Abstract: OBJECTIVE To investigate the distribution and drug resistance of nosocomial infections in elderly patients with coronary heart disease (CHD). METHODS Clinical data of 216 cases of hospitalized patients with coronary heart disease from Dec. 2014 to Feb. 2016 were analyzed. The sputum, blood and secretions of the patients were collected for pathogen cultures. The method of MIC test was used to analyze the distribution and drug resistance of pathogens in elderly patients with coronary heart disease, and the corresponding countermeasures were put forward according to the drug resistance of pathogenic bacteria. RESULTS The infection sites of nosocomial infections in elderly patients with coronary heart disease were respiratory tract, urinary tract and gastrointestinal tract. Totally 234 strains of pathogens were isolated. Among them, 138 strains were gram-negative bacteria, accounting for 58.97%, which were mainly Pseudomonas aeruginosa and Escherichia coli, 61 strains were gram-positive bacteria, accounting for 26.07%, which were mainly Staphylococcus aureus and Staphylococcus epidermidis, and 35 strains were fungi, accounting for 14.96%, which were mainly Candida albicans and Aspergillus. The resistant rates of P. aeruginosa to ampicillin/sulbactam, piperacillin, ceftriaxone and ceftazidime were relatively high, which were all 78.26%. The resistant rates of E. coli to amoxicillin/clavulanic acid and piperacillin were relatively high, which were 81.48%. The resistant rates of S. aureus and S. epidermidis to ciprofloxacin and erythromycin were relatively high, which were 54.84%, 51.61% and 44.44%, 55.56%. CONCLUSION The main pathogens of nosocomial infection in elderly patients with coronary heart disease are gram-negative bacteria, and the drug resistant rates are high, so we should select sensitive antibiotics, so as to improve clinical cure rate.