Objective To understand the distribution of clinical pathogenic isolates and their drug resistances in the Second Hospital of Hebei Medical University from 2019 to 2023, and provide evidence for the rational use of antibiotics in clinical practice.

Methods Data on clinical pathogen isolates and their drug resistance pattern in the hospital between January 2019 and December 2023 were analyzed by using WHONET 5.6 software, and statistical analysis on the results were performed by using SPSS 27.0.

Results After exclusion of duplicate isolates, a total of 81 000 0 clinical pathogenic isolates were collected from the hospital between 2019 and 2023, in which 64 953 (80.19%) were gram-negative bacterial strains and 16 047 (19.81%) were gram-positive bacterial strains. The three most common Gram-negative pathogens were Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa, whereas the three most common gram-positive pathogens were Staphylococcus aureus, Enterococcus faecium, and Staphylococcus epidermidis. Most isolates were isolated from sputum (57.46%), followed by urine (11.66%) and blood (9.39%). The isolation rate of the pathogens was highest in Respiratory Medicine Department, followed by the Intensive Care Unit and the Neurosurgery Department. K. pneumoniae was highly sensitive to imipenem, meropenem, and aminoglycosides, with an average resistance rate ranged from 15.51 to 33.2%. The resistance rates of A. baumannii to carbapenems ranged from 49.09% to 78.30%, whereas P. aeruginosa exhibited carbapenem resistance rates ranging from 18.44% to 37.21%. E. coli showed low resistance to carbapenems, with rates ranging from 1.75% to 6.30%. In the S. aureus isolates, methicillin-resistant S. aureus showed higher resistance rates to multiple antibiotics compared with methicillin-sensitive S. aureus with the exception of trimethoprim–sulfamethoxazole and gentamicin. From 2019 to 2023, the detection rates of carbapenem-resistant A. baumannii and carbapenem-resistant E. coli showed significant increase trends.

Conclusion Between 2019 and 2023, gram-negative bacteria predominated in clinical pathogens isolated in this hospital, reflecting distinct regional epidemiological characteristics. The increased isolation of multidrug-resistant organisms underscores the need for continuous antibiotic resistance surveillance and the rational use of antibiotics to curb the spread of multidrug-resistant bacteria.