呼吸道感染已成为手术病人并发感染的首位原因，其病原菌的变迁是动态的，目前革兰阴性（G-）杆菌是肺部感染的主要致病菌，革兰阳性（G+）菌和真菌的发病率在逐年增加。随着广谱抗生素的大量应用，主要致病菌耐药性日趋严重。积极应对策略包括：科学、合理应用抗生素以及采取各种有效措施，降低围手术期院内肺部感染的发生率。

Perioperative respiratory tract infections: the changing nature and strategy against bacterial pathogens        YU Wen-kui，ZHU Wei-ming. Research Institute of General Surgery, Nanjing General Hospital of Nanjing Military Command, Medical College of Nanjing University, Nanjing 210002, China
Corresponding  author ：ZHU Wei-ming, E-mail: juwiming@yahoo.com.cn
Abstract    Respiratory tract infection is the most common infectious complication in perioperative period. Pathogens causing respiratory tract infection change continuously. Now, Gram-negative bacteria is still the most common pathogen for respiratory tract infection. Incidence of Gram-positive bacterial and fungal infection is also increasing gradually. Antibiotic abuse causes increasing problem of bacterial resistance to antimicrobial treatment. Strategies to reduce the emergence of antibiotic-resistant bacteria include not only prescribing antibiotics judiciously and properly, but also various measures to reduce the incidence of perioperative nosocomial respiratory infections.