了解慢性难愈性创面感染的常见致病菌分布及耐药性变化，为临床合理应用抗菌药物和感染的控制提供可靠依据。

收集青海大学附属医院2015年1月至12月慢性难愈性创面患者的创面细菌培养分离的致病菌，用VITEK-AMS微生物自动鉴定仪做菌株鉴定，用K-B纸片扩散法进行药物敏感性试验，并按照美国临床实验室标准化委员会/临床和实验室标准协会标准判定结果，回顾性分析感染菌株分布特点及耐药性情况。

共分离致病菌92株，其中革兰阳性球菌58株(63.04%)，革兰阴性杆菌为34株(36.96%)。革兰阳性球菌分离率由高到底排序依次为金黄色葡萄球菌、表皮葡萄球菌、屎肠球菌、粪肠球菌、变异链球菌；革兰阴性杆菌分离率由高到底排序依次为大肠杆菌、肺炎克雷杆菌、大肠杆菌、铜绿假单胞菌、鲍曼不动杆菌。在革兰阳性球菌中，以金黄色葡萄球菌、屎肠球菌和粪肠球菌为主，对万古霉素、利奈唑胺敏感率较高；在革兰阴性杆菌中以大肠杆菌、肺炎克雷杆菌为主，对亚胺培南、氨曲南、阿米卡星敏感率较高。

每个创面分离的细菌所占的优势不同，都有其特殊性，细菌对抗生素的敏感性有一定的差异，合理应用抗生素，应用负压封闭引流等技术治疗可促进慢性创面的愈合。

To investigate the distribution of common pathogens on chronic refractory wound and analyze the characteristic of drug resistance, aiming to provide reliable prove for rational applying of antibiotics and infection control in clinical.

Pathogens were collected that isolated from the bacterial culture on the chronic refractory wound patients admitted in Qinghai University Affiliated Hospital during January to December in 2015. VITEK-AMS automatic identification system was applied for microbial strain identification, and drug sensitivity was tested by K-B disk diffusion method. The results were determined according to the US National Committee for clinical laboratory standards/clinical and laboratory standards institute, and the infecting strain distribution and drug resistance were analyzed.

A total of 92 bacteria strains were isolated, including 85 Gram-positive cocci (accounting for 63.04%), 34 Gram-negative bacilli (accounting for 36.96%). From high to low Gram-positive cocci were sorted as staphylococcus aureus, staphylococcus epidermidis, feces Enterococcus faecalis, Streptococcus mutans; gram-negative bacilli were sorted as escherichia coli, Klebsiella, Enterobacter genus, Pseudomonas aeruginosa, Acinetobacter spp. In Gram-positive cocci, Staphylococcus aureus, Enterococcus faecalis and Enterococcus feces were mainly sensitive to linezolid, vancomycin, imipenem, ciprofloxacin and rifampicin; Gram-negative bacteria Pseudomonas aeruginosa and Acinetobacter were mainly sensitive to imipenem, vancomycin, aztreonam and amikacin.

Bacterial isolated from each wound share different advantages and particularity, there are some differences of bacterial antibiotic sensitivity. Rational use of antibiotics and applying of vacuum sealing drainage technology therapy can promote healing of chronic wounds.