Abstract: OBJECTIVE To explore the prevalence of lower respiratory tract infections in critically ill hospitalized patients and observe the distribution of pathogens causing the infections so as to provide guidance for clinical prevention and control of the nosocomial infections. METHODS A total of 102 critically ill hospitalized patients who underwent tracheotomy from Jan 2014 to Dec 2016 were recruited as the study objects, the incidence of lower respiratory tract infections was compared among the patients with different diseases, the lower respiratory tract secretions that were obtained form all of the patients were cultured, the isolated pathogens were identified, and the distribution of pathogens was observed. RESULTS Of the 102 critically ill hospitalized patients who underwent tracheotomy, 57 had lower respiratory tract infections, with the infection rate 55.9%, of whom 19 (33.3%) were in neurosurgery department, 24 (42.1%) were in respiratory medicine department, and 14 (24.6%) were in other departments.Totally 84 strains of pathogens were isolated from the lower respiratory tract secretions of the 57 patients with infections, including 46 (54.8%) strains of gram-negative bacteria, 31 (36.9%) strains of gram-positive bacteria and 7 (8.3%) strains of fungi; Escherichia coli, Klebsiella pneumoniae and Acinetobacter baumannii were dominant among the gram-negative bacteria; the Staphylococcus aureus and Staphylococcus epidermidis were the predominant species of gram-positive bacteria. CONCLUSION The critically ill patients tend to have lower respiratory tract infections after the tracheotomy, and the gram-negative bacteria are dominant among the pathogens causing the infections.