| It is a inevitable natural phenomenon that antibiotic drug-resistance bacteria is exist, social factor and artificial factor have accelerated it's development and dissemination. To reform the world humanity destroyed the ecological environment which has resulted in the pollution of atmosphere,water and food . People's eating and living habit have changed and their immunity has decreased. People's activity space enlarging,International contacts and travel increasing and commodity exchange of poultry and finished goods have made microbe spread to new area and crowd. The humanity is possibly facing the poisonous insects,animals or environment under the new ecological condition. The antibiotic used unreasonably,wrongly used in the therapy of virus disease or enlarged dosage artificially have pricked up the production of drug-resistant bacterium. The patients often use antibiotic not according to doctor's guidance and can not finish the whole process of treatment which result in sensitive strains are inhibited while drug-resistant strains are reproduced and mutated.Bacteria producingβ-Lactamases is the main mechanism ofβ-lactam antibiotics drug resistance, while plasmid-mediated extended-spectrumβ–lactamases (ESBLs) is the main reason of new generationβ-lactam antibiotics drug resistance. ESBLs not only can hydrolyze Penicillin and cephalosporin, but also can hydrolyze the third,fourth generation of cephalosporins and plasmid-mediatedβ-Lactamases (BLA) of antibiotic, It's hydrolysis activity can be inhibited by BLA inhibitor, but cephalomycin and Carbapenems is more effective. TEM and SHV type are the most common plasmid-mediatedβ-Lactamases, and they have weak hydrolysis activity to the new generation of cephalosporin. In the middle eighties,cephem antibiotics were used widely which resulted in mutant enzyme of TEM and SHV typeβ-Lactamases appearance.β- Lactamases-mediated drug resistance developed rapidly, whenever a new kind ofβ-lactam antibiotics was used by clinic, a newβ-Lactamase which can hydrolyze it was produced in no long time. Anyway, there are a great various ESBLs in the world.Infectious disease is a frequent disease. The uses of broad-spectrum and ultra-broad-spectrum antibiotic result in the selective pressure of hospital environment and patient body, so restricting the abuse of antibiotic is the important measure to control the increase of drug resistance. As the development of medical institution reform, rational administration, avoidance of medical waste and reducing patients'burden become social need badly. It is the best opportunity of formulating and consummating administration of antibiotic drug rational use .In every grade hospital, pharmacy management committee and infective management committee should periodic inspect execution of management method , case and prescription, the reasonable of applying drug, clinical curative effect and adverse effect, report to leader, freed back to clinic. It can reinforce the power of antibiotic management, increase prevention and cure level of infective disease, control growth tendency of bacteria drug-resistance. Because of the character of drug fast bacteria geographical distribution, it is imperative to monitoring regional bacteria drug fast. We should develop the basis work periodicity and conventional.The drug-resistant pattern of gram-negative organisms isolated from patients with hospital acquired infection (HAI) in 5 class three grade A hospitals from 2004 to 2006 was determined in this paper . From January 1st 2004 to December 31st 2006, a total of 3892 strains of pathogenic bacterium were collected, gram-negative bacilli 2660 strains, gram-positive coccus 1232 strains, for in vitro susceptibility test by K-B method. The resistant rate (R%), intermediate rate (I%) and susceptibility rate (S%) of drugs were calculated according to the criteria in guidelines of NCCLS (2002). The result will be distributed in the form of bacterial resistance surveillance card. Then the genotype of ESBLs was amplified by polymerase chain reaction (PCR).Result: 1. Gram-negative bacilli: The first four is Escherichia coli (43%),K. pneumonia (16%),Pseudomonas aeruginosa (12%),Acinetobacter (10%). Carbapenems were the most active antibiotics tested against Gram-negative organisms (except S tenot rophomona smaltophilia). Cefoperazone/ sulbactam, piperacillin/tazobactam, cefepim and new fluoroquinolones such as gentifloxacin, moxifloxacin also showed excellent activity against Gram-negative bacilli, however, there were 50%-60% of Escherichia coli still resistant to fluoroquinolones. 2. The positive rate of ESBLs-producing K. pneumoniae and Escherichia coli is 41.2%, and its genotype by CTX-M-type primarily, further more it's drug-resistant rate is significant higher than non-ESBLs-producing K. pneumoniae and Escherichia coli. 3. Gram-positive coccus: Neither strains of S.aureus nor strains of Coagulase-negative Staphylococcus were found resistant to vancomycin and norvancomycin. The proportion of methicillin-resistant coagulase-negative staphylococcus (MRCNS) is increasing year by year. The resistant rate of Enterococcus faecium to ampicillin (72.4%) is significant higher than Enteroccoccus to ampicillin (37.5%) (P<0.01).IN this article, nosocomail bacterial resistance surveillance has been done for the first time.The resistant rate (R %), intermediate rate (I %) and susceptibility rate (S%) of drugs were calculated according to the criteria in guidelines of NCCLS. It is will be understood by clinicians about nosocomail infectious diseases in Changchun that etiology and antibiotic sensitivity of pathogens,the changing patterns of pathogens and molecular epidemiological feature of drug-resistant genotype of ESBLs, as a result , the uses of antibiotic must be more reasonable. What we have done is of significant meanings in the reasonable use of antibiotics of this area and in controlling and slowing the production of multidrug- resistant bacterium.
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