目的了解宁波市妇儿医院儿科重症监护室(PICU)患儿呼吸道标本病原菌的分布及耐药性情况,为临床合理用药提供参考。方法采用病原学标本分离培养和药敏试验方法 ,对PICU连续5年住院患儿呼吸道感染标本进行细菌检测与结果分析。结果 5年来共检测患儿呼吸道标本4 091份,检出病原菌1 273株,阳性率为31.1%。患儿呼吸道标本检出革兰阴性菌占68.5%,真菌占23.8%,其余为革兰阳性球菌。主要优势菌有鲍曼不动杆菌、白色念珠菌、肺炎克雷伯菌、大肠埃希菌、阴沟肠杆菌、金黄色葡萄球菌。临床分离的革兰阴性杆菌对常用抗菌药物广泛耐药;金黄色葡萄球菌对青霉素类耐药率超过90%。结论该妇儿医院PICU患儿呼吸道标本分离的病原菌以革兰阴性杆菌为主,真菌分离率较高,分离病原菌中多重耐药菌检出率也较高。 Objective To understand the distribution and drug resistance of pathogenic bacteria in respiratory tract specimens of children with pediatric intensive care unit (PICU) in Ningbo Women and Children Hospital, and to provide a reference for clinical rational drug use. Methods The pathogenic specimens were isolated and cultured and susceptibility testing methods were used to detect and analyze the bacteria of respiratory tract infection in hospitalized children with PICU for 5 consecutive years. Results A total of 4 091 respiratory tract specimens were detected in 5 years and 1 273 pathogenic bacteria were detected. The positive rate was 31.1%. Gram-negative bacteria detected in respiratory specimens of children accounted for 68.5%, fungi accounted for 23.8%, the remaining gram-positive cocci. The main dominant bacteria Acinetobacter baumannii, Candida albicans, Klebsiella pneumoniae, Escherichia coli, Enterobacter cloacae, Staphylococcus aureus. Gram-negative bacilli clinically isolated are widely resistant to commonly used antibiotics; Staphylococcus aureus is more than 90% resistant to penicillins. Conclusion The pathogenic bacteria isolated from respiratory specimens of PICU children in this women and children hospital are Gram-negative bacilli. The rate of fungi isolation is high, and the detection rate of multiple drug-resistant bacteria in isolated pathogens is also higher.