目的研究医院感染重点科室环境监测的细菌种类、存在方式与数量,分析与医院感染病原菌之间的同源性。方法收集重症监护室环境细菌学检测标本,进行分离鉴定并录入WHONET软件。应用WHONET软件分析与临床典型病原菌间的耐药谱同源性。结果共收集到环境监测标本1 450例,检出细菌396例,检出率27.3%。存在方式主要集于医务人员手,医疗物体表面。临床标本2 018例,检出菌株987株,检出率48.9%。分离数前5位的是鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌和屎肠球菌,约占总数的65%。环境监测来源的菌株耐药率普遍低于临床菌株。环境菌株耐药谱与在临床菌株耐药谱基本吻合,临床标本菌株耐药谱更为多样化。结论环境菌株与临床菌株存在高比例的耐药谱同源性。手与物表环境应作为医院感染控制的主要环节。医疗环境是外源性医院感染病原菌的主要来源,对侵入性治疗的危急症患者应进行接触隔离治疗。 Objective To study the bacterial species, existence and quantity of environmental monitoring in key departments of hospital infection and to analyze the homology with pathogenic bacteria in hospital. Methods Intensive bacteriological examination of bacteriological specimens was collected, separated and identified and entered into WHONET software. WHONET software was used to analyze the homology of drug resistance spectrum with the typical clinical pathogenic bacteria. Results A total of 1 450 samples of environmental monitoring samples were collected and 396 bacteria were detected, the detection rate was 27.3%. Presence exists mainly in medical staff hand, the surface of medical objects. A total of 2 018 clinical specimens were obtained, of which 987 strains were detected, the detection rate was 48.9%. The top five were Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli and Enterococcus faecium, accounting for 65% of the total. The strains resistant to environmental monitoring were generally lower than the clinical isolates. Resistant strains of environmental strains and clinical strains in the drug resistance spectrum is basically consistent, clinical specimens more resistant to drug resistance spectrum. Conclusion There is a high proportion of drug resistance spectrum homology between environmental strains and clinical strains. Hand and surface environment should be used as a major part of hospital infection control. The medical environment is the major source of pathogenic bacteria in exogenous hospitals and should be treated with contact isolation for patients with invasive therapies.