Objective To investigate the distribution and antimicrobial resistance of pathogens causing early infection in patients after lung transplantation(within 3 months) in a respiratory intensive care unit (RICU), so as to provide evidence for empirical antimicrobial treatment of early infection after lung transplantation. Methods Clinical and pathogenic data of patients with lung transplantation time<3 months in RICU of a hospital from September 2017 to September 2018 were collected, pathogens and antimicrobial resistance were statistically analyzed. Results A total of 134 patients were included in study, 349 strains of pathogens were isolated, Gram-negative bacteria accounted for 91.12%, 91.04% of which were mixed infection cases with more than 2 species of strains. The top three pathogens were Acinetobacter baumannii, Klebsiella pneumoniae, and Pseudomonas aeruginosa, accounting for 29.51%, 16.05%, and 15.47% respectively. Specimens were mainly from sputum (81.09%) and bronchoalveolar lavage fluid (12.89%). Resistance rate of Acinetobacter baumannii to polymyxin B was 2.91%, and resistance rates to other antimicrobial agents were 56.31%-100.00%. Resistance rates of Klebsiella pneumoniae to polymyxin B and imipenem were 3.57% and 69.64% respectively. Pseudomonas aeruginosa was sensitive to tobramycin,amikacin, gentamicin, piperacillin/tazobactam, ciprofloxacin, and levofloxacin, resistance rates were 1.85%-14.81%, polymyxin B-resistant strains were not found. Resistance rates of Stenotrophomonas maltophilia to levofloxacin, compound sulfamethoxazole and ceftazidime were all low (8.70%-28.26%). Isolation rate of methicillin-resistant Staphylococcus aureus (MRSA) was 95.24%, vancomycin- and linezolid-resistant Staphylococcus aureus strain was not found. Conclusion Gram-negative bacteria are the main pathogens causing early infection in patients after lung transplantation in RICU, the proportion of mixed infection is high. Antimicrobial resistance rates of different strains are varied, isolation rates of carbapenem-resistant Acinetobacter baumannii and carbapenem-resistant Klebsiella pneumoniae are higher, which should be paid more attention in clinic.