目的 了解2015—2017年鄂东医疗集团产超广谱β-内酰胺酶（ESBLs）肺炎克雷伯菌的临床分布及耐药性，为临床合理用药提供参考。方法 采用回顾性调查方法，对鄂东医疗集团2015—2017年临床分离的产ESBLs肺炎克雷伯菌的分布及耐药性进行统计学分析。结果 共分离肺炎克雷伯菌2 038株，其中产ESBLs菌株742株，分离率为36.41%。产ESBLs肺炎克雷伯菌的分离数和分离率呈逐年递增的趋势。标本主要来源于痰液、分泌物、尿液、引流液、血液及腹腔液，其中痰液、尿液、引流液和腹腔液的分离率较高。科室中ICU、呼吸内科、神经外科、烧伤整形科、血液内科和肿瘤内科的分离率较高。药敏结果显示，产ESBLs菌株对亚胺培南、美罗培南和阿米卡星的敏感率较高，对头孢曲松、庆大霉素、头孢他啶和磺胺甲（口恶）唑的敏感率较小。产ESBLs肺炎克雷伯菌对阿米卡星、头孢西丁的敏感率基本稳定，对阿莫西林克拉维酸钾、哌拉西林舒巴坦、头孢哌酮舒巴坦和左氧氟沙星的敏感率呈下降趋势。结论 产ESBLs肺炎克雷伯菌的分离率呈逐年递增的趋势，对亚胺培南、美罗培南和阿米卡星的敏感率较高，但敏感率也呈现一定的下降趋势，应引起临床科室的高度重视，加强对抗菌药物的管理，合理使用，避免耐药菌株的快速出现。

Objective To study the clinical distribution and drug resistance of extended spectrum β-lactamases (ESBLs)-producing Klebsiella pneumoniae in Edong Healthcare from 2015 to 2017, and to provide the reference for reasonable use of antibiotics. Methods A retrospective survey was conducted to analyze the distribution and drug resistance of K. pneumoniae in Edong Healthcare from 2015 to 2017. Results A total of 2 038 strains of K. pneumoniae were isolated, and there were 742 cases of ESBLs-producing K. pneumoniae, and the separation rate was 36.41%. The strains and separation rate of ESBLs-producing K. pneumoniae had a tendency of increasing year by year. The specimens were mainly obtained from the sputum, secretions, urine, drainage fluid, blood, and peritoneal fluid. And the separation rate of sputum, urine, drainage fluid, and peritoneal fluid were higher. The separation rate of ICU, department of respiratory, department of neurosurgery, department of burn and plastic surgery, department of hematology and department of oncology were higher. Drug sensitivity test showed drug sensitive rates of ESBLs-producing K. pneumoniae against imipenem, meropenem, and amikacin were higher. The drug sensitive rates of ESBLs-producing K. pneumoniae against ceftriaxone, gentamicin, ceftazidime, and sulfamethoxazole were lower. The sensitivity rates against amikacin and cefoxitin were basically stable, and against amoxicillin clavulanate potassium, piperacillin sulbactam, cefoperazone sulbactam and levofloxacin were decreased year by year. Conclusion The separation rate of ESBLs-producing K. pneumoniae increases year by year, and sensitive rates of imipenem, meropenem, and amikacin are higher, but sensitive rates has an downward trend. Clinical departments should attach great importance to strengthen the management of antimicrobial drugs to avoid the emergence of drug-resistant strains.