Abstract: OBJECTIVE To observe the clinical distribution and drug resistance rates of Ralstonia strains isolated from pediatrics department patients and analyze the differences among the species so as to provide bases for clinical diagnosis， prevention and control of infections. METHODS Totally 112 strains of clinical non-repetitive Ralstonia isolates were collected from Hunan Children's Hospital between 2015 and 2024. The specimen sources， distribution of species， results of antimicrobial susceptibility testing， and clinical data were retrospectively analyzed. RESULTS Of the clinical Ralstonia isolates， 66.96% were isolated from neonatology department; respiratory tract specimens were dominant among the specimen sources， accounting for 91.07%. Ralstonia mannitolilytica (88.39%) was the predominant species， and Ralstonia pickettii (6/7) was dominant among the strains causing bloodstream infections. The result of antimicrobial susceptibility testing showed that the strains were highly sensitive to sulfamethoxazole-trimethoprim， tetracyclines and quinolones (the drug susceptibility rates were more than 96%). The in vitro sensitivities of the R.pickettii strains to imipenem， meropenem and ceftazidime were superior to those of the R.mannitolilytica strains. The patients who were detected with R.mannitolilytica strains had longer length of hospital stay， higher proportion of being treated with ventilator， higher proportion of being treated with central venous catheter indwelling， and higher admission rate to intensive care unit. CONCLUSIONS It is demonstrated in the study that the Ralstonia strains are multidrug-resistant， and respiratory tract specimens are the major specimen source. There are differences in the pathogenesis characteristics and antimicrobial susceptibilities between the R.pickettii strains and the R.mannitolilytica strains， which may provide convincible bases for formulation of individualized programs for anti-infection therapies and the precise control of infections in key departments.