Abstract: OBJECTIVE To analyze the influencing factors and dignostic value of secondary blood flow infection in patients with biliary tract infection, and to provide basis for clinical diagnosis and treatment.METHODS Eighty patients with biliary tract infection diagnosed in a hospital from Jan. 2014 to Jun. 2018 were divided into simple biliary tract infection group（n=50） and secondary blood flow infection group（n=30）. Bile pathogens in two groups were analyzed. Age, sex, smoking, alcohol consumption, underlying diseases, invasive operation, timing of blood culture, use of antibiotics, distribution of biliary pathogens, number of biliary pathogens, Alanine aminotransferase（ALT）, Aspartate aminotransferase（AST）, glutamyl transpeptidase（GGT）, bilirubin, creatinine, albumin were analyzed to summarize the influencing factors of secondary blood flow infection in patients with biliary tract infection. The predictive value of risk factors was analyzed by receiver operating curve（ROC）.RESULTS A total of 150 strains of pathogens were isolated from 80 patients with biliary tract infection, including 110 strains of Gram-negative bacteria（73.33%）, 33 strains of Gram-positive bacteria（22.00%） and 7 strains of fungi（4.67%）. The main pathogens were Escherichia coli, Klebsiella pneumoniae and Enterococcus faecium. The number of bile pathogens and AST were the influencing factors of secondary blood flow infection in patients with biliary tract infection（P＜0.05）. ROC curve analysis showed that the sensitivity and specificity of AST in predicting secondary blood flow infection were 85.70% and 50.00%, when AST cut-off value was 50.20 IU/L.CONCLUSION Patients with biliary tract infections when with 2 or more strains of biliary pathogens and AST exceeding a certain threshold should pay close attention to the possibility of secondary blood flow infection and anti-infective regimen empirically should be strengthened as soon as possible.