分析院内临床分离的主要细菌的耐药性及标本来源和病区分布，为临床合理使用抗菌药物和院内抗菌药物管理提供依据。

用WHONET5.6软件分别对2015年我院临床分离率为前4位的1 049株大肠埃希菌、644株肺炎克雷伯菌、402株铜绿假单胞菌和354株鲍曼不动杆菌的耐药性及分布进行回顾性分析。

2015年我院临床分离率前4位细菌中，大肠埃希菌对亚胺培南等21种抗菌药物的耐药率为2.0%~82.0%；肺炎克雷伯菌对亚胺培南等21种抗菌药物的耐药率为6.2%~73.9%；铜绿假单胞菌对亚胺培南等12种抗菌药物的耐药率为6.2%~22.4%；鲍曼不动杆菌对亚胺培南等13种抗菌药物的耐药率为36.4%~70.9%。大肠埃希菌标本主要来自尿液(58.2%)，其次来自痰液(12.8%)和血液(12.5%)。而肺炎克雷伯菌(63.2%)、铜绿假单胞菌(74.1%)和鲍曼不动杆菌(89.2%)标本主要来自痰液。大肠埃希菌主要分布在肾内科病房(22.9%)，肺炎克雷伯菌主要分布在儿内科病房(13.8%)，铜绿假单胞菌主要分布在重症监护病房(16.4%)，鲍曼不动杆菌主要分布在重症监护病房(26.3%)和呼吸重症监护病房(19.2%)。

临床分离的主要细菌对各种抗菌药物的耐药率相差很大、分布也有差异，临床医师应及时掌握全院和重点科室细菌的耐药性及分布特点，合理使用抗菌药物。

To investigate the distribution of drug-resistant bacteria in clinical samples in our hospital, and provide evidence for clinical application and management of antibiotics.

Escherichia coli, Klebsiella pneumonia, Pseudomonas aeruginosa and Acinetobacter baumannii were the top four bacteria that collected from our hospital in 2015. Drug resistance of the 1 049 Escherichia coli strains, 644 Klebsiella pneumonia strains, 402 Pseudomonas aeruginosa strains and 354 Acinetobacter baumannii strains were retrospectively analyzed by WHONET5.6.

The drug resistance rates of 1 049 E.coli strains, and 644 Klebsiella pneumonia strains to 21 antibiotics (including imipenem) ranged from 2.0% to 82.0% and 6.2% to 73.9% respectively. Bacterial drug resistance rates of 402 Pseudomonas aeruginosa strains to 12 antibiotics including imipenem ranged from 6.2% to 22.4% and the rates for 354 Acinetobacter baumannii strains to 13 antibacterial ranged from 36.4% to 70.9%. E.coli were mainly isolated from urine specimens (58.2%), followed by sputum specimens (12.8%) and blood specimens (12.5%). In contrast, 63.2% of Klebsiella pneumonia strains, 74.1% of Pseudomonas aeruginosa strains and 89.2% Acinetobacter baumannii strains were isolated from sputum. E.coli was the primary bacteria that distributed in the urological ward (22.9%) while Klebsiella pneumonia was the primary bacteria that distributed in children ward (13.8%). Pseudomonas aeruginosa mainly distributed in Intensive Care Unit (ICU) (16.4%) and Acinetobacter baumannii also mainly distributed in ICU (26.3%) and Respiratory Intensive Care Unit (19.2%).

The drug resistance rates of bacteria to antibiotics were wide-ranging in our hospital and the distribution of bacteria varied widely. Clinicians should understand the pathogenic bacteria and drug-resistant bacteria distribution in the hospital in order to promote rational medicine utilization.