目的 了解廣西壯族自治區(qū)腦科醫(yī)院臨床常見革蘭陰性菌的分布及耐藥性變遷，為指導(dǎo)臨床合理使用抗菌藥物提供可靠依據(jù)。方法 回顧性分析2010—2013年廣西壯族自治區(qū)腦科醫(yī)院臨床各科室送檢標(biāo)本分離的革蘭陰性菌及其耐藥性進(jìn)行回顧性調(diào)查分析。結(jié)果 4年間送檢標(biāo)本共分離出7 450株病原菌，主要以大腸埃希菌、肺炎克雷伯菌、銅綠假單胞菌、鮑曼不動(dòng)桿菌和陰溝腸桿菌為主，檢出率依次為28.4 %、20.9%、18.7%、15.2%、6.2%。4年間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56.3%、36.9%。藥敏結(jié)果顯示，不同菌屬對(duì)抗生素的耐藥率有差別，肺炎克雷伯菌、大腸埃希菌和陰溝腸桿菌對(duì)碳青霉烯類抗菌藥物總體上有較高的敏感性；銅綠假單胞菌對(duì)喹諾酮類、亞胺培南、頭孢哌酮/舒巴坦耐藥率相對(duì)較低；鮑曼不動(dòng)桿菌對(duì)多數(shù)抗菌藥物高度耐藥，且呈逐年上升趨勢(shì)。結(jié)論 廣西壯族自治區(qū)腦科醫(yī)院臨床常見革蘭陰性菌對(duì)常用抗菌藥物耐藥嚴(yán)重，應(yīng)加強(qiáng)革蘭陰性菌耐藥性的動(dòng)態(tài)監(jiān)測(cè)，以指導(dǎo)臨床進(jìn)行合理規(guī)范的抗感染治療。

Objective To investigate the distribution and antimicrobial resistance of common Gram-negative bacteria in Brain Hospital of Guangxi Zhuang Autonomous Region during 2010 to 2013, and to instruct the reasonable clinical application of antibiotics. Methods The clinical data and drug resistance of Gram-negative bacteria isolated from various clinical specimens from 2010 to 2013 were reviewed retrospectively. Results All of 7 450 Gram-negative bacteria were isolated, and the main strains were Escherichia coli (28.4 %), Klebsiella pneumoniae (20.9%), Pseudomonas aeruginosa (18.7%), Acinetobacter baumannii (15.2%), and Enterobacter cloacae (6.2%). The extended spectrum β-lactamases (ESBLs) of E. coli and K. pneumoniae were 56.3% and 36.9%, respectively. The rates of sensitive to antimicrobial agents were different between bacteria. K. pneumoniae, E. coli, and E. cloacae kept high sensibility to imipenem, meropenem, and piperacillin/tazobactam. P. aeruginosa had the low drug resistance to imipenem and cefoperazone/sulbactam. P. aeruginosa kept high resistance to most antibiotics and increased year by year. Conclusion The drug resistance status of common clinical Gram-negative bacteria in Brain Hospital of Guangxi Zhuang Autonomous Region is more and more serious. People should strengthen the detecting of pathogens and monitoring of bacterial drug resistance, so as to instruct the clinicians to have anti-infectious remedy reasonably and normatively.