AbstractBackgroundTo investigate the distribution of bacterial pathogens of lower respiratory tract infection (LRTI) in hospitalized elderly patients during the COVID‐19 epidemic and to explore the influence of COVID‐19 on the distribution of bacterial pathogens, to provide guidance for clinical diagnosis.MethodsSpecimens of sputum from elderly LRTIs patients at Fuding Hospital of China were consecutively collected from October 2022 to January 2023. Cultures and identification were done, and RT‐PCR was employed to detect SARS‐Cov‐2 nucleic acid.ResultsA total of 195 isolates were characterized in 163 sputum samples of consecutive hospitalized elderly patients, of which 11.3% were Gram‐positive bacteria and 88.7% were Gram‐negative. The top of frequently isolated pathogens wasKlebsiella pneumonia(30.3%),Pseudomonas aeruginosa(19.0%),Acinetobacter baumannii(12.8%),Stenotrophomonas maltophili, (7.7%),Escherichia coli(7.2%). According to the results of novel coronavirus nucleic acid detection, the 163 patients were divided into COVID‐19 group and non‐COVID control (CNT) group. The comparison of bacterial distribution between the groups revealed thatStenotrophomonas maltophiliawas lower in the COVID‐19 than in the CNT group, whileA. baumanniiwas higher in the COVID‐19 group, and the difference was statistically significant (p< .05).ConclusionThe major bacteria identified in sputum culture of hospitalized elderly patients wereK. pneumonia,P. aeruginosa,A. baumannii,S. maltophilia, andE. coli. Furthermore, the distribution ofS. maltophiliaandA. baumanniibetween the COVID‐19 and CNT groups was found to be significantly different (p< .05), while there were no significant differences in the distribution of other bacteria.