目的 了解2015—2017年鄂東醫(yī)療集團(tuán)產(chǎn)超廣譜β-內(nèi)酰胺酶（ESBLs）肺炎克雷伯菌的臨床分布及耐藥性，為臨床合理用藥提供參考。方法 采用回顧性調(diào)查方法，對(duì)鄂東醫(yī)療集團(tuán)2015—2017年臨床分離的產(chǎn)ESBLs肺炎克雷伯菌的分布及耐藥性進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果 共分離肺炎克雷伯菌2 038株，其中產(chǎn)ESBLs菌株742株，分離率為36.41%。產(chǎn)ESBLs肺炎克雷伯菌的分離數(shù)和分離率呈逐年遞增的趨勢(shì)。標(biāo)本主要來(lái)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離率較高。科室中ICU、呼吸內(nèi)科、神經(jīng)外科、燒傷整形科、血液內(nèi)科和腫瘤內(nèi)科的分離率較高。藥敏結(jié)果顯示，產(chǎn)ESBLs菌株對(duì)亞胺培南、美羅培南和阿米卡星的敏感率較高，對(duì)頭孢曲松、慶大霉素、頭孢他啶和磺胺甲（口惡）唑的敏感率較小。產(chǎn)ESBLs肺炎克雷伯菌對(duì)阿米卡星、頭孢西丁的敏感率基本穩(wěn)定，對(duì)阿莫西林克拉維酸鉀、哌拉西林舒巴坦、頭孢哌酮舒巴坦和左氧氟沙星的敏感率呈下降趨勢(shì)。結(jié)論 產(chǎn)ESBLs肺炎克雷伯菌的分離率呈逐年遞增的趨勢(shì)，對(duì)亞胺培南、美羅培南和阿米卡星的敏感率較高，但敏感率也呈現(xiàn)一定的下降趨勢(shì)，應(yīng)引起臨床科室的高度重視，加強(qiáng)對(duì)抗菌藥物的管理，合理使用，避免耐藥菌株的快速出現(xiàn)。

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.