Abstract: OBJECTIVE To investigate the distribution of pathogens causing postoperative nosocomial infections in patients with cholelithiasis and analyze the related influencing factors so as to provide guidance for clinical use of antibiotics. METHODS A total of 950 patients who received biliary stones surgery in the hospital from Dec 2012 to Dec 2016 were enrolled in the study, the prevalence of postoperative nosocomial infections was analyzed, the distribution and drug resistance of pathogens causing the infections were observed, and the univariate analysis and non-conditional multivariate logistic regression analysis were performed for the influencing factors for the nosocomial infections. RESULTS Of the 950 patients with cholelithiasis, 48 had postoperative nosocomial infections, with the infection rate 5.05%.Totally 46 strains of pathogens were isolated from the 48 patients with nosocomial infections, of which 29 (63.04%) were gram-negative bacteria, 15 (32.61%) were gram-positive bacteria, and 2 (45.35%) were fungi.Among the gram-negative bacteria, the drug resistance rates of Escherichia coli strains to ciprofloxacin and levofloxacin were 91.67% and 83.33%, respectively; the drug resistance of Klebsiella pneumoniae straisn to ciprofloxacin and gentamicin were 90.91% and 81.82%, respectively.The drug resistance rates of Staphylococcus aureus strains to erythromycin, penicillin G and ampicllin were 100.00%, 85.71% and 85.71%, respectively; the drug resistance rates of Staphylococcus haemolyticus strains to penicllin G, erythromycin and ampicllin were 100.00%, 83.33% and 83.33%, respectively.The non-conditional logistic regression analysis indicated that the age, smoking, drinking and length of hospital stay were the independent risk factors for the postoperative nosocomial infections in the patients with cholelithiasis. CONCLUSION The gram-negative bacteria are dominant among the pathogens causing the postoperative nosocomial infections in the patients with cholelithiasis.The age, smoking, drinking and length of hospital stay are the independent risk factors for the postoperative nosocomial infections in the patients with cholelithiasis.It is necessary for the hospital to take targeted intervention measures according to the above characteristics.