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目的：监测多重耐药性革兰氏阴性杆菌（ＭＲＧＮＢ），做到合理用药，提高感染治愈率。方法：１９９６年１ 月至１９９７ 年１２ 月，在上海第二医科大学新华医院，临床痰液标本中分离出８４１ 株革兰氏阴性杆菌（ＧＮＢ）。应用美国ＢＥＣＴＯＮ－ＤＩＣＫＩＮＯＮ公司的药敏检测板（ＭＩＣ法），按ＮＣＣＬＳ标准判定敏感性。结果：８４１株ＧＮＢ占同期细菌总数７１．５４％ ，ＧＮＢ中非发酵菌占６９．４６％ ，其中以铜绿假单胞菌最多见，其次为鲍氏不动杆菌。在肠杆菌科中以肺炎克雷伯氏菌最多见，其次为阴沟肠杆菌。多数ＧＮＢ对常用抗生素的耐药率均有不同程度的上升，ＧＮＢ对哌拉西林耐药率高（＞ ６６％ ）。肠杆菌科菌对氨苄西林耐药率更高（９３％ ），对第三代头孢菌素耐药率高达５３％ ～６７％ 。不动杆菌对第三代头孢菌素耐药率高（７５％ ～８４％ ）。铜绿假单胞菌对β－内酰胺类药物耐药率为２２％ ～８６％ 。对ＧＮＢ作用较强者，依次为亚胺培南、阿米卡星、环丙沙星和头孢他啶，上述药物可作为治疗ＧＮＢ感染经验用药的选择。ＭＲＧＮＢ发生率为１７％ ，对４ 类主要抗菌药（氨基糖苷类、喹诺酮、第三代头孢菌素及亚胺培南）中的２类产生耐药性为１０％ ，３ 类产生耐药性为６％
Objective: To monitor multi-drug resistant Gram-negative bacilli (MRGNB) and make rational use of drugs to improve the cure rate of infection. Methods: From January 1996 to December 1997, 841 Gram - negative bacilli (GNB) were isolated from clinical sputum from Xinhua Hospital, Shanghai Second Medical University. Application of the United States BECTON-DICKINON company’s drug sensitivity detection board (MIC method), according to the NCCLS standard to determine the sensitivity. Results: 841 strains of GNB accounted for 71.54% of the total bacteria in the same period and non-fermentative bacteria in GNB accounted for 69.46%, of which Pseudomonas aeruginosa was the most common, followed by Acinetobacter baumannii. Enterobacteriaceae Klebsiella pneumoniae most common, followed by Enterobacter cloacae. Most of the GNB resistance rate of commonly used antibiotics have increased to varying degrees, GNB piperacillin resistance rate (> 66%). Enterobacteriaceae ampicillin resistant rate is higher (93%), the third generation cephalosporin resistance rate as high as 53% to 67%. Acinetobacter third generation cephalosporin resistance rate (75% to 84%). Pseudomonas aeruginosa β-lactam drug resistance rate of 22% to 86%. Those who have a strong effect on GNB, followed by imipenem, amikacin, ciprofloxacin and ceftazidime, may be used as an option for the empirical treatment of GNB infection. The incidence of MRGNB was 17%, and 10% of the 4 major antimicrobial agents (aminoglycosides, quinolones, third generation cephalosporins and imipenem) were found in 2% 6%