Abstract: Objective To provide the evidence for clinical treatment of bacteremia by studying the distribution and drug resistance of blood cultured pathogens in elderly patients. Methods Clinical data about elderly patients with positive blood samples admitted to our hospital from January 2008 to December 2011 were retrospectively analyzed.Blood samples were cultured and tested with the BacT/ALERT3D automatic blood culture system.Pathogens were identified and their drug sensitivity was tested with the VITEK-2 automatic analyzer. Results Four hundred and seventy-three strains were isolated from 3 310 blood samples with a positive rate of 14.29%.Of the 473 strains,gram-positive bacteria,gram-negative bacteria and fungi accounted for 62.16%,27.27% and 10.57%,respectively.The number of isolated coagulase-negative Staphylococci was the greatest,followed by that of Enterococci,Escherichia coli,Klebsiella pneumoniae,Staphylococcus aureus,Pseudomonas aeruginosa and Acinetobacter baumannii pneumoniae.Of these bacteria,Escherichia coli and Klebsiella pneumoniae had a stronger resistance while P.aeruginosae had a weaker resistance to carbapenems.Gram-positive Staphylococci and fungi were most sensitive to linezolid and aminoglycosides while fungi were sensitive to common antifungal agents. Conclusion Gram-positive bacteria are the main pathogens isolated from blood samples taken from elderly patients and have a high drug resistance.Understanding of their distribution and drug resistance can provide reference for rational use of antibiotics in clinical treatment of bacteremia.