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目的:探讨头孢噻肟联合左氧氟沙星治疗社区获得性肺炎(CAP)对患者肠道菌群结构和多样性的影响。方法:选择2018年10月至12月浙江省立同德医院感染科收治的CAP住院患者6例，予头孢噻肟注射液2.0 g(1次/8 h)联合左氧氟沙星注射液0.5 g(1次/d)静脉给药治疗，留取患者抗菌药物治疗前和经7 d治疗后粪便样本共12份，采用自身配对设计研究，对治疗前后的粪便样本进行16S核糖体RNA(16S rRNA)测序分析。结果:⑴治疗前和治疗后患者肠道菌群的组成结构：在门水平：厚壁菌门59.2% vs 40.8%，变形菌门18.6% vs 35.5%，拟杆菌门14.8% vs 20.8%，放线菌门5.6% vs 1.2%；在科水平：瘤胃菌科34.5% vs 13.0%、毛螺菌科15.9% vs 9.7%、韦荣球菌科1.8% vs 3.3%、乳杆菌科0.3% vs 8.0%、肠球菌科0.02% vs 5.2%、链球菌科2.9% vs 1.1%、肠杆菌科16.4% vs 34.6%、拟杆菌科13.3% vs 16.8%、紫单胞菌科0.3% vs 3.4%、红蝽杆菌科4.4% vs 0.5%。治疗前后患者肠道菌群的组成结构比较差异无统计学意义(n P>0.05)。⑵治疗前和治疗后患者肠道菌群的多样性：OTU值(150.5±59.0) vs (93.2±34.1)，n t＝2.72，n P＝0.04；Chao1指数(169.25±49.61) vs (117.92±35.06)，n t＝3.22，n P＝0.02；shannon指数(3.61±0.83) vs (2.31±0.73)，n t＝4.54，n P＝0.01；simpson指数(0.80±0.10) vs (0.61±0.20)，n t＝2.76，n P＝0.04。治疗前后患者肠道菌群的多样性比较差异均有统计学意义(n P0.05). ⑵ The diversity of intestinal flora before and after treatment: operational taxonomic units (OTU) mean (150.5±59.0) vs (93.2±34.1),n t=2.72, n P=0.04; Chao1 index (169.25±49.61) vs (117.92±35.06), n t=3.22, n P=0.02; shannon index (3.61±0.83) vs (2.31±0.73), n t=4.54, n P=0.01; simpson index (0.80±0.10) vs (0.61±0.20), n t=2.76, n P=0.04. There were significant differences in the diversity of intestinal flora before and after treatment (n P<0.05). ⑶ There was significant difference in desulfovibrio between the two groups before and after treatment (LDA=2.03,n P=0.02).n Conclusions:After intravenous infusion of cefotaxime combined with levofloxacin for one week , the diversity of intestinal flora was significantly reduced after treatment. Desulfovibrio was the flora with statistical differences between before and after treatment.