Abstract: OBJECTIVE To observe the distribution of pathogens isolated from wound specimens of the emergency department patients with open wounds and analyze the changing trend of drug resistance so as to provide bases for clinical anti-infection therapy. METHODS The result of bacterial culture of wound secretion specimens and the result of antimicrobial susceptibility testing were collected from all of the patients with open wounds who were treated in the emergency department of Ningbo No. 6 Hospital from 2017 to 2024. The above results were retrospectively analyzed. RESULTS Totally 21 782 strains of pathogens were isolated from the wound secretion specimens of the patients with open wounds from 2017 to 2024. Coagulase-negative Staphylococcus (31.33%) and Staphylococcus aureus (13.26%) were the predominant species of gram-positive bacteria. The drug resistance rate to oxacillin showed an upward trend between 2018 and 2021 and decreased to 40.78% and 3.93% in 2024, respectively. Enterococcus faecalis accounted for 2.47%, although the vancomycin-resistant strains (with the highest 1.39%) were sporadically detected but were generally sensitive to tigecycline and linezolid. Pseudomonas aeruginosa (11.19%), Enterobacter cloacae (5.13%) and Escherichia coli (4.82%) were dominant among the gram-negative bacteria. The overall drug resistance rate to carbapenems was relatively low, however, the drug resistance rate of the P. aeruginosa strains to meropenem firstly rose and then showed a downward trend, decreasing to 1.81% in 2024. The drug resistance rates of the E. cloacae strains to imipenem and meropenem were 1.61% and 1.97%, respectively. The P. aeruginosa strains were sensitive to piperacillin-tazobactam and cefoperazone-sulbactam. The drug resistance rate of the E. coli strains to fluoroquinolones was high and was higher than that of the P. aeruginosa and E. cloacae strains. CONCLUSIONS The gram-positive bacteria are dominant among the bacterial flora isolated from the wound specimens of the emergency patients with open wounds, and the drug resistance spectrum varies significantly with time. It is necessary for the hospital to dynamically adjust the empirical anti-infection program according to the epidemiological data of this region.