Abstract: OBJECTIVE To investigate the distribution of pathogens causing nosocomial infections in hospitalized patients of respiratory intensive care unit (RICU) and analyze the risk factors so as to reduce the incidence of the nosocomial infections in the RICU. METHODS From May 2010 to May 2015, the clinical data of 410 patients who were hospitalized the RICU for more than 48 hours were retrospectively analyzed, then the infection sites, distribution of pathogens, and related risk factors were observed, and the statistical analysis of data was performed with the use of SPSS 20.0 software. RESULTS Of the 410 RICU patients, 131 had nosocomial infections with the infection rate of 31.95%, of whom 62.60% had lower respiratory tract infections, and 15.27% had urinary tract infections. A total of 195 strains of pathogens were isolated, of which 71.28% were gram-negative bacteria, 18.97% were gram-positive bacteria, and 9.75% were fungi. Pseudomonas aeruginosa and Acinetobacter baumannii were the predominant species of the gram-negative bacteria, accounting for 25.64% and 18.97%. The logistic regression analysis indicated that the independent risk factors for the nosocomial infections in the RICU patients included the length of RICU stay no less than 15 days, endotracheal intubation, combination use of more than 2 types of antibiotics, and lung cancer (P＜0.05). CONCLUSION The patients with lower respiratory tract infections are dominant among the hospitalized RICU patients with the hospital-acquired infections. The gram-negative bacteria are the predominant pathogens. There are a variety of related risk factors for the hospital-acquired infections, and it is necessary to take targeted measures so as to reduce the incidence of the hospital-acquired infections.