ObjectiveTo investigate the change in distribution and antimicrobial resistance of pathogens from blood culture of children，and provide a basis for treatment of bloodstream infection. MethodsPathogens isolated from blood culture of hospitalized children between January 2009 and December 2013 were divided into group 2009—2011 and 2012—2013. Distribution and antimicrobial susceptibility of pathogens were analyzed. ResultsFrom 2009 to 2013, a total of 48 455 blood specimens were taken for culture, 2 730 pathogenic bacteria were isolated, positive rate was 5.63%. The positive rate of blood culture decreased yearbyyear (χ2=415.30，P＜0.01).Of 2 730 isolates of pathogenic bacteria，grampositive bacteria, gramnegative bacteria, and fungi accounted for 80.37% (n=2 194），18.68%（n=510），and 0.95%（n=26）respectively. The difference between two groups of pathogenic bacteria was significant（χ2=180.334，P＜0.001）. Susceptibility rates of grampositive cocci to vancomycin, linezolid and teicoplanin were all  100%, resistance rates of coagulasenegative Staphylococcus and Staphylococcus aureus to ciprofloxacin, compound sulfamethoxazole and tetracycline all decreased. Susceptibility rates of gramnegative bacilli to imipenem,meropenem and amikacin were all≥97.50%, susceptibility rate of Klebsiella pneumoniae to levofloxacin was 100%; Of cephalosporins, Escherichia coli and Klebsiella pneumoniae had high resistance except ceftazidime  and  cefepime.   ConclusionDistribution of pathogens from blood culture of children in 20092013 changed significantly, pathogens have high resistance to commonly used antimicrobial agents,more attention should be paid to the monitor of pathogens from blood culture and pathogenic antimicrobial resistance.