Objective To study the bacterial resistance in different levels of hospitals in China from 2014 to 2019. Methods Data related to different levels of hospitals were extracted from reports of China Antimicrobial Resistance Surveillance System (CARSS) in 2014-2019, change in data of tertiary and secondary hospitals were analyzed and compared. Results From 2014 to 2019, the top 5 Gram-positive bacteria isolated from all hospitals were Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecalis, Streptococcus pneumoniae and Enterococcus faecium. Compared with tertiary hospitals, proportion of Streptococcus pneumoniae in secondary hospitals was higher. The top 5 Gram-negative bacteria from all hospitals were Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii and Enterobacter cloacae. During 6 years, isolation rates of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase negative Staphylococcus (MRCNS) in tertiary hospitals decreased from 36.2% to 30.6% and 79.9% to 76.1% respectively, isolation rates of MRSA and MRCNS in secondary hospitals also decreased. Isolation rate of vancomycin-resistant Enterococcus faecalis in tertiary hospitals was lower than that in secondary hospitals, isolation rates of vancomycin-resistant Enterococcus faecium in tertiary and secondary hospitals all showed a downward trend. Isolation rate of imipenem-resistant Pseudomonas aeruginosa in different levels of hospitals didn't change much, but isolation rates in tertiary hospitals (18.8%-21.4%) were all higher than those in secondary hospitals (12.3%-16.3%) during the same period. Isolation rates of imipenem-resistant Acinetobacter baumannii in different levels of hospitals increased year by year, tertiary hospitals (55.5%-60.2%) were all higher than those in secondary hospitals (38.2%-42.8%) during the same period. Isolation rate of cefotaxime-resistant Escherichia coli in tertiary and secondary hospitals decreased gradually, but tertiary hospitals (51.9%-60.9%) were all higher than those in secondary hospitals (46.7%-56.0%) during the same period. In different levels of hospitals, isolation rate of imipenem-resistant Escherichia coli changed little, all were lower than 2%. In tertiary hospitals, isolation rate of imipenem-resistant Klebsiella pneumoniae increased significantly in different levels of hospitals (from 4.9% to 11.1%), while in secondary hospitals, it increased from 3.6% to 5.3%. Conclusion The proportion of special antimicrobial-resistant bacteria in Gram-positive bacteria in tertiary hospitals has decreased, but change is not obvious in secondary hospitals. Among Gram-negative bacteria, isolation rates of imipenem-resistant Klebsiella pneumoniae and imipenem-resistant Acinetobacter baumannii present a significant upward trend, antimicrobial resistance in tertiary hospitals is more serious than that in secondary hospitals. Management on rational use of antimicrobial agents as well as prevention and control of healthcare-associated infection should be continued to strengthen.