Objective To explore the distribution characteristics and drug resistance of 267 strains of pathogenic bacteria in the intensive care unit.Methods 180 specimens sent for examination from 180 patients admitted to the intensive care unit of Yiwu Central Hospital who developed hospital-acquired infections from January 2021 to November 2023 were collected,and the sites of infection and the sources of specimens of patients with hospital-acquired infections were counted.The distribution characteristics of the patient's protozoa were analyzed,and the drug resistance of major Gram-positive bacteria(Staphylococcus aureus,Staphylococcus epidermidis)and Gram-negative bacteria(Escherichia coli,Pseudomonas aeruginosa,and Klebsiella pneumoniae)was analyzed in combination with drug sensitivity assessment results.Results Among the 180 patients with hospital-acquired infections,pulmonary and urinary tract infections accounted for a relatively high proportion,and sputum and urine specimens accounted for a relatively high proportion of the samples submitted for examination.180 specimens were cultured for pathogenic bacteria and 267 strains of pathogenic bacteria were detected,of which Gram-positive bacteria accounted for 29.59%,Gram-negative bacteria accounted for 67.04%,and fungi accounted for 3.37%.From 2021 to 2023,the detection rates of Gram-positive bacteria and fungi showed an increasing trend,and Gram-negative bacteria detection rates showed a decreasing trend.Staphylococcus aureus had high sensitivity to linezolid and Staphylococcus epidermidis had high sensitivity to moxifloxacin and linezolid.Escherichia coli and Pseudomonas aeruginosa had high sensitivity to piperacillin/tazobactam,and Klebsiella pneumoniae had high sensitivity to cotrimoxazole,imipenem,and piperacillin/tazobactam.Conclusion The distribution of pathogenic bacteria in patients with hospital-acquired infections admitted to the intensive care unit mainly consisted of Staphylococcus aureus,Staphylococcus epidermidis and Escherichia coli,Pseudomonas aeruginosa,and Klebsiella pneumoniae,and there were varying degrees of resistance to antimicrobial drugs.The subsequent selection of clinical drugs should be cautious,and antimicrobials with high sensitivity should be prioritized.