目的    调查北京大学人民医院外科2008-2011年血标本病原菌的分布及耐药情况，为临床合理应用抗菌药物提供依据。方法    采用BacT/ALERT3D全自动培养仪、VITEK-2系统对外科送检血标本进行菌种鉴定和药物敏感试验，运用 WHONET5.6软件及Spss16.0软件统计分析。结果    4074份血标本检出病原菌358株，其中革兰阴性（G-）菌166株（46.4%），革兰阳性（G+）菌137株（38.3％），真菌32株（8.9%），前5位检出的病原菌为大肠埃希菌（19.8%）、肺炎克雷伯菌（11.2%）、表皮葡萄球菌（10.1%）、人葡萄球菌（6.7%）、金黄色葡萄球菌（5.9%）及屎肠球菌（5.9%）。产超广谱β-内酰胺酶（ESBLs）的大肠埃希菌及肺炎克雷伯菌检出率分别为54.5%和42.9%，耐甲氧西林金黄色葡萄球菌（MRSA）和耐甲氧西林表皮葡萄球菌（MRSE）检出率分别为39.2%和79.4%。碳青霉烯类对肠杆菌的抗菌活性最强; 鲍曼不动杆菌耐药严重; 万古霉素、替考拉宁对革兰阳性球菌活性最强，未发现万古霉素耐药的葡萄球菌；检出1株耐万古霉素屎肠球菌。结论    应采取更为积极有效地感染控制措施减少耐药菌的发生及传播，及时选用敏感药物对提高外科血流感染治疗效果具有重要意义。

Surveillance of bacterial distribution and durg resistance in bloodstream infections inpatients of surgical depatement of Peking University People's Hospitel during 2008-2011        JIANG Ke-wei*, LV You,GUO Peng, et al. *Department of Gastrointestinal Surgery，Surgical Oncology Laboratory，Peking University People’s Hospital, Bejing 100044，China
Corresponding author：WANG Shan, E-mail：Dr.wangshan@sohu.com
Abstract    Objective    To investigate the pathogens distribution and drug resistance in patients with bloodstream infections during 2008-2011 in Peking University people's hospital and provide the basis for clinical appropriate antimicrobial therapy. Methods    Bacterial identification and antibiotic susceptibility testing were initially performed using BacT/ALERT 3D automatic culture system，VITEK-2 system for blood samples of surgical department，and  Statistical analysis was performed using the software WHONET 5.6 and SPSS 16.0. Results    A total 358 strains isolated from 4074 blood samples, including 166 Gram-negative strains(46.4%), 137 Gram-positive strains(38.3%) and 32 fungal strains(8.9%). Escherichia coli(19.8%),Klebsiella pneumoniae (11.2%),Staphylococcus epidermidis(10.1%), Staphylococcus hominis(6.7%)，Staphylococcus aureus(5.9%) and Enterococcus faecium(5.9%) were the most common isolates．The rate of Extended-spectrum beta-lactamase (ESBLs) produced by Escherichia coli and Klebsiella pneumoniae were 54.5% and 42.9％,respectively. The isolation rates of the Methicillin resistant Staphylococcus aureus (MRSA) and Methicillin resistant Staphylococcus epidermidis(MRSE) were 39.2% and 79.4%,respectively. The resistant rates of Enterobacter to carbapenem antibacterial activity were very low,  and the resistant of Acinetobacter baumannii was very serious. Vancomycin, Teicoplanin are the most effective antimicrobial agents against Gram-positive cocci, No vancomycin-resistant Staphylococcus aureus were found. Conclusion    It should adopt a more positive effectively infection control measures to reduce the occurrence and spread of antibiotic resistant bacteria, appropriate initial antimicrobial therapy is of great significance to  improve outcomes in patients with bloodstream infection.