Objective：To investigate the clinical distribution and resistance characteristics of pathogens isolated from bloodstream infection patients in a intensive care unit of geriatric medicine（geriatric ICU）in a tertiary teaching hospital. Methods：Blood culture results and clinical data of hospitalized patients in geriatric ICU from 2016 to 2019 were collected and then analyzed using WHONET 5.6 software. Patients with positive blood culture were divided into old group（≥60 years）and non-old group（<60 years）according to age. And the constitute as well as drug resistance of blood culture pathogens were compared between the two groups. Results：A total of 100 strains of pathogen were isolated from 96 patients with positive blood culture. Of the 100 isolates，gram negative bacilli，gram positive cocci，fungi and anaerobes accounted for 63%，22%，10%，and 5%，respectively. The top three gram negative pathogens were K. pneumoniae（25%），E. coli（13%）and A. baumannii（11%）. The top three gram positive pathogens were Enterococcus（25%），S. aureus（13%）and viridians Streptococcus（11%）. The proportion of carbapenem-resistant Enterobacteriaceae（CRE）in K. pneumoniae，carbapenem-resistant A. baumannii（CRAB）in A. baumannii and methicillin-resistant Staphylococcus aureus（MRSA）in S. aureus were 72.0%，81.3% and 57.2%，respectively. E. coli resistant to carbapenem and S.aureus resistant to vancomycin or linezolid were not found. One strain of E. faecium was identified as resistant to vancomycin. Almost all CRE strains were not resistant to tigecyclin，polymyxin B or ceftazidime-avibactam except one strain of K. pneumoniae that was determined to be resistant to ceftazidime-avibactam. Among CRAB，only one strain showed resistance to tigecyclin，and no resistance to tigecyclin or polymyxin B was detected in others. There was no significant differences in pathogen distribution between old and non-old group. Compared with non-old group，pathogens in old group showed higher drug resistance. Conclution：Gram-negative bacteria with high drug resistance to carbapenem were the dominant pathogens associated with bloodstream infection in old severe patients in geriatric ICU. And bacterial resistance surveillance might be helpful for guiding rational use of antimicrobial agents in clinic.