关键词: 鲍曼不动杆菌；碳青霉烯类抗生素；β-内酰胺酶抑制剂；多药耐药；非耐药；敏感性；频率

Abstract:

Abstract:Objective To investigate the influence of the adoption preference in the clinical choice of antibiotics on   drug resistance of Acinetobacter baumannii (Ab),and to provide references for clinical  treatment.Methods 1 078 Ab-positive strains  isolated from clinical specimens were divided into multi-drug resistance Ab straains(n=449) and non-drug resistance strins(n=437) based on drug resistance.The relationship  between clinicians, preferences of choosing carbapenem antibiotics and(or) β-lactam antibiotics adding β-lactamase inhibitor to treat non-drug resistance Ab  and the changes of drug resistance of Ab strains was analyzed.Results There were 394 Ab strains in 2006，354 Ab strains in 2007，and 330 Ab strains in 2008. 449 multi-drug resistance Ab strains contained 206 strains in 2006，124 strains in 2007，and 119 strains in 2008.In multi-drug resistance Ab group,the ratios of sensitivity to carbapenem antibiotics and adding β-lactamase inhibitor from 2006 to 2008 were 25.2%,50.8%,and 25.2%.The ratios only sensitive to carbapenem antibiotics from 2006 to 2008 were 68.0%,11.3%,and 2.5%；the ratios only sensitive to antibiotics adding β-lactamase inhibitor from 2006 to 2008 were 6.8%,37.9%,and 72.3%. 437 non-drug resistance Ab strains contained 88 strains in 2006，230 strains in 2007，and 119 strains in 2008.The ratios of clinician’s preference of choosing carbapenem antibiotics from 2006 to 2008 were 0%,9.3%,and 20.7%.The ratios of clinician’s preference of choosing antibiotics adding β-lactamase inhibitor from 2006 to   2008 were 35.5%,38.4%,and 22.4%.With the increasing frequencies of using carbapenem antibiotics in non-drug resistance Ab from 2006 to 2008,the carbapenem resistance of Ab  increased rapidly.From 2006 to 2007,with the slow increasing of choosing antibiotics adding β-lactamase inhibitor in non-drug resistance Ab infected patients,the drug resistance of Ab to adding β-lactamase inhibitor  decreased  obviously.In 2008, the frequencies of using antibiotics adding β-lactamase inhibitor in non-drug resistance Ab decreased,the sensitivity to antibiotics adding β-lactamase inhibitor increased twice in multi-drug resistance Ab. Conclusion The preferences of clinicial antibiotics adoption may influence the changes of drug resistance of Ab strains,but β-lactamase inhibitor maybe obviously suppress the production of drug resistance of Ab strains.

Key words: acinetobacter baumannii;carbapenem antibiotics;β-lactamase inhibitor, multi-drug resistance;non-drug resistance;sensitivity, frequency