Objective To understand the distribution as well as antimicrobial resistance of bacteria isolated from wound and pus specimens of patients nationwide. Methods Data about antimicrobial susceptibility testing of bacteria isolated from wound and pus specimens from member hospitals of China Antimicrobial Resistance Surveillance System (CARSS) in 2020-2024 were analyzed using WHONET 5.6 software. Antimicrobial susceptibility testing results were interpreted according to American Clinical and Laboratory Standards Institute (CLSI). Results In 2020-2024, a total of 1 808 994 bacterial strains were isolated from wound and pus specimens from member hospitals of CARSS, with the top 5 bacteria being Escherichia coli (28.5%), Staphylococcus aureus (18.9%), Klebsiella pneumoniae (10.1%), Pseudomonas aeruginosa (6.3%) and Staphylococcus epidermidis (3.1%). In 2020-2024, detection rate of methicillin-resistant Staphylococcus aureus (MRSA) decreased from 26.2% to 24.9% (P＜0.001); detection rate of methicillin-resistant coagulase negative Staphylococcus (MRCNS) decreased from 67.9% to 64.9%(P＜0.001); vancomycin-resistant Staphylococcus were not found. The resistant rates of Enterococcus faecalis to most antimicrobial agents were all lower than Enterococcus faecium, but resistance rate to linezo-lid was higher than Enterococcus faecium (［2.4%-3.4%］ vs ［0.6%-1.3%］). The susceptibility rate of Escherichia coli to carbapenem antibiotics was >98%, resistance rates to quinolones, cefepime, and piperacillin/tazobactam increased (all P<0.05). Klebsiella pneumoniae showed lower resistance rates to ceftazidime,ceftriaxone, cefotaxime, cefepime, quinolones, and compound sulfamethoxazole than Escherichia coli, and increased resistance rates to piperacillin/tazobactam (P<0.001), while the resistance rates to other antimicrobial agents remained unchanged or decreased. The resistance rates of Pseudomonas aeruginosa to piperacillin and piperacillin/tazobactam increased (both P<0.001), while those to other antimicrobial agents decreased or showed no significant changes. The resis-tance rates of Acinetobacter baumannii to ampicillin/sulbactam, cefepime, gentamicin, and minocycline decreased (all P<0.05), while that to levofloxacin increased (P=0.012). Conclusion Antimicrobial resistance of pathoge-nic bacteria isolated from wound and pus specimens remains severe. It is necessary to regularly surveil the distribution and antimicrobial resistance changes of bacteria isolated from wound and pus specimens, and persistently strengthen the surveillance on rational use of antimicrobial agents, so as to provide basis for clinical empiric treatment.