Abstract: OBJECTIVE To investigate the characteristics of pathogenic distribution and risk factors for pulmonary infection in children with acute asthma, and to construct regression equation. METHODS A total of 452 children with acute asthma admitted to Jianyang People's Hospital from Jan 2020 to Dec 2022 were analyzed retrospectively. According to whether pulmonary infection occurred, they were divided into the infection group (86 cases) and the non-infection group (366 cases). The status of pulmonary infection and pathogenic bacteria distribution in children with acute asthma were analyzed. The risk factors for the pulmonary infection in children with acute asthma were analyzed by univariate and multivariate analysis, and the risk factor model was established. The receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of the risk factor model for pulmonary infection in children with acute asthma. RESULTS A total of 89 strains of pathogenic bacteria were detected in 86 children with acute asthma pulmonary infection, among which 61 strains of gram-negative bacteria accounted for 68.54%, 18 strains of gram-positive bacteria accounted for 20.22%, 4 strains of fungi accounted for 4.49% and 6 strains of Mycoplasma accounted for 6.74%. Multivariate logistic analysis showed that the number of asthma attacks, complicated with nasal polyps or rhinosinusitis or nasal septum deviation, use of antibiotics, use of glucocorticoids, animals raised in the home and high serum IgE level were risk factors for pulmonary infection in children with acute asthma (P＜0.05). Accordingly, the risk factor model was as follows: Logit (P) =-13.515+0.753× number of asthma attacks +0.789× complicated with nasal polyps or rhinosinusitis or nasal septum deviation +0.676× use of antibiotics +0.771× use of glucocorticoids +0.795×animals raised in the home+0.904× high serum IgE level. The ROC curve for the prediction of pulmonary infection in children with acute asthma was drawn according to the risk factor model. The results showed the diagnostic sensitivity of 80.23% and the specificity of 79.78%. CONCLUSION The main pathogenic bacteria of pulmonary infection in children with acute asthma are gram-negative bacteria. The established risk factor model has a high value in predicting the occurrence of pulmonary infection in children with acute asthma. Therefore, targeted preventive measures can be taken to reduce the risk of pulmonary infection in children with acute asthma.