Abstract: OBJECTIVE To explore the related factors for postoperative nosocomial infections in elderly patients of orthopedics department and analyze the prevention strategies so as to provide guidance for prevention of the postoperative nosocomial infections.METHODS A total of 1377 elderly patients with fracture who were hospitalized in orthopedics department from Jan 2013 to Dec 2015 were enrolled in the study. The medical records of the patients were reviewed, the incidence of postoperative nosocomial infections, infection sites and distribution of pathogens causing the infections were observed, the influencing factors were analyzed, and the prevention strategies were put forward.RESULTS Totally 68 patients had postoperative infections, with the infection rate 4.94%, 52.94% of whom had respiratory tract infections. Of 128 submitted specimens, 96 were cultured positive, with the positive rate 75.00%. Totally 106 strains of pathogens were isolated from the positive specimens, 56 of which were gram-positive bacteria, and 50 were gram-negative bacteria. The result of logistic regression analysis showed that the infection was closely associated with the age, operation duration, use of ventilator, use of antibiotics and length of hospital stay (P<0.05).CONCLUSION Lower respiratory tract and incision are the major infection sites of the elderly patients with postoperative nosocomial infections in orthopedics department. The proportion of the gram-negative bacteria causing the infection is equivalent to that of the gram-positive bacteria. It is an effective way to give diet and environmental regulation before and after surgery, reasonably use invasive operations and rationally use antibiotics after surgery so as to reduce the incidence of postoperative infections.