Abstract： Objective To investigate the distribution and drug resistance of the pathogenic bacteria of intensive care unit(ICU) hospital-acquired pneumonia. Methods Totally 747 patients who suffered from hospital-acquired pneumonia and acquired a positive result after cultivation were enrolled. Results Among the patients, 170 were infected with gram-positive bacterium(22.8% )and the frequently-seen pathogenic bacteria were Staphylococcus aureus(62.9%) and S. haemolyticus(22.9%). The methicillin resistant Stophylococcus aureus(MRSA)incidence was 83.6% and no strains resistant to vancomycin and linezolid was found. Four hundred and ninty-seven patients were affected by Gram-negative bacillus(66.5% ). Frequently-seen pathogenic bacteria included Acinetobocter bau-mannii(30. 4%), Pseudomonas aeruginosa (22. 1% ) , Klebsiella Pneumoniae (21. 3%) and Escherichia coli (5.4%). Eighty patients suffered from fungal infection (10.7%). Frequently-seen pathogenic bacteria include Candida albicans(47.5%) , Candida glabrata ( 26.3% ) , Candida tropicalis ( 22.5% ) and Aspergillus (2.5%). The patients who had mechanical ventilation also showed high incidence of Staphylococcus aureus, Acinetobacter bau-mannii, Pseudomonas aeruginosa and epiphyte. Conclusions Regarding MRSA or methicillin resistant coagulase-negative staphylococci(MRCNS) , vancomycin and linezolid are the first choice, whereas for Gram negative bacterial , corresponding antibiotics should be selected according to drug sensitive test. Aminoglycoside antibiotic is an important choice and drug combination is generally required.