ObjectiveTo investigate the distribution and antimicrobial resistance of clinical isolates from patients with lower respiratory tract (LRT) infection in neurological intensive care unit (NICU), so as to provide the basis for clinical treatment.MethodsSputum samples of patients with LRT infection in NICU from October, 2005 to December, 2008 were collected according to the standard criteria for routine bacterial culture ， identification and antimicrobial susceptibility test.ResultsA total of 567 pathogenic strains were isolated from 168 patients, 359 (63.32%) of which were gramnegative bacilli, 99(17.46%) were grampositive cocci, and 109 (19.22%) were fungi. Multidrug resistant (MDR) bacteria were common, 73.68% (28/38) of Escherichia coli and 62.30% (38/61) of Klebsiella pneumonia were extendedspectrum βlactamaseproducing strains respectively; carbapenemresistant rate of Acinetobacter baumannii was 43% in 2008, 87.10% (81/93) of Staphylococcus aureus were methicillinresistant strain, all were sensitive to teicoplanin and vancomycin.ConclusionGramnegative bacteria are the most common pathogens in patients with LRT infection in this NICU, drug resistance is severe, surveillance on antimicrobial resistance should be enhanced and rational use of antimicrobial agents should be advocated to reduced drugresistance.