Abstract: OBJECTIVE To analyze the drug resistance of pathogens in urinary system infection in patients with diabetic nephropathy, in order to improve the therapeutic effect of antibiotics and prevent the constantly producfion of drug-resistant strains. METHODS A total of 58 cases of diabetic nephropathy with urinary system infection treated in the hospital were selected. The specimen collection, bacterial culture, identification of bacteria species, and the corresponding sensitivity test were carried out. The data were analyzed by SPSS 18.0. RESULTS Totally 46 strains of pathogens were isolated from 58 cases of patients with diabetic nephropathy and urinary system infection, with the majority of 28 strains of gram-negative bacteria, accounted for 60.87%. The drug resistance of Escherichia coli and Klebsiella pneumonia to imipenem were all 0, and the drug resistance of Staphylococcus epidermidis and Staphylococcus aureus to ceftriaxone were low, less than 20%. CONCLUSION There are many kinds of urinary system infection pathogens in patients with diabetic nephropathy, and different pathogens have different drug resistance. It is necessary to timely monitor the pathogens species, distribution and drug resistance, which can help to improve the treatment efficacy and prevention of the constantly produce of drug-resistant strains.