Abstract: OBJECTIVE To explore the distribution and drug resistance of pathogens causing postoperative intracranial infections in patients of neurosurgery department so as to reduce the infection rate. METHODS A total of 1 900 patients who were treated in the department of neurosurgery from Jan 2012 to Jan 2014 were recruited as the study objects, and the cerebrospinal fluid (CSF) specimens were collected for the bacterial culture and drug susceptibility testing; totally 40 patients who were hospitalized the department of neurosurgery were enrolled in the study, then the scalp specimens were collected by using sterile cotton swab on the day of surgery, or Day 1, 3, or 7 after the surgery, the bacterial culturing was conducted, and the drug susceptibility testing was performed. RESULTS The intracranial infections occurred in 179 of 1 900 patients, with the infection rate of 9.42%.A total of 163 strains of pathogens were isolated from the CSF specimens, including 119 (73.01%) strains of gram-positive bacteria and 44 (26.99%) strains of gram-negative bacteria.Totally 160 strains of pathogens were isolated from 160 scalp specimens that were obtained from 40 patients, including 143 (89.37%) strains of gram-positive bacteria, 5 (3.13%) strains of gram-negative bacteria, and 12 (7.5%) strains of fungi.The gram-positive bacteria isolated from the CSF specimens were susceptible to vancomycin, and the drug-resistant strains were not found; the gram-positive bacteria isolated from the scalp specimens were also susceptible to vancomycin, only 5 drug-resistant strains were found.The drug resistance rates of the pathogens isolated from the CSF specimens to oxacillin and penicillin were 83.19% and 79.83%, respectively; all of the pathogens isolated from the scalp specimens were resistant to penicillin.The drug resistance rate of the gram-negative bacteria isolated from the CSF specimens to kanamycin was the highest (52.27%); the drug resistance rates of the 5 strains of gram-negative bacteria isolated from the scalp specimens to cefepime and ceftazidime were 100.00% and 100.00%, respectively. CONCLUSION The gram-positive bacteria, especially the coagulase-negative Staphylococcus and Staphylococcus aureus, are dominant among the pathogens causing the intracranial infections.It is necessary for the hospital to use the broad-spectrum antibiotics aiming at the gram-positive bacteria before or during the surgery.