目的 了解血培养大肠埃希菌阳性患儿的临床特征和细菌耐药模式。方法 回顾性分析2007 年1 月至2014年12 月血培养大肠埃希菌阳性患儿的临床资料。结果 研究期间有154 774 例患儿进行血培养，血培养阳性8 446 例，其中大肠埃希菌408 例，占血培养阳性者4.83%。大肠埃希菌阳性者以 < 1 岁婴儿为主，占51.72%，其中新生儿占36.77%。275 例患儿有基础疾病，以白血病最为常见。199 株菌株（48.77%）产ESBLs，85.23% 的菌株对氨苄西林耐药，所有菌株均对美洛培南敏感。结论 儿童大肠埃希菌脓毒症好发白血病患儿和新生儿，引起血流感染的大肠埃希菌产ESBLs率较高，对碳氢酶烯类抗生素应注意保护性使用。

Objective To investigate the clinical manifestations and the antibiotics resistance patterns in children with positive blood culture of Escherichia coli. Methods The clinical data of children with positive blood culture of Escherichia coli were retrospectively analyzed from Jan.2007 to Dec.2014. Results In a total of 154774 children who had blood culture in the study period, 8446 children were positive, among whom 408 (4.83%) children were isolated Escherichia coli. The children with the positive blood culture of Escherichia coli mainly were under one year old (51.72%), of which 36.77% was neonates. There were 275 children had underlying diseases, and the most common disease was Leukemia. 199 (48.77%) Escherichia coli strains were producing extended spectrum β-lactamase (ESBLs) and 85.23% were resistant to ampicillin. All strains were susceptible to meropenem. Conclusions Septicemia caused by Escherichia coli is usually occurred in children with leukemia or in neonates. Since blood infections of Escherichia coil had high rate of ESBLs, the use of carbapenem antibiotics should be cautious.