Objective To compare the detection rates and antimicrobial resistance rates of Klebsiella pneumoniae (KP) between the intensive care unit of The First People’s Hospital of Changzhou (CZFPH-ICU) and the American Medical Information Mart for Intensive Care-IV (MIMIC-Ⅳ), as well as the changes in the antimicrobial resistance rate of KP and detection rate of carbapenem-resistant KP (CRKP) in CZFPH-ICU. Methods Differences in specimen distribution and antimicrobial resistance rate of KP detected from CZFPH-ICU and MIMIC-Ⅳ from 2017 to 2019, as well as the changing trends of specimen distribution, antimicrobial resistance rate, detection rates of KP and CRKP from different specimen sources in CZFPH-ICU from 2017 to 2023 were retrospectively analyzed. Results A total of 2 434 strains of KP were detected in CZFPH-ICU from 2017 to 2019, mainly from sputum specimens. A total of 1 137 strains of KP were detected from MIMIC-Ⅳ database, mainly from urine specimens. Compared with MIMIC-Ⅳ, KP detected from CZFPH-ICU showed higher resistance rate to commonly used antimicrobial agents. A total of 4 874 strains of KP were detected from CZFPH-ICU from 2020 to 2023, mainly from sputum specimens. The detection rates of CRKP from sputum, urine, drainage fluid and bile specimens decreased from 17.77%, 20.15%, 24.22% and 24.07% in 2017-2019 to 12.99%, 13.56%, 13.63% and 8.00% in 2020-2023, respectively (all P<0.05). The changing trend of resistance rate of KP isolated from CZFPH-ICU from 2017 to 2023 to commonly used antimicrobial agents such as piperacillin/tazobactam, imipenem, and meropenem increased in 2017-2019, decreased in 2020-2022, and slightly increased in 2023. In 2013, the resistance rates of KP isolated from CZFPH-ICU to ceftazidime/avibactam, polycolistin B and tigacycline were 21.28%, 10.22% and 7.03%, respectively. Conclusion In recent 7 years, resistance rate of KP from CZFPH-ICU showed a slow decline trend, but it was still higher than that in foreign MIMIC-Ⅳ database. Hospitals should strengthen various infection prevention and control measures to effectively control KP resistance and infection.