目的 分析2016-2018年新疆医科大学第一附属医院肿瘤中心感染性疾病病原菌的分布特点及其耐药性，指导临床合理使用抗菌药物。方法 采用回顾性调查方法，对2016-2018年新疆医科大学第一附属医院肿瘤中心送检的肿瘤住院患者的各种临床标本进行感染性疾病病原菌分布及耐药性分析。结果 共分离出2 368株病原菌，其中革兰阴性菌1 510株，构成比为63.77%，主要为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌和阴沟肠杆菌；革兰阳性菌577株，构成比为24.37%，主要为金黄色葡萄球菌、无乳链球菌、表皮葡萄球菌和奇异变形杆菌；真菌281株，构成比为11.86%，主要为白色念珠菌、光滑假丝酵母菌。主要革兰阴性菌对亚胺培南、阿米卡星、美罗培南和利奈唑胺的耐药性极低，耐药率都接近于0；对氯霉素、头孢唑啉、头孢替坦、头孢噻肟和头孢吡肟等有较低的耐药性，耐药率普遍<50%；对氨苄西林、头孢呋辛、头孢唑啉的耐药性较高，耐药率>70%。主要革兰阳性菌对利奈唑、氨曲南、呋喃妥因、氨苄西林、万古霉素有极低的耐药性，耐药率<5%；对环丙沙星、红霉素、四环素等有较强耐药性，耐药率>70%；对左氧氟沙星、克林霉素有较弱的耐药性，耐药率<30%。主要真菌对伊曲康唑、5-氟胞嘧啶、两性霉素B的耐药率较低，耐药率<5%；对咪康唑、酮康唑、益康唑的耐药率较高，耐药率>20%。结论 新疆医科大学第一附属医院肿瘤中心感染病原菌以革兰阴性菌最为多见，由于病原菌的多样性与日趋严重的耐药现状，建议临床应重视病原学检查，以药敏结果指导用药。

Objective To analyze the distribution characteristics and drug resistance of pathogenic bacteria of infectious diseases in cancer center of First Affiliated Hospital of Xinjiang Medical University from 2016 to 2018, in order to provide a basis for clinical rational drug use. Methods A retrospective survey was conducted to analyze the distribution and drug resistance of pathogenic bacteria of infectious diseases in cancer center of First Affiliated Hospital of Xinjiang Medical University from 2016 to 2018. Results A total of 2 368 strains of pathogenic bacteria were isolated, of which 1 510 strains were Gram-negative, with a composition ratio of 63.77%, including Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Enterobacter cloacae. There were 577 strains of Gram-positive bacteria with a composition ratio of 24.37%, mainly including Staphylococcus aureus, Streptococcus agalactiae, Staphylococcus epidermidis, and Proteus mirabilis. Fungi (281 strains) accounted for 11.86%, and main of them were Candida albicans and Candida glabrata. The main Gram-negative bacilli were extremely resistant to imipenem, amikacin, meropenem, and linezolid, and the resistance rates were close to 0. The main Gram-negative bacilli against chloramphenicol, cephalosporin oxazoline, cefotetan, cefotaxime, and cefepime had lower drug resistance with the drug resistance rate lower than 50%. And the resistantce rate against ampicillin, cefuroxime, and cefazolin was extremely higher than 70%. The main Gram-positive bacilli had very low resistance to linezolid, aztreonam, nitrofurantoin, ampicillin, and vancomycin with the resistance rate lower than 5%. The main Gram-positive bacilli had high resistance to ciprofloxacin, erythromycin, tetracycline, etc with the drug resistance rate higher than 70%. And the resistance rate against levofloxacin and clindamycin with resistance rate lower than 30%. The main fungi had lower resistance rate against itraconazole, 5-fluorocytosine, and amphotericin B, and the drug resistance rate was less than 5%. The resistance rate against miconazole, ketoconazole, and econazole was higher, with the resistance rate higher than 20%. Conclusion The pathogenic bacteria of infectious diseases in cancer center of First Affiliated Hospital of Xinjiang Medical University from 2016 to 2018 are mainly Gram-negative bacteria. Due to the diversity of pathogens and the increasingly serious status of drug resistance, it is necessary to pay attention to pathogen examination and guide medication according to drug susceptibility results.

R978.1