Abstract: OBJECTIVE To explore the distribution and drug resistance of pathogens causing infections in critically ill patients after craniotomy so as to provide guidance for clinical control of postoperative infections.METHODS A total of 584 patients who underwent the craniotomy in hospitals from Jun 2012 to Jun 2016 were enrolled in the study.The bacterial culture and drug susceptibility testing were carried out for 52 patients with postoperative intracranial infections, and the infection rate and distribution and drug resistance of pathogens were analyzed.The isolated pathogens were identified by using VITEK-2 Compact automatic identification system of BioMérieux, France, the drug susceptibility testing was conducted by means of disk method, and the statistical analysis of data was performed with the use of SPSS19.0 software.RESULTS Of the 584 patients who underwent the craniotomy, 52 had the postoperative intracranial infections, with the infection rate 8.9%.Totally 52 strains of pathogens were isolated, of which 36 (69.2%) were gram-negative bacteria, 14 (26.9%) were gram-positive bacteria, and 2 (3.9%) were fungi; Klebsiella pneumoniae and Acinetobacter baumannii were dominant among the gram-negative bacteria, accounting for 30.8% and 26.9%, respectively; Staphylococcus aureus and Staphylococcus epidermidis were the predominant species of the gram-positive bacteria, accounting for 11.5% and 11.5%, respectively. Among the gram-negative bacteria, the drug resistance rate of the A.baumannii strains to ceftriaxone was the highest (78.6%), the drug resistance rate to ciprofloxacin was the lowest (21.4%); the drug resistance rate of the K.pneumoniae strains to aztreonam and ciprofloxacin was the highest (81.3%), and the drug resistance rate to imipenem was the lowest (12.5%).Among the gram-positive bacteria, the drug resistance rate of the S.epidermidis strains to penicillin was the highest (100.0%), the drug resistance rate to vancomycin and linezolid was the lowest (0); the drug resistance rate of the S.aureus strains to erythromycin was the highest (83.3%), and the drug resistance rate to vancomycin and linezolid was the lowest (0).CONCLUSIONThe patients undergoing the craniotomy are at high risk of the postoperative infections, the gram-negative bacteria are dominant among the pathogens causing the postoperative infections and are resistant to a variety of antibiotics.It is necessary to strengthen the monitoring of pathogens during the treatment period so as to take effective intervention measures to control the infections.