methods: A total of 213 women of childbearing age who were treated in hospital due to abnormal vaginal secretions were selected from July 2019 to July 2020. The vaginal secretions samples of all patients were collected for pathogen examination, and the distribution and drug resistance of pathogenic bacteria as well as the infection-related factors were analyzed. Results: There were 191 cases of vaginal infection among the 213 women of childbearing age, accounting for 89.67%. A total of 202 strains of pathogenic bacteria were detected, including 101 strains of Gram-positive bacteria (50.00%), 35 strains of Gram-negative bacteria (17.33%) and 66 strains of fungi (32.67%). Escherichia coli had high drug resistant rates to ampicillin, ciprofloxacin and levofloxacin, Candida albicans had high drug resistance rates to itraconazole and fluconazole, Enterococcus had high drug resistance rates to tetracycline, coagulase negative Staphylococcus had high drug resistance rates to ampicillin and penicillin. The incidence of vaginal infection in women aged 26~40 years old, married, childbearing, contraception, abortion history and previous history of genital infection were higher than those in young age, unmarried, non-pregnant and without history of contraception, abortion and genital infection (P<0.05). Age, history of abortion, contraception and previous infection of reproductive system were independent risk factors for vaginal infection (P<0.05). Conclusion: The incidence of vaginal infection in women of childbearing age treated in hospital is high, the distribution of pathogenic bacteria is complex and they have different degrees of resistance to antibacterials. In order to avoid blind drug usage and the emergence of drug-resistant strains, clinical attention should be paid to the isolation and culture of pathogenic bacteria and drug sensitivity test to improve the pertinence of drug usage.
  • Analysis of Serotypes and Drug Resistance of Salmonella in 955 Patients with Diarrhea in an Area and Its Prevention and Treatment Countermeasures
    WEN Ying-ming, ZHANG Dan, GU Li-hong, LAI Zhi-jian
    2022, 19(1): 116-119. https://doi.org/10.13493/j.issn.1672-7878.2022.01-032
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    Objective: To analyze the serotypes and drug resistance of Salmonella in patients with diarrhea in Huidong area so as to provide reference for formulating prevention and treatment measures and guiding clinical medication. Methods: The bacterial culture results of stool samples from 955 patients with diarrhea diagnosed and treated in hospitals from 2018 to 2020 were collected, and the serotypes and drug resistance of Salmonella isolates were analyzed. Results: A total of 61 strains of Salmonella were detected in the stool samples from 955 patients with diarrhea, and 12 serotypes were isolated (Salmonella typhimurium and Salmonella enteritidis were the main serotypes, accounting for 34.43% and 24.59%, respectively). The drug sensitivity results showed that the drug resistance rates of Salmonella to ampicillin, tetracycline and chloramphenicol were 88.52%, 72.13% and 55.74%, respectively. The sensitivity rates of Salmonella to the third generation cephalosporins were about 73.00%, to quinolones were about 95.00%, to carbapenem was 100.00%. There were 34 strains of Salmonella resistant to more than 3 kinds of antibacterials, and the multi-drug resistance rate was 55.74%. Conclusion: The serotypes of Salmonella in diarrhea patients in Huidong area are mainly typhus and enteritis which have strong drug resistance and serious multi-drug resistance. Therefore, drug resistance monitoring and prevention and treatment countermeasures should be actively carried out to guide clinical scientific drug use.
  • Analysis of Clinical Characteristics of 220 Cases of Adverse Drug Reactions in a Hospital in 2020
    CHEN Dong, YAN Lu-qing
    2022, 19(1): 120-124. https://doi.org/10.13493/j.issn.1672-7878.2022.01-033
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    Objective: To analyze the characteristics and regularity of adverse drug reactions (ADRs) in Qinghai Provincial People's Hospital in 2020 so as to provide reference for clinical safe drug usage. Methods: Through retrospective study, 220 cases of ADRs reported in 2020 were selected to analyze and evaluate the characteristics and regularity. Results: In the 220 patients with ADRs, the male-female ratio was 1∶0.83, which mainly occurred in patients over 50 years old (72.72%), and mainly occurred in hospitalized patients with 40 to 50 years old (15.45%). The main drugs involved were anti-tumor drugs and antibacterial drugs (26.36% and 17.27%, respectively). The main clinical manifestations of ADRs were skin and accessory damage and digestive system damage (25.00% and 24.55%, respectively) and the dosage forms and delivery routes involved were injection (60.00%) and intravenous administration (54.55%). Conclusion: Clinical attention should be paid to the safe usage of anti-tumor drugs and intravenous antibacterials, and the publicity of rational drug usage knowledge should be strengthened so as to improve the level of rational drug usage.
  • Analysis of Clinical Characteristics of 47 Cases of Adverse Drug Reactions of Traditional Chinese Medicine Paste and Its Prevention Strategy
    JIN Xiao-qin, SHEN Jian-fei, SHENG Yi-liang
    2022, 19(1): 125-129. https://doi.org/10.13493/j.issn.1672-7878.2022.01-034
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    Objective: To analyze the clinical characteristics of adverse drug reactions caused by traditional Chinese medicine (TCM) paste in a hospital and propose prevention strategies so as to provide reference for the safe and effective usage of TCM paste in clinic. Methods: A total of 1 310 prescriptions (agent) from patients using TCM paste in 2018 were selected as research data, and the types and causes of adverse drug reactions after taking TCM paste were statistically analyzed. Results: A total of 47 cases of adverse drug reactions occurred in 1 310 prescriptions of TCM paste, and the incidence of adverse drug reactions was 3.59%. Most of the adverse reactions were abnormal liver function, followed by gastrointestinal discomfort and allergic reaction. After discontinuation, symptomatic treatment turned out to be good. Conclusion: In the hospital, the usage of TCM paste is reasonable, but some minor adverse drug reactions also occur. In order to prevent the occurrence of adverse drug reactions, the prevention measures of drug-induced liver injury caused by TCM paste are put forward.
