ObjectiveTo investigate the distribution and the drug resistance of pathogens in nosocomial infection (NI) in a surgical intensive care unit (SICU).MethodsNI prevalence was surveyed retrospectively in SICU of a hospital from October 2004 to September 2009.ResultsThe average NI rate was 9.79% (119/1 216), the major sites of NI were lower respiratory tract (40.25%), abdominal cavity (28.39%) and  bloodstream (9.32%). Among isolated pathogens, 67.03% (185/276) were gramnegative bacteria, 22.83% (63/276) were grampositive cocci, and 10.14% (28/276) were fungi. Pseudomonas aeruginosa and coagulasenegative Staphylococci (CNS) were the most frequent gramnegative and positive organism, respectively. 38.46% of Klebsiella pneumonia and 34.78% Escherichia coli were tested positive for extendedspectrum βlactamase; 60.00% of Staphylococcus aureus and 58.82% of CNS were methicillinresistant. Enterobacteriaceae were susceptible to carbapenems, amikacin and levofloxacin， sensitive rate was up to more than 86%; nonfermentative bacteria were seriously resistant to most antimicrobial agents， the resistant rate to carbapenems was more than 45%; all grampositive cocci were sensitive to both teicoplanin and vancomycin， the sensitive rate was 100%.ConclusionNI and drugresistance of pathogens in SICU are serious, rational use of antimicrobial agents  as well as constant surveillance on microbial trends are essential to control NI effectively.