Objective To investigate the clinical features of donor-derived drug-resistant Klebsiella pneumoniae infection and to summarize the experience of clinical treatment. Methods The clinical data of 13 patients with postoperative donor-derived drug-resistant Klebsiella pneumoniae infection from January 2016 to October 2017 in three kidney transplant centers of Shanghai were analyzed retrospectively. Results Among the 13 patients，one donor-vascular germiculture was positive，and the graft lavage fluid germicultures of other patients were positive. Five patients who were not treated with avibactam died for widespreadly drug-resistant Klebsiella pneumoniae infection. One patien was cured after combination therapy with ceftazidime-avibactam and carbapenems. As soon as cultures of perirenal fluid drainages were found positive in 6 patients，combination therapies of ceftazidimeavibactam and carbapenems were given，and all of them cured. One patient positive in renal arterial culture was treated with ceftazidime-avibactam. After that his drainage fluid culture became negative and the patient aquired a long-term survival. Conclusion The treatment for donor-derived drug-resistant Klebsiella pneumoniae infection by ceftazidime-avibactam and carbapenems is an effective and without significant side effects. When the graft lavage fluid culture is positive，this treatment should be given in time to ensure the safety of patients.

目的 探讨肾移植供者来源耐药肺炎克雷伯杆菌感染的临床特点，总结临床治疗经验。 方法 回顾性分析 2016 年 1 月 -2017 年 10 月上海市 3 家肾移植中心 13 例术后发生供者来源耐药肺炎克 雷伯杆菌感染的受者临床资料。结果 13 例受者中，1 例为供体血管培养阳性，12 例为供体肾脏灌洗液培 养阳性。13 例受者中，5 例未使用阿维巴坦治疗，均引起广泛移植肾周耐药肺炎克雷伯杆菌感染，导致受 者死亡 ；1 例术后移植肾周引流液培养持续阳性，应用头孢他啶 - 阿维巴坦和碳青霉烯类药物联合治疗后 痊愈；6 例术后供体肾脏灌洗液培养为阳性时，即开始应用头孢他啶 - 阿维巴坦和碳青霉烯类药物联合治疗， 均治愈。1 例术后供肾动脉培养为阳性，应用头孢他啶 - 阿维巴坦治疗后引流液未培养出细菌，患者长期存活。 结论 头孢他啶 - 阿维巴坦联合碳青霉烯类药物联合治疗移植肾供体来源耐药肺炎克雷伯杆菌感染效果确 切，且未见明显不良反应。供肾灌洗液培养阳性时，应及早干预，保障患者安全。