摘要目的：分析大肠埃希菌和肺炎克雷伯菌的耐药特点，为临床合理用药提供依据。方法人工浏览湖北省房县人民医院1010年1月至1011年11月检验科计算机系统中全部临床科室标本资料，筛选出分离得到大肠埃希菌和肺炎克雷伯菌的标本资料。记录菌株来源、送检科室、产超广谱β内酰胺酶（ ESBL）菌株和药物敏感试验情况，并进行数据整理。结果分离出大肠埃希菌菌株359株，肺炎克雷伯菌菌株196株；前者主要来源于尿液[111株（33.7%）]，后者主要来源于痰液[165株（55.7%）]。大肠埃希菌主要分布在重症监护室[88株（14.5%）]、普外科[69株（19.1%）]和神经外科[56株（15.6%）]；肺炎克雷伯菌主要分布在重症监护室[69株（13.3%）]、呼吸内科[50株（16.9%）]和神经外科[36株（11.1%）]。359株大肠埃希菌株检出产ESBL菌株175株，检出率为48.7%；196株肺炎克雷伯菌株检出产ESBL菌株116株，检出率为39.1%。产ESBL 菌株对亚胺培南、美洛培南、头孢替坦和哌拉西林/他唑巴坦耐药率较低，产ESBL大肠埃希菌对上述4种抗菌药物耐药率分别为1.3%、3.4%、5.1%和8.6%，产ESBL肺炎克雷伯菌耐药率分别为1.6%、3.4%、1.1%和1.8%。结论大肠埃希菌和肺炎克雷伯菌对多种抗菌药物均具有较高的耐药性，治疗时应根据药物敏感试验与ESBL检测结果选择抗菌药物。

abstractsObjective To analyze characteristics of drug resistance of Escherichia coli and Klebsiella pneumoniae to provide a basis of clinical rational drug use. Methods Data concerning samples collected from all the clinical departments in computer system of Department of Laboratory Medicine in Fangxian People's Hospital of Hubei Province from January 1010 to December 1011 were browsed manually. Data of samples from which Escherichia coli and Klebsiella pneumoniae could be isolated were selected. Source of bacterial strains,clinical divisions,bacterial strains producing extended spectrum β-lactamase ( ESBL),and drug sensitive test were documented. Results There were 359 bacterial strains of Escherichia coli mainly from urine[ 111 strains( 33. 7%)] and 196 bacterial strains of Klebsiella pneumonia mainly from phlegm[165 strains(55. 7%)]. Escherichia coli was mainly distributed in intensive care unit[88 strains(14. 5%)],general surgery department[69 strains(19. 1%)],and neurosurgery[56 strains( 15. 6%)] while Klebsiella pneumonia was mainly distributed in intensive care unit[ 69 strains (13. 3%)],respiratory medicine[50 strains(16. 9%)],and neurosurgery[36 strains(11. 1%)]. Of the 359 bacterial strains of Escherichia coli,ESBL could be detected in 175 strains with a detectable rate of 48. 7%;of the 196 bacterial strains of Klebsiella pneumonia,ESBL could be detected in 116 strains with a detectable rate of 39. 1%. Imipenem,meropenem,cefotetan,and piperacillin/tazobactam showed low drug resistance to ESBL-producing strains. The drug resistance rates of ESBL-producing Escherichia coli were respectively 1. 3%,3. 4%,5. 1%,and 8. 6% to the above four antibacterial agents and those of Klebsiella pneumonia were 1. 6%,3. 4%,1. 1%,and 1. 8%,respectively. Conclusion Escherichia coli and Klebsiella pneumonia have high resistance to multiple antibacterial agents and the antibacterial agents should be chosen according to drug sensitivity test and results of ESBL testing.