Abstract: OBJECTIVE To investigate the distribution and drug resistance of pathogens causing abdominal infections in patients with decompensated liver cirrhosis so as to provide guidance for reasonable use of antibiotics. METHODS A total of 320 decompensated liver cirrhosis patients complicated with abdominal infections who were treated in hospitals from Oct 2014 to Feb 2017 were recruited as the study objects.The ascites specimens were collected from the patients after abdominal paracentesis, the isolated pathogens were identified, and the drug susceptibility testing was performed. RESULTS Among the 320 patients, 83 were positive for culture of pathogens, with the positive rate 25.94%.Totally 136 strains of pathogens were isolated from the patients who were positive for culture of ascites, of which 89 (65.44%) were gram-negative bacteria, 43 (31.62%) were gram-positive bacteria, and 4 (2.94%) were fungi; the Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa were dominant among the gram-negative bacteria, and the drug resistance rates of the E.coli strains to carbapenems (imipenem, meropenem) and semi-synthetic penicillin as well as β-lactamase inhibitor preparations (piperacillin-tazobactam) were 0; the K.pneumoniae strains were generally resistant to β-lactams, the drug resistance rate to amoxacillin was as high as 100.00%, however, the drug resistance rate to carbapenems (imipenem) was 0; the drug resistance rates of the P.aeruginosa strains to imipenem and amikacin were 0.The Staphylococcus epidermidis and Streptococcus pneumoniae were the predominant species of the gram-positive bacteria, the drug resistance rate of the two species to penicillin was as high as 100.00%, the drug resistance rates of the S.epidermidis strains to vancomycin, teicoplanin and amikacin were 0, and the drug resistance rates of the S.pneumoniae strains to vancomycin and teicoplanin were 0. CONCLUSION The gram-negative bacteria are dominant among the pathogens causing the abdominal infections in the patients with liver cirrhosis, the E.coli and K.pneumoniae are the predominant species and are susceptible to imipenem and meropenem, which can be used as the preferred antibiotics for clinical treatment, however, the drug resistance rates to the third and fourth generation cephalosporins show upward trends, and it is necessary for the hospital to treat the patients based on the result of the drug susceptibility testing.