目的 分析廣西柳州市工人醫(yī)院2009年1月—2012年12月呼吸病房常見革蘭陰性菌的分布及對(duì)抗菌藥物的耐藥情況，為臨床醫(yī)師合理用藥提供可靠依據(jù)。方法 對(duì)2009年1月—2012年12月柳州市工人醫(yī)院呼吸病房送檢分離出的病原菌菌株及其耐藥性進(jìn)行回顧性調(diào)查分析。結(jié)果 共分離出常見的革蘭陰性菌1 434株，主要以肺炎克雷伯菌和鮑曼不動(dòng)桿菌為主，分別占25.9%、19.7%；大腸埃希菌和銅綠假單胞菌檢出率分別17.0%、12.6%。大腸埃希菌和肺炎克雷伯菌超廣譜β-內(nèi)酰胺酶（ESBLs）的平均檢出率分別為34.4%、54.9%。大腸埃希菌、肺炎克雷伯菌和陰溝腸桿菌對(duì)亞胺培南、美羅培南和哌拉西林/他唑巴坦保持較高的敏感性，敏感率為65%～100%。鮑曼不動(dòng)桿菌、銅綠假單胞菌對(duì)多數(shù)抗菌藥物高度耐藥，且呈逐年上升趨勢。結(jié)論 不同的革蘭陰性菌對(duì)各類抗菌藥物的耐藥性存在差異，應(yīng)加強(qiáng)革蘭陰性桿菌耐藥性的動(dòng)態(tài)監(jiān)測，為臨床醫(yī)師合理使用抗菌藥物提供科學(xué)依據(jù)。

Objective To analyze the distribution and drug resistance of Gram-negative bacteria in the Respiration Department of Liuzhou Worker’s Hospital from January, 2009 to December, 2012, in order to provide the reliable basis for clinical rational drug use. Methods Bacteria strains separated from the Respiration Department of Liuzhou Worker’s Hospital from January, 2009 to December, 2012 and their drug resistance were studied, respectively. Results All of 1 434 Gram-negative bacteria were separated and the main strains were Klebsiella pneumoniae (25.9%), Acinetobacter baumannii (19.7%), Escherichia coli (17.0%), and Pseudomonas aeruginosa (12.6%). The average detection rates of extended-spectrum beta-lactamases (ESBLs) in K. pneumoniae and E. coli were 34.4% and 54.9%, respectively. E. coli, K. pneumoniae. and Enterobacter cloacae kept high sensibility to imipenem, meropenem, and piperacillin/tazobactam, and the sensitivity rate was 65%—100%. A. baumannii and P. aeruginosa kept high resistance to the most antibiotics and increased year by year. Conclusion The antimicrobial resistance of Gram-negative bacteria is different, so we should strengthen dynamic monitoring on drug resistance of Gram-negative bacteria, in order to provide the scientific basis for the clinical rational usage of antimicrobial drug.