目的:回顾性分析新型冠状病毒肺炎(COVID-19)患者合并细菌及真菌感染的临床特点和耐药情况。方法:收集同济医院2020年2月10日至3月31日血液、尿液、痰液和纤支镜冲洗液培养阳性的COVID-19患者的临床资料，采用WHONET5.6分析统计药敏数据。结果:共收集病原菌培养阳性COVID-19患者95例，非危重型患者23例，危重型72例，临床症状主要为发热、咳嗽咳痰、乏力、呼吸困难等，危重型男性患者占63.89%，女性患者占36.11%，危重型患者以男性居多，患者合并多种细菌和真菌感染以危重型为主，占23.61%，非危重型和危重型患者的死亡率分别为13.04%和61.11%,危重型患者的死亡率明显高于非危重型患者。病原菌共179株，大肠埃希菌在非危重型患者中检出率较危重型高，占37.50%,鲍曼不动杆菌和肺炎克雷伯菌在危重型患者中检出率较非危重型都高，各占29.87%，革兰阳性菌及真菌在非危重型和重型患者中的差异无统计学意义，但危重型患者血液真菌培养中提示近平滑念珠菌占比较高，为36.40%，临床不容忽视。药敏分析结果显示未发现大肠埃希菌对碳青霉烯类药物的耐药株，肺炎克雷伯菌对碳青霉烯类药物的耐药率为60.87%，鲍曼不动杆菌对3种抗菌药物的耐药率均为100%，耐甲氧西林金黄色葡萄球菌占71.43%，未发现万古霉素耐药的革兰阳性球菌。结论:COVID-19患者危重型以男性患者居多，其容易合并多种细菌和真菌感染，且死亡率比非危重型患者高。危重型患者常合并感染细菌为鲍曼不动杆菌和肺炎克雷伯菌等医院获得性菌株，其耐药性较高。“,”Objective:To retrospectively analyze the clinical characteristics and drug resistance among COVID-19 patients with bacterial and fungal infections.Methods:Clinical data of COVID-19 patients whose blood, urine, sputum and alveolar lavage fluid samples were positive for bacteria and fungi were collected in Tongji Hospital from February 10 to March 31, 2020. WHONET5.6 software was used to analyze drug susceptibility test results.Results:A total of 95 COVID-19 patients positive for pathogenic bacteria were enrolled and among them, 23 were non-critical patients and 72 were critical patients. The main symptoms in these patients included fever, cough with sputum, fatigue and dyspnea. Male and female critical patients accounted for 63.89% and 36.11%, respectively. Most of the patients with bacterial and fungal infections were critical type, accounting for 23.61%. The mortality rates of non-critical and critical patients were 13.04% and 61.11%, respectively. A total of 179 strains of pathogenic bacteria were isolated. The positive rate of n Escherichia coli in non-critical patients was 37.50%, which was higher than that in critical patients. However, the positive rates of n Acinetobacter baumannii and n Klebsiella pneumoniae in critical patients were both 29.87%, higher than those in non-critical patients. There was no significant difference in the positive rate of gram-positive bacteria or fungi between non-critical and critical patients. It was noteworthy that the positive rate of n Candida parapsilosis in blood samples of critical patients was relatively high, reaching 36.40%. Drug susceptibility test results showed that no carbapenem-resistant n Escherichia coli stains were detected and 60.87% of n Klebsiella pneumoniae strains were resistant to carbapenems. n Acinetobacter baumannii strains were 100% resistant to three antimicrobial drugs. Methicillin-resistant n Staphylococcus aureus strains accounted for 71.43%, but no vancomycin-resistant gram-positive cocci were found.n Conclusions:Critical COVID-19 patients were mostly male and prone to multiple bacterial and fungal infections. The mortality of critical patients was higher than that of non-critical patients. Critical COVID-19 was often complicated by hospital acquired infections caused by bacteria including n Acinetobacter baumannii and n Klebsiella pneumoniae with high drug resistance.n