目的 分析阿壩州人民醫(yī)院重癥監(jiān)護(hù)病房下呼吸道感染病原菌的分布及耐藥性，為臨床合理用藥提供參考。方法 對(duì)2012年1月-2015年12月阿壩州人民醫(yī)院重癥監(jiān)護(hù)病房分離下呼吸道感染病原菌的分布及藥敏結(jié)果進(jìn)行回顧性分析。結(jié)果 共分離出病原菌192株，其中革蘭陰性菌124株，占64.6%，主要為銅綠假單胞菌、肺炎克雷伯菌、流感嗜血桿菌和鮑曼不動(dòng)桿菌。革蘭陽性菌56株，占29.1%，主要為金黃色葡萄球菌和腸球菌。真菌12株，占6.3%。主要革蘭陰性菌對(duì)氨芐西林、亞胺培南都較為敏感。銅綠假單胞菌和鮑曼不動(dòng)桿菌對(duì)青霉素類、第2、3代頭孢菌素類耐藥率較高；肺炎克雷伯菌和流感嗜血菌對(duì)第2、3代頭孢菌素類耐藥率較高。革蘭陽性菌對(duì)萬古霉素、替加環(huán)素都較為敏感；金黃色葡萄球菌對(duì)青霉素G耐藥率較高；腸球菌對(duì)利奈唑烷耐藥性高。白色念球菌和白色假絲酵母菌對(duì)氟康唑、伊曲康唑和兩性霉素敏感率較高。結(jié)論 阿壩州人民醫(yī)院重癥監(jiān)護(hù)病房下呼吸道感染病原菌以革蘭陰性菌為主，高海拔地區(qū)患者易產(chǎn)生多重耐藥性菌株，臨床應(yīng)及時(shí)了解病原菌分布及耐藥情況，合理使用抗菌藥物。

Objective To analyze the distribution and drug resistance of pathogenic bacteria causing lower respiratory tract infection in Intensive Care Unit of People's Hospital of Aba Prefecture, and to provide reference for rational drug use in clinic. Methods The distribution and drug resistance of pathogenic bacteria causing lower respiratory tract infection in Intensive Care Unit of People's Hospital of Aba Prefecture from January 2012 to December 2015 were analyzed retrospectively. Results Total 192 strains of pathogens were isolated, in which Gram-negative bacteria were 124 strains (64.6%), main of them were Pseudomonas aeruginosa, Klebsiella pneumoniae, Haemophilus influenzae, and Acinetobacter baumannii. Gram-positive bacteria (56 strains) accounted for 29.1%, main of them were Staphylococcus aureus and Enterococcus faecalis. While there were also 12 strains of fungus (6.3%) isolated. Most Gram-negative bacteria were more sensitive to ampicillin and imipenem. The resistance rate of P. aeruginosa and A. baumannii against penicillins and the second and third generation was higher. And the resistance rate of K. pneumoniae and H. influenzae against the second and third generation was higher. Gram-positive bacteria were more sensitive to vancomycin and tigecycline. The resistance rate of S. aureus against penicillin G was higher. And the resistance rate of E. faecalis against linezolid was higher. The sensitive rate of Tritirachium album and Candida albicans against fluconazole, itraconazole, and amphotericin was higher. Conclusion The main pathogens causing lower respiratory tract infection in Intensive Care Unit of People's Hospital of Aba Prefecture is Gram-negative bacteria, and patients with high altitude are prone to multiple drug-resistant strains. The physician should understand local pathogenic bacteria distribution and drug resistance timely, in order to guide the clinical empirical use of antibacterial drugs.