OBJECTIVE: To provide basis for the rational application of clinical antibiotics in orthopedics. METHODS: In 2017, the distribution, composition and drug resistance of common pathogens in Shanghai Kaiyuan Orthopedics Hospital (hereinafter referred to as "our hospital") were statistically analyzed by retrospective analysis. RESULTS: A total of 470 pathogens were detected, mainly from wound secretions, puncture fluid and cerebrospinal fluid, including 242 Gram-negative bacteria (51.5％), 210 Gram-positive bacteria (44.7％), and 18 fungi (3.8％). The top 6 strains were Staphylococcus aureus (67 strains, 14.3％), Escherichia coli (59 strains, 12.6％), and Staphylococcus epidermidis (52 strains, 11.1％). Lactobacillus (49 strains, 10.4％), Pseudomonas aeruginosa (36 strains, 7.7％) and Acinetobacter baumannii (34 strains, 7.2％). Gram-positive bacteria detected in our hospital were mainly Staphylococcus aureus and Staphylococcus epidermidis. No strains resistant to vancomycin or linezolid were found, and the resistance to teicoplanin was low. Gram-negative bacteria were mainly Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii, which had a certain degree of resistance to different varieties of antibiotics, including Klebsiella pneumoniae, the resistance rate of bacteria to carbapenem antibiotics was＞30％. CONCLUSIONS: The pathogens in our hospital are mainly Gram-negative bacteria, slightly more than the Gram-positive bacteria. The overall drug resistance is not optimistic. The monitoring of drug resistance of pathogens should be strengthened to improve the rational application level of antibiotics.%目的:为骨科临床抗菌药物的合理应用提供依据.方法:采用回顾性分析方法,对2017年上海开元骨科医院(以下简称"我院")常见病原菌分布、构成及对临床常用抗菌药物的耐药情况进行统计分析.结果:共检出病原菌470株,主要来源于伤口分泌物、穿刺液及脑脊液;其中,革兰阴性菌242株(占51.5％),革兰阳性菌210株(占44.7％),真菌18株(占3.8％);菌株数排序居前6位的分别为金黄色葡萄球菌(67株,占14.3％)、大肠埃希菌(59株,占12.6％)、表皮葡萄球菌(52株,占11.1％)、肺炎克雷伯菌(49株,占10.4％)、铜绿假单胞菌(36株,占7.7％)和鲍曼不动杆菌(34株,占7.2％).我院检出的革兰阳性菌主要为金黄色葡萄球菌、表皮葡萄球菌,未发现对万古霉素、利奈唑胺耐药的菌株,对替考拉宁罕见耐药;革兰阴性菌主要为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌及鲍曼不动杆菌等,其对不同品种的抗菌药物均有一定程度的耐药,其中肺炎克雷伯菌对碳青霉烯类抗菌药物的耐药率＞30％.结论:我院病原菌以革兰阴性菌为主,略多于革兰阳性菌,整体耐药情况不容乐观,应加强病原菌耐药性监测,以提高抗菌药物合理应用水平.
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