Objective To investigate the clinical distribution and drug resistance characteristics of extended-spec-trumβ-lactamases(ESBLs)-producing Klebsiella pneumoniae and Escherichia coli and provide a basis for guiding the rational use of clinical drugs.Methods Pathogens isolated from the specimens of inpatient in our hospital since oct. 2011 to oct.2014 were cultured,pathogens identification and drug susceptibility test were performed using VITEK-2 microorganism analyze system.and the ESBL-prodESBL-producingucing bacteria were detected by using the double disc recommended by NCCLS and the phenotypic confirmatory test.Investigation and analysis of use antibiotics in Patients with positive.Results Among 374 strains of K.pneumoniae and E.coli,totally 172strains of ESBLs-producing isolates were isolated with the totaldetection rate of 46.0%.there were 276 strains of e.coli,among which there were there were 132 (47.8%)strains of ESBL-producing E.coli,Check out before the third generation of antimicrobial usage by 81.1%.Specimens from the urine (50.7%),and pus (16.7%)in the detection,mostly distributed in the urological ward department (40.8%)and general surgery ward (12.9%);there were 98 strains of K.pneumoniae,among which there were there were 40 (40.8%)strains of ESBL-producing K.pneumoniae,Check out before the third generation of antimicrobial usage by 90.0%.The specimen Mainly from the sputum (37.5%)and detection in the pus (15.0%), mainly from medical ward (40.0%)and infection (12.5%).The drug resistance rates of ESBLs-produeing strains of e. coli were 6.5%-22.5 % respectively to carbapene-mase and a part of complex antimicrobial drugs containing β-1actamases inhibitor,but the drug resist-ance rates to the other antimicrobial drugs were 36.2%-88.3%,respectively. The drug resistance rates of ESBLs-produeing strains of K.pneumoniae were 3.1 %-28.5 % respectively to carbapene-mase,cefepime ,levofloxacin and a part ofcomplex antimicrobial drugs containing β-1actamases inhibitor,but the drug resist-ance rates to the other antimicrobial drugs were 41.9%-88.8%,respectively.E.coli in the two groups produced with the producing ESBLs strains with cefepime,imipenem,amikacin,Sulbactam and Cefopcrazone and Piperacillin and Tazobactamis resistance rates to compare is P >0.05,no statistically significant difference,Klebsiella pneumoniae in the two groups produced with the producing ESBLs strains of imipenem,Sulbactam and Cefopcrazone is P >0.05,no statis-tically significant difference.Conclusion Formulate rational and effective infection control measures,rational use of an-tibiotics,avoid and reduce the ultra broad spectrum beta lactamase bacteria causing Hospital infection outbreak.%目的：调查产超广谱β-内酰胺酶大肠埃希菌和肺炎克雷伯菌临床分布及耐药性分析，指导临床合理用药。方法收集2011年10月-2014年10月我院住院病人送检各类标本，采用 VITEK-Ⅱ进行细菌鉴定及药敏试验；采用采用 CLSI 推荐的双纸片和表型确证试验检测产 ESBLs 细菌；对阳性患者的抗菌药物应用情况进行调查分析。结果从374株阳性标本检出产 ESBLs 大肠埃希菌和肺炎克雷伯菌172株，总检出率46．0％。276株大肠埃希菌中，检出产 ESBLs 大肠埃希菌132株，检出率为47．8％，检出前第三代抗菌药物使用率81．1％；标本主要从尿液（50．7％）和脓液（16．7％）中检出，科室大多分布于泌尿科病房（40．8％）及普外科病房（12．9％）。98株肺炎克雷伯菌中，检出产ESBLs 肺炎克雷伯菌40株，检出率为40．82％，检出前第三代抗菌药物使用率90．0％；标本主要从痰液（37．5％）和脓液（15．0％）中检出，科室大多分布于内科病房（40．0％）及感染科（12．5％）。产 ESBLs 大肠埃希菌对碳青霉烯类及部分β-内酰胺酶抑制剂复合剂的耐药率分别为6．5％-22．5％，对其他抗菌药物的耐药率分别为36．2％-88.3％。产 ESBLs肺炎克雷伯菌对碳青霉烯类、头孢吡肟、左氧氟沙星及部分β-内酰胺酶抑制剂复合剂的耐药率分别为3．1％-28．5％，对其他抗菌药物的耐药率分别为41．9％-88．8％。大肠埃希菌两组产与非产 ESBLs 菌株对头孢吡肟、亚胺培南、阿米卡星、头孢哌酮／舒巴坦及哌拉西林／他唑巴坦耐药率比较 P＞0．05，差异不具有统计学意义；肺炎克雷伯菌两组产与非产 ES-BLs 菌株对亚胺培南、头孢哌酮／舒巴坦耐药率比较 P ＞0．05，差异不具有统计学意义。结论制定合理有效的感染控制措施，合理使用抗菌药物，避免及减少产超广谱β-内酰胺酶细菌引起医院感染的暴发流行。
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