目的 分析中国医科大学附属盛京医院住院患者胸腹水标本中分离病原菌的构成和药敏情况，为临床合理使用抗菌药物提供依据。方法 对中国医科大学附属盛京医院2016年1月-2018年12月收集的胸腹水标本进行菌株鉴定和药敏试验，并进行回顾性分析。结果 共分离出病原菌280株，胸水标本分离出105株病原菌，其中革兰阴性菌53株，构成比为50.48%，主要为鲍曼不动杆菌和肺炎克雷伯杆菌；革兰阳性菌45株，构成比为42.86%，主要为金黄色葡萄球菌和凝固酶阴性葡萄球菌；真菌7株，构成比为6.67%。腹水标本分离出175株病原菌，其中革兰阴性菌112株，构成比为64.00%，主要为大肠埃希菌和铜绿假单胞菌；革兰阳性菌58株，构成比为33.14%，主要为屎肠球菌和金黄色葡萄球菌；真菌5株，构成比为2.86%。大肠埃希菌和肺炎克雷伯菌对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、厄他培南、亚胺培南、阿米卡星、替加环素的耐药率较低，均<30%；大肠埃希菌对哌拉西林的耐药率为100.00%，肺炎克雷伯菌对氨苄西林的耐药率为100.00%。鲍曼不动杆菌对多数β-内酰胺类抗生素的耐药率较高。铜绿假单胞菌对氨苄西林、氨苄西林/舒巴坦、头孢唑啉、头孢曲松、头孢替坦、呋喃妥因、复方新诺明和多西环素的耐药率为100.00%，对阿米卡星、庆大霉素的完全敏感。屎肠球菌对环丙沙星、克林霉素和利福平的耐药率为100.00%，对喹努普汀/达福普汀、利奈唑胺、替加环素完全敏感；金黄色葡萄球菌对呋喃妥因、达普霉素、喹努普汀/达福普汀、替考拉宁、利奈唑胺、替加环素和万古霉素完全敏感。结论 临床上应及时对患者胸腹水标本进行菌株鉴定和药敏试验，并根据药敏结果合理选用抗菌药物，提高治疗效果。

Objective To investigate antimicrobial susceptibility pattern and epidemiology of bacteria isolated from pleural effusion specimens and ascites specimens of inpatients in Shengjing Hospital of China Medical University, so as to provide guidance for clinical rational use of antibiotics. Methods Identification of bacteria and antibiotic susceptibility tests were performed on the strains isolated from inpatients in Shengjing Hospital of China Medical University from January 2016 to December 2018. These results were analyzed retrospectively. Results A total of 280 strains of pathogenic bacteria were isolated, among which 105 strains from pleural effusion specimens. Gram-negative (53 strains) accounted for 50.48%, and main of them were Acinetobacter baumannii and Klebsiella pneumonia. Gram-positive bacteria were 45 strains (42.86%), and main of them were Staphylococcus aureus and coagulase negative staphylococcus. Fungi were 7 strains, accounting for 6.67%. 175 Strains of pathogenic bacteria were from ascites specimens. Gram-negative (112 strains) accounted for 64.00%, and main of them were Escherichia coli and Pseudomonas aeruginosa. Gram-positive bacteria bacteria were 58 strains (33.14%), and main of them were Enterococcus faecium and Staphylococcus aureus. Fungi were 5 strains, accounting for 2.86%. The drug resistance rates of E. coli and K. pneumoniae against piperacillin/tazobactam, cefoperazone/sulbactam, ertapenem, Imipenem, amikacin, and tigecycline were lower than 30%. The drug resistance rate of E. coli against piperacillin was 100.00%. The drug resistance rate of K. pneumoniae against ampicillin was 100.00%. The drug resistance rates of A. baumannii against most β-lactam antibiotics were at a high level. The drug resistance rates of P. aeruginosa against ampicillin, ampicillin/sulbactam, cefazolin, ceftriaxone, cefotetan, macrodantin, sulfamethoxazole, and doxycycline were 100.00%. P. aeruginosa was completely sensitive to amikacin and gentamycin. The drug resistance rates of E. faecium against ciprofloxacin, clindamycin, and rifampin. E. faecium was completely sensitive to quinupristin/dalfopristin, linezolid, and tigecycline. S. aureus was completely sensitive to macrodantin, daptomycin, quinupristin/dalfopristin, teicoplanin, and vancomycin. Conlusion The identification and drug sensitivity test of pleural effusion specimens and ascites specimens of inpatients should be carried out as early as possible. So the antimicrobial agents should be chosen reasonably according to the results of the drug susceptibility to improve the effect of the treatment.