Objective To study the main pathogenic bacteria and drug sensitivity in patients with chronic sup-purative otitis media and patients with middle ear cholesteatoma in Xinjiang ,and to provide evidence for reasonable u-sing antibiotics for the two diseases .Methods We performed a retrospective analysis of the middle ear secretion bac-terial culture results of 409 patients with chronic suppurative otitis media and middle ear cholesteatoma at our hospi-tal from January 2008 to December 2013 .Results ①There were 361 strains of microbes isolated from 409 patients , and 16 of them were fungi ,and 245 were bacteria .There was a statistical significance of the pathogen detection rate about G+ and G- bacteria between chronic suppurative otitis media and middle ear cholesteatoma (χ2 =12 .216 ,P=0 .000) .②Staphylococcus aureus(in 78 of 254 ears ,30 .7% ) ,pseudomonas aeruginosa(in 46 of 254 ears ,18 .1% ) , coagulase-negative staphylococcus(in 42 of 254 ears ,16 .5% ) ,and proteus mirabilis(in 20 of 254 ears ,7 .87% ) were the most frequently insolated pathogens in chronic suppurative otitis media ,while staphylococcus aureus(in 26 of 107 ears ,24 .30% ) ,pseudomonas aeruginosa(in 17 of 107 ears ,15 .9% ) ,coagulase-negative staphylococcus (in 16 of 107 ears ,15 .0% ) ,and proteus mirabilis(in 14 of 107 ears ,13 .1% ) were the most frequently insolated patho-gens in middle ear cholesteatoma .③Staphylococcus aureus and coagulase -negative staphylococcus were all sensi-tive to quinoline nupu ting /dalfopristin ,teicoplanin ,vancomycin ,and moxifloxacin .The sensitivity of coagulase -negative staphylococcus to gentamicin ,trimethoprim -sulfamethoxazole ,and erythromycin in the middle ear chol-esteatoma were higher than those of in chronic suppurative otitis media .The sensitivity of pseudomonas aeruginosa to ceftazidime ,and imipenem were lower in the middle ear cholesteatoma .The drug sensitivity of pseudomonas aeruginosa ,proteus to trimethoprim/sulfamethoxazole and cefazolin was higher in middle ear cholesteatoma .Conclu-sion There are differences between chronic suppurative otitis media (active) and middle ear cholesteatoma about G+ ,G- bacteria detection rate .Staphylococcus aureus ,coagulase-negative staphylococcus ,pseudomonas aerugi-nosa ,and proteus mirabilis are the main pathogenic bacteria in these two chronic otitis media .There is a difference of some commonly used antimicrobial sensitivity in these two kinds of otitis media ,which is more obvious in pseudo-monas aeruginosa and proteus mirabilis .