目的 调查儿童重症监护室(PICU)患儿感染病原菌分布，并分析耐药性情况，以期为临床防治提供指导。方法 回 顾性分析2014年6月-2016年12月我院5754例PICU患儿感染数据，行病原菌鉴定及药敏试验，分析病原菌分布及 耐药情况。结果 PICU 5754例患儿中812例出现感染，发生率为14.11%(812/5754)，明显高于普通儿科病房的 7.68%(1808/23546)，差异有统学意义(χ2 =235.039，P<0.05)；812株病原菌中，主要为革兰阴性杆菌(G- )，占比 59.24%，病原菌主要分布于下呼吸道(63.66%)、尿道(17.12%)及血液系统(11.95%)；G以肺炎克雷伯菌为主，其对 哌拉西林耐药率为100.00%，对氨曲南及多种头孢类抗菌药物耐药率都在50.00%以上；G+ 以屎肠球菌为主，主要分 布于泌尿道，该菌对青霉素、磺胺甲恶唑、克林霉素、氨苄西林耐药率均为100.00%，但对呋喃妥因、利奈唑胺有 较好敏感性，但也出现万古霉素耐药菌株。结论 PICU感染发生率较高，耐药形势较为严峻，临床应有针对地应用 抗菌药物，以遏制院内感染蔓延。

Objective To investigate the pathogen distribution of infection in children with pediatric intensive care unit (PICU) and analyze the drug resistance so as to provide guidance for clinical prevention and treatment. Methods From Jun. 2014 to Dec. 2016, the infection data of 5754 children with PICU in our hospital were analyzed retrospectively. Pathogenic bacteria identification and drug sensitivity test were carried out to analyze the distribution of pathogens and drug resistance. Results The incidence rate of infection in PICU was 14.11% (812/5754) which was significantly higher than that in the general pediatric ward 7.68% (1808/23546), the difference was statistically significant (χ2 =235.039, P<0.05), among the 812 strains of pathogenic bacteria, gram negative bacilli (G- ) were the main pathogens (59.24%), and the pathogen bacteria were mainly distributed in the lower respiratory tract (63.66%), urinary tract (17.12%) and blood system (11.95%). G- whose resistance rate to piperacillin was 100%, and resistancerates to aztreonam and other cephalosporins were above 50%, was mainly Klebsiella pneumoniae. G+ (mainly Enterococcus faecium) whose resistance rates to penicillin, sulfamethoxazole, clindamycin and ampicillin were 100%, were mainly distributed in the urinary tract. G+ had good sensitivity to linezolid and linezolid, but vancomycin resistant strains were also appeared. Conclusion The incidence of PICU infection is high, and the situation of drug resistance is severe. Therefore, proper antibiotics should be applied to prevent the spread of nosocomial infection.