目的　回顾分析细菌性角膜炎致病菌菌属的分布及变化。方法　对 1989～ 1998年间送检的 2 2 2 0份细菌性角膜炎患者角膜细菌培养标本进行革兰染色及分类 ;对不同菌属的分布及变化情况进行回顾性分析。结果　在 2 2 2 0份培养的角膜细菌标本中 ,培养阳性菌株 4 90株 ,阳性率为2 2 1%。其中革兰阳性球菌 2 5 0株 ,占 5 1 0 % ;革兰阴性球菌 2株 ,占 0 4 % ;革兰阴性杆菌 193株 ,占39 4 % ;革兰阳性杆菌 4 5株 ,占 9 2 %。假单胞菌属的检出率最高 ,占 32 2 % ,其次为凝固酶阴性葡萄球菌属为 18 6 % ,第 3位为肺炎球菌 12 0 %。 10年中 ,革兰阳性球菌检出率呈上升趋势 ,革兰阴性杆菌检出率则呈下降趋势。结论　假单胞菌属及凝固酶阴性葡萄球菌属仍是细菌性角膜炎较常见的致病菌 ,革兰阴性杆菌检出率下降与革兰阳性球菌检出率升高趋势应引起临床眼科医师的注意 Objective To retrospectively analyze the distribution and changes of bacterial keratitis pathogens. Methods Gram stain and classification were performed on 2220 specimens of bacterial keratitis from 1989 to 1998. The distribution and changes of different bacteria were analyzed retrospectively. Results A total of 4 90 positive strains were cultured in 2220 cultured corneal bacterial samples, the positive rate was 21.2%. Among them, 250 strains were Gram-positive cocci, accounting for 510%; 2 strains were Gram-negative cocci, accounting for 0.4%; 193 strains were Gram-negative bacteria, accounting for 39.4%; 45 strains were Gram-positive bacilli, accounting for 9% 2 %. The detection rate of Pseudomonas was the highest (32.2%), followed by coagulase-negative Staphylococcus (18.6%) and pneumococcal third (12.0%). In 10 years, the detection rate of gram-positive cocci showed an upward trend, and the detection rate of gram-negative bacilli showed a downward trend. Conclusions Pseudomonas and coagulase-negative staphylococcus are still the most common pathogens of bacterial keratitis. The decrease of Gram-negative bacilli and the detection rate of Gram-positive cocci should be caused by clinical ophthalmologists Attention