Abstract: Objective To investigate the distribution and drug resistance characteristic trend of Escherichia coli in the Affiliated Hospital of Xuzhou Medical University firstly isolated clinically during 2013-2015,and to provide the reference for clinical rational using of antimicrobial agents. Methods Escherichia coli isolates firstly collected clinically were identified and the data were judged with CLSI 2012 and analyzed with WHONET 5.6. Results A total of 2 426 isolates of Escherichia coli were collected from 2013 to 2015.The department distribution is dominated by ICU 466(19.2%)and Department of Urology 375(15.5%).The Escherichia coli positive specimens were mostly isolated from sputum 733(30.2%),urine 720(29.7%)and blood 447(18.4%).The prevalence of E.coli decreased with time from 19.2% in 2013 to 15.5% in 2015.Susceptibility testing showed that during the three years,the bacterium has a certain change in the resistance of all kinds of antibiotics,the resistance rates of the bacteria to the third and the fourth generation of Cephalosporin has a stable downward trend,for example,the rate to cefotaxime decreased from 82.7% to 60.5% and the rate to cefepime decreased from 71.1% to 41.2%;the rate to carbapenem stabilizes from 3.4% to 4.0%;the rates to ampicillin and piperacillin are the highest (90.7% and 89.6%). Conclusion The multiple drug resistance still exists in Escherichia coli in our hospital.The use of antimicrobial agents should be standardized continually and the prevalence and spread of Escherichia coli should be controlled.