为探讨老年患者感染肺炎克雷伯菌(Klebsiella pneunoniae)的临床特征、耐药情况及相关危险因素，本研究收集了2021—2023年上海市宝山区仁和医院收治的322例老年社区获得性肺炎(community-acquired pneumonia，CAP)患者的诊疗数据。将患者分为肺炎克雷伯菌感染组(56例)和非肺炎克雷伯菌感染组(266例)。采用多因素Logistic回归分析识别患者感染肺炎克雷伯菌的危险因素。通过受试者工作特征曲线分析各指标评估患者感染肺炎克雷伯菌的临床价值。研究结果显示，肺炎克雷伯菌株对氨苄西林、头孢呋辛、头孢他啶和哌拉西林表现出较高的耐药率。多因素分析表明，男性、呼吸衰竭、影像学显示肺部实变影和空腹血糖水平高是老年CAP患者感染肺炎克雷伯菌的独立危险因素。ROC曲线显示，男性、呼吸衰竭和空腹血糖水平高的评估感染风险的曲线下面积(area under the curve, AUC)均超过0.6，独立危险因素的联合指标的AUC达到0.762。在临床实践中，应尽早识别这些高风险人群并有针对性地实施有效的治疗和管理策略。

To investigate the clinical characteristics, drug resistance rates and risk factors of Klebsiella pneumoniae infection in elderly patients, the clinical data from 322 elderly patients with community-acquired pneumonia (CAP) who admitted to Baoshan Renhe Hospital from 2021 to 2023 were collected. The patients were divided into a Klebsiella pneumoniae-infected group (KP group, 56 patients) and a non-Klebsiella pneumoniae-infected group (NKP group, 266 patients). Multivariate logistic regression analysis was used to identify the risk factors for Klebsiella pneumoniae infection in patients. The clinical value of various indicators in assessing the risk of Klebsiella pneumoniae infection was analyzed using receiver operating characteristic (ROC) curves. The results showed that Klebsiella pneumoniae exhibited high rates of resistance to ampicillin, cefuroxime, ceftazidime and piperacillin. Multifactorial analysis showed that males, respiratory failure, solid shadows in the lungs, and high fasting glucose levels were independent risk factors for Klebsiella pneumoniae infection. The ROC curve showed that the area under the curve (AUC) for assessing the risk of infection based on male gender, respiratory failure, and elevated fasting blood glucose levels all exceed 0.6, and the AUC for the combined index of independent risk factors reached 0.762.Therefore, early identification and implementation of effective treatment and management strategies for these high-risk groups is essential in clinical practice.