Objective To analyze the distribution and antimicrobial resistance of pathogens in patients with pemphigus and infection, and guide rational clinical use of antimicrobial agents. Methods Patients with pemphigus and infection in a hospital from January 2014 to September 2019 were chosen retrospectively, distribution and antimicrobial resistance of pathogens, as well as influencing factors for multidrug-resistant organism(MDRO) infection was analyzed. Results A total of 114 patients with pemphigus and infection were chosen, and 121 strains of pathogens were isolated, including 73 (60.33%) strains of Gram-positive (G⁺) bacteria, 26 (21.49%) Gram-negative (G^-) bacteria and 22 (18.18%) fungi. G⁺ bacteria were mainly isolated from skin (n=70, 95.89%), including 53 strains of Staphylococcus aureus (S. aureus) and 10 strains of Staphylococcus epidermidis (S. epidermidis). G^- bacteria were also mainly isolated from skin (n=14, 53.85%), followed by urine (n=6, 23.08%) and sputum (n=5, 19.23%). Fungi were mainly isolated from oral mucosa (n=16, 72.72%). A total of 37(30.58%) MDRO strains were isolated. Resistance rates of S. aureus and S. epidermidis to penicillin were both 100%; resistance rates of S. aureus to fluoroquinolones, ceftriaxone, ampicillin/sulbactam, and tetracycline were all <50%, resis-tance rates to clindamycin and erythromycin were both >90%. Resistance rates of S. epidermidis to ampicillin/sulbactam, gentamycin, tetracyclines and moxifloxacin were all <50%. Isolation rates of methicillin-resistant S. aureus (MRSA) and methicillin-resistant S. epidermidis (MRSE) were 43.40% and 60.00% respectively. Vancomycin-, linezolid-, and quinupristin/dalfopristin-resistant G⁺ bacteria were not found. Resistance rates of Escherichia coli to most commonly used antimicrobial agents, such as the third generation cephalosporins, fluoroquinolones, and tetracyclines were all ≤ 50%, to aztreonam was 30%, Escherichia coli were sensitive to both cefoperazone/sulbactam and imipenem. Patients with moderate/severe disease and hypoproteinemia had a higher incidence of MDRO infection, differences were all statistically significant (all P<0.05). There was no significant difference in the incidence of MDRO infection among patients of different age, gender, oral involvement, and diabetes history (all P>0.05). Conclusion Patients with pemphigus are susceptible to all kinds of infection, mainly skin bacterial infection, MDRO infection rate is high, pathogenic bacteria and antimicrobial resistance have certain characteristics.