Objective To investigate the distribution and antimicrobial resistance profiles of pathogenic bacteria in Children's Hospital of Hebei Province to inform reasonable use of antibiotics.Methods Antimicrobial susceptibility of the bacterial isolates was tested using Kirby-Bauer method,VITEK-2 Compact,BD Phoenix 100 automated systems,and E-test method.The results were interpreted according to the breakpoints recommended by the Clinical and Laboratory Standards Institute (CLSI) in 2022.Results were analyzed by WHONET 5.6 software.Results A total of 11909 isolates were collected from 2020 to 2022,of which 45.1% were Gram positive organisms and 54.9% were Gram negative organisms.The prevalence of MRSA and in S.aureus and MRCNS in coagulase-negative Staphylococcus was 36.8% and 73.8%,respectively.The resistance rate of Enterococcus faecalis and Enterococcus faecium to ampicillin was 2.6% and 93.5%,respectively,while the resistance rates of E.faecalis and E.faecium to high concentration gentamicin was 42.2% and 66.2%,respectively.E.faecium showed significantly higher resistance rates to the antibiotics tested than E.faecalis.The prevalence of PRSP and PSSP was 1.7% and 95.7% respectively in the non-meningitis S.pneumoniae isolates.No vancomycin-or linezolid-resistant strains were found in Staphylococcus,Enterococcus,or Streptococcus.The prevalence of ESBLs-producing E.coli and K.pneumoniae was 47.4% and 32.3%,respectively.The prevalence of carbapenem-resistant E.coli and K.pneumoniae was 2.0% and 22.4%,respectively.The prevalence of carbapenem-resistant P.aeruginosa (CRPA) and carbapenem-resistant A.baumannii (CRAB) was 9.5% and 22.1%,respectively.The resistance rate of Haemophilus influenzae to ampicillin was 83.8%.The prevalence of β-lactamase-producing H.influenzae and β-lactamase-non-producing ampicillin-resistant (BLNAR) H.influenzae was 76.1% and 7.7%,respectively.No meropenem-resistant strains were found in H.influenzae.Majority (98.0%) of Moraxella catarrhalis strains produced β-lactamase.Conclusions Multi-drug resistant bacterial pathogens are still serious in pediatric inpatients.The common clinical isolates showed various levels of resistance to different antimicrobial agents.It is important to continue the surveillance of bacterial resistance in children,take proactive measures to curb the spread of drug-resistant bacteria,and use antibiotics rationally.