Abstract: OBJECTIVE To investigate pathogen detection and type of hospital infection through anasis on the different diagnostic pathway of patients with acute ischemic stroke in stroke centers, and provide the basis for more effective prevention and control strategies of hospital infection management.METHODS Retrospective analysis were carried out on the clinical data of 533 acute ischemic stroke patients in the stroke center of a large-scale top three hospital from January, 2014 to March, 2019, and then the infection rate, infection case rate, type of infection and distribution of pathogens were analyzed systematically.RESULTS Among 533 acute ischemic stroke patients, 55 cases occurred nosocomial infection,and the case rate of infection was 10.32%. The case rate of nosocomial infections of patients with emergency intravenous thromolysis, endovascular interventioanl treatment and bridging treatment in the ward was 10.92%, 8.11%, 11.88%, respectively（P=0.947）. The 40 cases of lower respiratory tract infection, 8 cases of urinary tract and 4 cases bloodstream infections are the the top three infection types, accounting for 72.73%, 14.55%, and 7.27%, respectively. 78 strains of pathogenic bacterial were isolated from infected patients, among which 54 cases were Gram-negative bacteria, accounting for 69.23%, dominated by Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae; 15 strains were Gram-positive bacteria, accounting for 19.23%, dominated by Staphylococcus aureus; and 9 strains were fungi, accounting for 11.54%, dominated by smooth Candida and C. sphaeroides mainly.CONCLUSION Patients with acute ischemic stroke are susceptible to pulmonary and urinary tract infection, of which Gram-negative bacteria are the dominantpathogens of infection. Therefore, the prevention and control of infection, and continuous improvement of infection is urgent.