目的对肺炎克雷伯菌的耐药谱进行回顾性调查,以期为临床经验性用药,合理使用抗菌药物提供依据。方法用美国德灵公司生产WALKAWAY96全自动微生物鉴定及药敏系统对细菌进行鉴定及药敏试验;采用纸片扩散确证法检测ESBLs。结果 2005-2009年肺炎克雷伯菌的检出率从163株增加到261株;肺炎克雷伯菌对青霉素类抗菌药物耐药率最高,且呈逐年上升的趋势;产ESBLs的检出率基本稳定,且有下降趋势;对亚胺培南的耐药率由2005年和2006年未检出耐药菌株上升至2009年的2.7%。结论肺炎克雷伯菌耐药性的增长速度越来越快,耐药谱越来越广,多药耐药菌株也越来越多见,加强耐药性的监测,合理使用抗菌药物是预防肺炎克雷伯菌医院内暴发流行的当务之急。 Objective To investigate the resistance spectrum of Klebsiella pneumoniae in order to provide evidences for clinical experience and rational use of antibacterial drugs. Methods The WALKAWAY96 automatic microbial identification and drug susceptibility system was used to identify bacteria and susceptibility testing. ESBLs were detected by disk diffusion test. Results The detection rate of Klebsiella pneumoniae increased from 163 strains to 261 strains from 2005 to 2009; the Klebsiella pneumoniae showed the highest resistance rate to penicillin-resistant antibiotics, and showed an upward trend year by year. The detection rate of ESBLs-producing strains The rates of resistance to imipenem rose from undetectable strains in 2005 and 2006 to 2.7% in 2009. Conclusions The growth of Klebsiella pneumoniae is getting faster and faster, the spectrum of drug resistance is more and more widely, multidrug resistant strains are more and more seen, the monitoring of drug resistance is strengthened, and the rational use of antimicrobial agents is prevention Klebsiella pneumonia outbreak in the hospital epidemic imperative.