目的 了解廣西柳州市工人醫(yī)院2010—2013年血液科常見革蘭陰性菌的分布及耐藥趨勢，以指導(dǎo)臨床合理使用抗菌藥物。方法 對2010年1月—2013年12月廣西柳州市工人醫(yī)院血液科送檢分離出的病原菌菌株及其耐藥性進行回顧性調(diào)查分析。結(jié)果 共分離出常見的革蘭陰性菌508株，主要以大腸埃希菌和肺炎克雷伯菌為主，分別占26.2%、21.7%；銅綠假單胞菌和鮑曼不動桿菌檢出率分別為16.5%、13.6%。超廣譜β-內(nèi)酰胺酶檢測結(jié)果顯示，肺炎克雷伯菌和大腸埃希菌的平均檢出率分別為40.2%、60.5%。陰溝腸桿菌、肺炎克雷伯菌和大腸埃希菌對碳青霉烯類抗菌藥物總體上有較高的敏感性；銅綠假單胞菌、鮑曼不動桿菌對多數(shù)抗菌藥物高度耐藥，且呈逐年上升趨勢。結(jié)論 血液科臨床分離的革蘭陰性菌的比例較高，對常用抗菌藥物耐藥嚴(yán)重，應(yīng)加強革蘭陰性桿菌耐藥性的動態(tài)監(jiān)測，以指導(dǎo)臨床進行合理規(guī)范的抗感染治療。

Objective To investigate the distribution and antimicrobial resistance of commonly Gram-negative bacteria from the hematology department of Liuzhou Worker’s Hospital during 2010 to 2013, and to instruct the reasonable clinical application of antibiotics. Methods The clinical data and drug resistance of Gram-negative bacteria distribution isolated from the hematology department from 2010 to 2013 were reviewed retrospectively. Results All of 508 Gram-negative bacteria were isolated, the main strains were Escherichia coli (26.2%), Klebsiella pneumoniae (21.7%), Pseudomonas aeruginosa (16.5%), and Acinetobacter baumannii (13.6%). The extended spectrum β-lactamases (ESBLs) of E. coli and K. pneumoniae were 60.5% and 40.2%, respectively. The antibiotics sensibility result was analyzed, E. cloacae, K. pneumoniae, and E. coli kept high sensibility to carbapenem. P. aeruginosa and A. baumannii kept high resistance to most antibiotics and increased year by year. Conclusion The Gram-negative bacteria are the most common bacteria in hematology department and showed multi-drug resistance. We should strengthen the dynamic monitoring of drug resistance of Gram-negative bacteria, so as to instruct the clinicians to have anti-infectious remedy reasonably and normatively.