Abstract：Objective：To explore the correlation between pathogen distribution，drug resistance，and antimicrobial susceptibility results with traditional Chinese medicine syndrome types in patients with diabetic foot. Methods： A retrospective study was conducted on 159 diabetic foot patients with positive pathogen cultures admitted to The First Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2024 to December 2025. According to traditional Chinese medicine syndrome differentiation，patients were divided into four groups：the damp-heat toxin exuberance group （49 cases）， the heat toxin injuring yin group （34 cases）， the qi and blood deficiency group （38 cases），and the qi and yin deficiency group （38 cases）. Inflammatory markers，disease duration，pathogen infection types， distribution of major pathogens， detection rates of drug-resistant bacteria， and antimicrobial susceptibility results were compared among the four groups. The correlation between various indicators and traditional Chinese medicine syndrome types was analyzed. Results：There were significant differences in white blood cell count （WBC）， C-reactive protein（ CRP），and duration of diabetic foot among the four groups（ P＜0.05）. The WBC and CRP levels in the damp-heat toxin exuberance group were the highest among all groups. The distribution of pathogen infection types among the four groups showed significant differences （P＜0.05）. The damp-heat toxin exuberance group was predominantly characterized by Gram-positive bacterial infections and mixed infections； the heat toxin injuring yin group was mainly characterized by mixed infections；and the qi and blood deficiency group and the qi and yin deficiency group were mainly characterized by Gram-negative bacterial infections and mixed infections. There were significant differences in the detection rates of major pathogens such as Staphylococcus aureus and Escherichia coli，as well as in the detection rates of multidrug-resistant bacteria， methicillin-resistant Staphylococcus aureus （MRSA）， and extended-spectrum β-lactamase （ESBL）-producing strains among the four groups （P＜0.05）. The susceptibility rates of Gram-positive bacteria to Rifampicin and Trimethoprim-Sulfamethoxazole showed statistically significant differences among the four groups （P＜0.05）， and the susceptibility rate to Levofloxacin approached statistical significance （P= 0.051）. There were no statistically significant differences in the susceptibility rates of Gram-negative bacteria to commonly used antibiotics among the four groups （P＞0.05）. Conclusion： There is a correlation between traditional Chinese medicine syndrome types in diabetic foot and disease duration， inflammatory factor levels， wound pathogen infection types，distribution of major bacterial species，and resistance characteristics. The damp-heat toxin exuberance syndrome is more frequently associated with Gram-positive bacterial infections and mixed infections，while qi and blood deficiency with collateral stasis syndrome and qi and yin deficiency with collateral stasis syndrome are more likely to present with Gram-negative bacteria and drug-resistant strains.