Abstract: OBJECTIVE To provide clinical basis for the prevention and treatment of blood stream infection through analyzing the resistance characteristics and the clinical distribution of pathogens isolated from blood culture in elderly patients in one grade A hospital.METHODS A retrospective study was conducted to collect the clinical data of blood culture from 10 000 elderly inpatients in the affiliated Hospital of Jiangsu University from Jan. 2015 to Dec. 2017, to understand the types and distribution of bacteria, and to analyze the drug resistance of bacteria.RESULTS A total of 312 strains of pathogenic bacteria were isolated from 10 000 blood specimens of elderly patients, of which 182 strains were Gram-negative bacteria（58.33%）, 125 strains were Gram-positive bacteria（40.07%）,and 5 strains were fungi（1.60%）.The top five species of pathogens were Escherichia coli（25.00%）, Klebsiella pneumonia（11.54%）,Staphylococcus epidermidis（9.62%）, Staphylococcus haemolyticus（9.29%）, and Acinetobacter baumannii（8.33%）. The positive strains of blood culture were mainly from intensive care unit（n=107, 34.29%）. Both E. coli and K. pneumoniae were sensitive to imipenem. The resistance rate of A. baumannii to carbapenems and compound enzyme inhibitors was more than 75%. No Staphylococcus spp. were found resistant to vancomycin and linezolid. The detection rate of methicillin-resistant Staphylococcus aureus（MRSA） was 41.18%（7/17）.CONCLUSION Gram-negative bacteria were the main pathogens in blood culture of elderly patients, and A. baumannii had the highest drug resistance rate. It is necessary for clinicians to take reasonable prevention and treatment measures, and select sensitive antibacterial agents according to the drug sensitivity results so as to minimize the nosocomial infection.