  • Analysis of Correlation between Azithromycin and Hematuria in 1 case and Its Possible Mechanism
    ZHANG Bao, ZHAO Shan, YANG Hong, MA Xiao, TIAN Hong-xing, LI Yue
    2022, 19(1): 130-132. https://doi.org/10.13493/j.issn.1672-7878.2022.01-035
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    Objective: To analyze the correlation between azithromycin and hematuria and its possible mechanism so as to provide reference for the clinical treatment of similar patients. Methods: Based on the data of a severe pneumonia patient with azithromycin induced hematuria, and combined with similar cases reported in the literature, the general situation, primary disease and drug treatment process of such patients were analyzed.The characteristics, pathogenesis, management and outcome of azithromycin induced hematuria were discussed. Results: Azithromycin associated hematuria was mostly visible to the naked eye, which could occur from 40 min to 4 d after administration. The symptoms of hematuria were improved after stopping azithromycin and symptomatic treatment. Azithromycin-associated hematuria might be related to kidney injury caused by azithromycin. Conclusion: Azithromycin is a commonly used antibacterial agent in clinical practice. Although there are few literature reports on hematuria caused by azithromycin, it is still necessary to be cautious in clinical usage. When the patient has hematuria, azithromycin should be stopped immediately, and symptomatic measures should be taken if necessary.
  • Pharmaceutical Care of a Patient with Bechchet Syndrome Complicated with Multisystem Cryptococcus Infection*1
    LONG Liang, LIU Xiang, GUO Xiao-lan
    2022, 19(1): 133-135. https://doi.org/10.13493/j.issn.1672-7878.2022.01-036
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    Objective: To analyze the rationality of antifungal treatment of patients with Behcet syndrome complicated with multisystem Cryptococcus infection so as to explore the role of clinical pharmacists in participating in antifungal therapy. Methods: Clinical pharmacists participated in the formulation of antifungal treatment plan and pharmaceutical care of antifungal drug treatment for 1 case of Behcet syndrome complicated with systemic Cryptococcus infection to ensure the safety of drug usage. Results: In the formulation of antifungal treatment plan of clinical pharmacists, the adverse reactions of renal damage were related to amphotericin B, and the adverse reactions of bleeding were related to the interaction between fluconazole and warfarin. After individual medication treatment, it gradually subsided, and the curative effect was definite. Conclusion: Clinical pharmacists are fully involved in the treatment process of patients with Behcet syndrome, and implement pharmaceutical care, which not only ensures drug efficacy, but also avoids the occurrence of adverse reactions.
  • Pharmaceutical Care of a Patient with Recurrent Acute Pancreatitis Treated with Integrated Traditional Chinese and Western Medicine
    WANG Li-jun, MA Wen-xiang, LI Yi-xuan
    2022, 19(1): 136-139. https://doi.org/10.13493/j.issn.1672-7878.2022.01-037
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    Objective: To analyze the rationality of a case of acute pancreatitis treated with the integrated Traditional Chinese and Western medicine. Methods: Clinical Chinese pharmacists participated in the clinical diagnosis and treatment of patients with acute pancreatitis and the formulation of the integrated Traditional Chinese and Western medicine, as well as the implementation of pharmaceutical care. Results: After the treatment with the integrated Traditional Chinese and Western medicine developed by clinical Chinese pharmacists, it promoted the circulation of blood to remove stasis, the absorption of abdominal effusion, improved the exudation of pancreatic fluid, and improved the symptoms and discharged from hospital. Conclusion: The implementation of traditional Chinese medicine pharmaceutical care has brought into full play the professional expertise of traditional Chinese pharmacists, improved the clinical efficacy and ensured the safety of drug use.
  • Analysis of Anti-infective Therapy Consultation of 138 Patients and Typical Case Participated by Clinical Pharmacists
    ZHANG Jing-wen, LI Hui-ying
    2022, 19(1): 140-143. https://doi.org/10.13493/j.issn.1672-7878.2022.01-038
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    Objective: To analyze the formulation of anti-infective treatment protocol for consulting cases and the pharmaceutical care of typical cases participated by clinical pharmacists so as to provide reference for the continuous improvement of clinical pharmacy work. Methods: The information of 138 cases of consultation participated by clinical pharmacists in the hospital in 2020 was collected to analyze the distribution of consultation departments, the recommended adoption rate of consultation, the outcomes after clinical treatment, and the pharmaceutical care of typical cases and difficult cases encountered in the consultation process. Results: Among the 138 consultation cases, 82.61% fully accepted the pharmacist's advice (or opinion), 13.77% partially accepted, and 3.62% did not accept. Among them, the consultations on the usage of antibacterials accounted for 97.83%. Conclusion: The participation of clinical pharmacists in drug therapy is gradually recognized by doctors, nurses and patients, and their important role in rational drug usage is initially shown, which improves the professional level and work status of pharmacists.