ObjectiveTo investigate the distribution and antimicrobial resistance of the clinical strains isolated from the First Affiliated Hospital of Xi’an Jiaotong University in 2019 and provide a basis for clinical rational use of antibiotics.MethodsAll the clinical samples which were collected from January 1st to December 31st in 2019 were employed to determine antimicrobial resistance retrospectively. Results were interpreted according to Clinical and Laboratory Standards Institute 2019 breakpoints and analyzed by WHONET 5.6 software.ResultsA total of 6 784 nonduplicate strains were isolated in 2019, including 2 865 (42.2%) strains of Gram-positive bacteria and 3 919 (57.8%) strains of Gram-negative bacteria. The top five pathogens with the highest detection rate were Escherichia coli, Klebsiella pneumoniae, Enterococcus faecium, Pseudomonas aeruginosa, and Staphylococcus aureus. Methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase negative Staphylococcus accounted for 33.0% and 72.0%, respectively. The detection rate of vancomycin-resistant Enterococcus faecium was 1.0% and the detection rates of linezolid-resistant Enterococcus faecium and Enterococcus faecalis were 0.3% and 2.9%, respectively. As for the non-meningitis Streptococcus pneumoniae, the prevalence of penicillin-susceptible Streptococcus pneumoniae was 100% in the isolates from adults. Extended-spectrum β-lactamases-producing strains accounted for 58.2%, 33.6%, and 33.3% in Escherichia coli, Klebsiella spp., and Proteus mirabilis, respectively. The total detection rate of carbapenem-resistant Enterobacteriaceae was 7.8%, among which the detection rates of carbapenem-resistant Escherichia coli and carbapenem-resistant Klebsiella pneumoniae were 1.5% and 17.2%, respectively. The percentages of Pseudomonas aeruginosa strains resistant to imipenem and meropenem were 25.0% and 21.6%, respectively, and those of Acinetobacter baumannii were 73.8% and 74.2%, respectively.ConclusionsBacterial resistance is still serious in this hospital. It is necessary to strengthen rational drug use. At the same time, effective prevention and control measures should be taken to avoid cross-infection.