目的 分析天津市北辰医院糖尿病及非糖尿病患者合并者血流感染临床特点、分离菌及其耐药情况等，为血流感染经验选择抗菌药物提供依据。方法 收集2023、2024年血流感染临床病例资料进行收集统计，并对感染部位及分离菌的分布、常见分离菌耐药情况进行分析。结果 血流感染主要来源于泌尿系感染，分离菌为大肠埃希菌。2023年糖尿病患者及非糖尿病患者耐药情况运用χ²检验，发现P＜0.05的药物有左氧氟沙星、头孢曲松、复方新诺明、头孢呋辛钠、头孢他啶、阿莫西林/棒酸。2024年，糖尿病患者及非糖尿病患者耐药情况运用χ²检验，发现除阿米卡星、亚胺培南、厄他培南、替加环素外，药敏卡的药物均P＜0.05。结论 天津市北辰医院血流感染主要来源于泌尿系统感染，主要分离菌为大肠埃希菌，大肠埃希菌对左氧氟沙星耐药率较高，高达82.9%。耐药率＞30%且P＜0.05的药物分析发现，2023年及2024年大肠埃希菌对左氧氟沙星耐药率非糖尿病组均高于糖尿病组。

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

天津市北辰区卫健系统科技项目（SHGY-2023009）