Objective To explore the epidemiological characteristics and differences in antimicrobial resistance between catheter-associated urinary tract infection (CAUTI) and non-CAUTI of healthcare-associated infection (HAI), and provide scientific basis for precise clinical prevention and control. Methods Based on the regional HAI surveillance platform in Suzhou City, urinary tract infection (UTI) surveillance data reported by 61 member units from January 2020 to December 2024 were analyzed retrospectively. Pathogen distribution, detection rate of multidrug-resistant organisms (MDROs), and antimicrobial resistance spectrum characteristics of patients in the CAUTI group and non-CAUTI group were compared. Results The incidence of CAUTI in patients in CAUTI group was 0.99‰, the incidence of healthcare-associated UTI in patients in non-CAUTI group was 0.14%. There was statistically significant difference in the distribution of UTI pathogens between the two groups (P<0.05). The pathogens of the CAUTI group were mainly Gram-negative bacteria (56.0%), with high proportions of Escherichia coli (19.6%) and Klebsiella pneumoniae (15.0%). In the non-CAUTI group, the proportion of Gram-negative bacteria was higher (64.7%). Antimicrobial susceptibility testing results showed that the resistance rates of Escherichia coli to tobramycin, cephalosporins, and carbapenems in the CAUTI group were all higher than those in the non-CAUTI group (all P<0.05). Except for tigecycline, the resistance rates of Klebsiella pneumoniae to other antimicrobial agents in the CAUTI group were all significantly different from the non-CAUTI group (all P<0.05). The resis-tance rates of Acinetobacter baumannii to ticarcillin/clavulanic acid, quinolones, most cephalosporins, carbapenems, and aminoglycosides in the CAUTI group were higher than those of the non-CAUTI group (all P<0.05). The detection rates of MDROs were higher in the CAUTI group, especially that of carbapenem-resistant Klebsiella pneumoniae, accounting for 57.8%. Conclusion There are significant differences in pathogen distribution and antimicrobial resistance of UTI between the CAUTI group and the non-CAUTI group. It is necessary to establish a regional antimicrobial resistance surveillance system for pathogens in UTI, and provide basis for the rational use of antimicrobial agents in clinical practice.