Abstract: Objective To analyze occurrence of Gram-negative bacteria producing extended-spectrum β-lactamase (ESBL) in patients with lower respiratory tract infection and assess their drug sensitivity to provide evidence for clinical management of lower respiratory tract infection with drug-resistant ESBL-producing bacteria. Methods A total of 312 Gram-negative bacterial strains were isolated from patients with lower respiratory tract infection and identified for the presence of ESBL by Vitek ESBL detection test and double-disk synergy tests as well as standard disk diffusion test. The effects of 10 antibacterial drugs on ESBL-producing strains were compared. Results A rate of 20.1% of the isolated strains were identified to produce ESBLs, including Klebsiella Pneumoniae, Escherichia coli, Enterobacter cloacae, Pseudomonas aeruginasa and Klebsiella oxytocla (accounting for 30.1%, 29.1%, 27.0%, 11.3%, and 2.5%, respectively, of the ESBL-producing strains). Imipenem possessed the most powerful antibacterial activity against ESBL-producing strains. Conclusions Attention should be given to lower respiratory tract infections with ESBL-producing Gram-negative bacilli, and imipenem can be the primary choice for fighting such infections.