目的 分析天津市北辰醫(yī)院糖尿病及非糖尿病患者合并者血流感染臨床特點、分離菌及其耐藥情況等，為血流感染經驗選擇抗菌藥物提供依據。方法 收集2023、2024年血流感染臨床病例資料進行收集統(tǒng)計，并對感染部位及分離菌的分布、常見分離菌耐藥情況進行分析。結果 血流感染主要來源于泌尿系感染，分離菌為大腸埃希菌。2023年糖尿病患者及非糖尿病患者耐藥情況運用χ²檢驗，發(fā)現P＜0.05的藥物有左氧氟沙星、頭孢曲松、復方新諾明、頭孢呋辛鈉、頭孢他啶、阿莫西林/棒酸。2024年，糖尿病患者及非糖尿病患者耐藥情況運用χ²檢驗，發(fā)現除阿米卡星、亞胺培南、厄他培南、替加環(huán)素外，藥敏卡的藥物均P＜0.05。結論 天津市北辰醫(yī)院血流感染主要來源于泌尿系統(tǒng)感染，主要分離菌為大腸埃希菌，大腸埃希菌對左氧氟沙星耐藥率較高，高達82.9%。耐藥率＞30%且P＜0.05的藥物分析發(fā)現，2023年及2024年大腸埃希菌對左氧氟沙星耐藥率非糖尿病組均高于糖尿病組。

Objective To analyze the clinical characteristics, isolated bacteria, and their resistance patterns in patients of Tianjin Beichen Hospital with and without diabetes mellitus who have bloodstream infections, in order to provide a basis for the empirical selection of antimicrobial agents for bloodstream infections. Methods Clinical case data of bloodstream infections in 2023 and 2024 years were collected and statistically analyzed. The distribution of infection sites and isolated bacteria, as well as the resistance patterns of common isolated bacteria, were analyzed. Results Bloodstream infections mainly originated from urinary tract infections, with Escherichia coli being the main isolated bacterium. In 2023, the resistance patterns of diabetic and non-diabetic patients were analyzed using the chi-square test, and drugs with P＜0.05 included levofloxacin, ceftriaxone, co-trimoxazole, cefuroxime sodium, ceftazidime, and amoxicillin/clavulanate. In 2024, the drug resistance of diabetic patients and non-diabetic patients was tested by Chi-square test, and it was found that P< 0.05 was used for all drug sensitive cards except amikacin, imipenem, ertapenem and tigecycline. Conclusion Bloodstream infections in Tianjin Beichen Hospital mainly originated from urinary tract infections, with Escherichia coli being the main isolated bacterium. The resistance rate of Escherichia coli to levofloxacin was high, reaching 82.9%. In the analysis of drugs with resistance rates＞30% and P＜0.05, it was found that in 2023 and 2024, the resistance rate of Escherichia coli to levofloxacin was higher in the non-diabetic group than in the diabetic group.

R978.1

天津市北辰區(qū)衛(wèi)健系統(tǒng)科技項目（SHGY-2023009）