Abstract: OBJECTIVE To analyze the distribution and drug resistance of pathogens in patients with AIDS complicated with perianal abscess,so as to guide rational application of antibiotics in clinical practice.METHODS Retrospective analysis of bacterial distribution and drug susceptibility test results of patients with AIDS perianal abscess in Hangzhou Xixi Hospital from January 2017 to October 2021.RESULTS The 54 samples were sent from 91 patients and totaled 68 strains of bacteria were isolated,including 43 gram-negative bacteria (63.24%),23 gram-positive bacteria (33.82%),and 2 fungi (2.94%).The detection rate of gram-negative bacteria producing extended-spectrum β-Lactamase was 25.58%,and the resistance rate to imipenem,ertapenem,amikacin,cefotetan,cefepime,piperacillin and tazobactam was low.The resistance rate of Escherichia coli to ampicillin,ampicillin/sulbactam,ceftriaxone,levofloxacin,ciprofloxacin and compound trimethoprim was more than 40%.Among Gram-positive bacteria,Streptococcus accounted for 47.83%,and the resistance rate to clindamycin was 100%.No strains were found resistant to vancomycin and linezolid.CONCLUSION The pathogenic bacteria of AIDS patients with perianal abscess are mainly gram-negative bacteria Escherichia coli and Klebsiella pneumoniae,as well as gram-positive bacteria and fungi.The fourth generation cephalosporin and β-internal amidase inhibitors,cephalosporins can be selected when using antibacterial drugs in experience,carbapenems can be used when empirical treatment is not effective.