目的 分析2013-2015年徐州市第一人民醫(yī)院病原菌的分布和耐藥性分析。方法 回顧性分析2013年1月-2015年12月于徐州市第一人民醫(yī)院進(jìn)行住院治療患者的臨床資料，探討病原菌分布特點(diǎn)和細(xì)菌耐藥情況。結(jié)果 醫(yī)院感染病原菌標(biāo)本來(lái)源主要為痰液、尿液、血液，分別占55.0%、17.6%、10.6%。2013-2015年共分離病原菌菌株3 106株，其中革蘭陰性菌占63.1%，革蘭陽(yáng)性菌占21.2%，真菌占15.7%；各年度病原菌分布均以革蘭陰性菌為主，主要以大腸埃希菌（18.1%）、鮑曼不動(dòng)桿菌（14.0%）、銅綠假單胞菌（13.2%）、肺炎克雷伯菌（9.7%）為主。大腸埃希菌、肺炎克雷伯菌均對(duì)氨芐西林、哌拉西林耐藥嚴(yán)重，對(duì)阿米卡星、哌拉西林/他唑巴坦、美洛培南、亞胺培南、頭孢哌酮/舒巴坦敏感；鮑曼不動(dòng)桿菌對(duì)阿莫西林/克拉維酸、氨芐西林、氨曲南耐藥、哌拉西林耐藥嚴(yán)重，對(duì)頭孢哌酮/舒巴坦敏感；銅綠假單胞菌對(duì)阿莫西林/克拉維酸、氨芐西林、氨芐西林/舒巴坦、復(fù)方新諾明、頭孢噻肟耐藥嚴(yán)重，對(duì)阿米卡星、頭孢哌酮/舒巴坦敏感。革蘭陽(yáng)性菌主要以金黃葡萄球菌（10.4%）為主，對(duì)氨芐西林、克林霉素、青霉素、紅霉素耐藥嚴(yán)重，對(duì)喹奴普汀/達(dá)夫普汀、嗎啉酮、替考拉寧、萬(wàn)古霉素敏感。結(jié)論 2013-2015年徐州市第一人民醫(yī)院病原菌主要以革蘭陰性菌為主，耐藥情況比較普遍，需根據(jù)藥敏試驗(yàn)結(jié)果合理用藥，減少醫(yī)院感染。

Objective To investigate the distribution and drug resistance of pathogenic bacteria in the First People's Hospital of Xuzhou from 2013 to 2015. Methods A retrospective analysis from January 2013 to December 2015 in the First People's Hospital of Xuzhou were collected on the clinical data of patients with nosocomial infection, and the distribution and drug resistance of pathogenic bacteria were investigated. Results The pathogens of nosocomial infection were mainly isolated from sputum, urine, blood, accounted for 55.0%, 17.6%, and 10.6%, respectively. A total of 3 106 strains of pathogenic bacteria were isolated from 2013 to 2015, including Gram-negative bacteria (63.1%), Gram positive bacteria (21.2%), and fungi (15.7%). Gram negative bacteria were mainly Escherichia coli (18.1%), Acinetobacter baumanniis (14.0%), Klebsiella pneumoniae (13.2%), and Pseudomonas aeruginosa (9.7%). E. coli and K. pneumoniae were seriously resistant to ampicillin and piperacillin, and sensitive to amikacin, piperacillin/tazobactam, meropenem, imipenem, and cefoperazone/sulbactam. A. baumanniis were seriously resistant to amoxicillin/clavulanic acid, ampicillin, aztreonam and piperacillin, and sensitive to amikacin, cefoperazone/sulbactam. Gram positive bacteria were mainly Staphylococcus aureus (10.4%), which were seriously resistant to ampicillin, penicillin, erythromycin, clindamycin, and sensitive to quinupristin/dave leptin, teicoplanin, vancomycin, and linezolid. Conclusion The pathogenic bacteria in the First People's Hospital of Xuzhou from 2013 to 2015 are mainly Gram negative bacteria, and the drug resistance is more common, so it is necessary to use the drug in accordance with the results of drug sensitivity test, and reduce hospital infection.