Objective To analyze the distribution and drug resistance of pathogenic bacteria in 124 cases with pulmonary tuberculosis combined with lower respiratory tract infection, to grasp the epidemic trends and the characteristics of drug resistance in patients with pulmonary tuberculosis combined with lower respiratory tract infection in the hospital, and provide reference for clinical rational drug uses. Methods A total of 124 strains of pathogenic bacteria were cultured and drug sensitivity tests were performed on the patients who had been diagnosed with pulmonary tuberculosis combined with lower respiratory tract infection. Results There were 15 strains of Gram-positive cocci (G+) (12.10%), which included 3 strains of staph-ylococcus aureus (2.42%), 3 strains of staphylococcus epidermidis (2.42%),and 9 strains of staphylococcus haemolyticus (7.26%) and they were highly sensitive to vancomycin. There were 60 strains of Gram- negative bacilli(G－) (48.38%),which included 15 strains of klebsiella pneumoniae subspecies (12.10%), 12 strains of pseudomonas aeruginosa (9.68%),10 strains of enterobacter cloacae ( 8.06%), 4 strains of Esche-richia coli (3.23%), 19 strains of enterobacter cloacae (15.31%). Pneumoniae subspecies and Esche-richia coli were both sensitive to imipenem and meropenem. There were 49 strains of fungus, 4 strains of aspergillus and 45 strains of candida. Except for some drugs, they were all showed sensitivity. Conclusion The main pathogenic bacteria of pulmonary tuberculosis patients with lower respiratory tract infection in the hospital were Gram-negative bacteria and fungus.Drug resistance of the bacteria was severe, which indicated that we should pay attention to bacterial culture and drug sensitivity test.