Background:　Treatment　of　pulmonary　infections　in　the　intensive　care　unit　(ICU)　represents　a　great　challenge,　especially　infections　caused　by　antibiotic　resistance　pathogens.　A　thorough　and　up-to-date　knowledge　of　the　local　spectrum　of　antibiotic　resistant　bacteria　can　improve　the　antibiotic　treatment　efficiency.　In　this　study,　we　aimed　to　reveal　the　profile　of　bacteria　with　antibiotic　resistance　genes　(ARGs)　in　real-world　samples　from　ICU　admission　patients　with　pulmonary　infection　in　Mainland,　China,　by　metagenomic　next-generation　sequencing　(mNGS).　Methods:　A　total　of　504　different　types　of　clinical　samples　from　452　ICU　admission　patients　with　pulmonary　infection　were　detected　by　mNGS　analysis.　Results:　A　total　of　485　samples　from　434　patients　got　successful　mNGS　results.　Among　434　patients,　one　or　more　bacteria　with　ARGs　were　detected　in　192　patients　(44.24%,　192/434),　and　＞=　2　bacteria　with　ARGs　were　detected　in　85　(19.59%,　85/434)　patients.　The　predominant　detected　bacteria　were　Corynebacterium　striatum　(C.　striatum)　(11.76%,　51/434),　Acinetobacter　baumannii　(A.　baumannii)　(11.52%,　50/434)　and　Enterococcus　faecium　(E.　faecium)　(8.99%,　39/434).　ermX　conferred　resistance　to　MSL　B　and　cmx　to　phenicol　were　the　only　two　ARGs　detected　in　C.　striatum;　in　A.　baumannii,　most　of　ARGs　were　resistance-nodulation-division　(RND)-type　efflux　pumps　genes,　which　conferred　resistance　to　multi-drug;　ermB　conferred　resistance　to　MSLB　and　efmA　to　multi-drug　were　the　pre-dominant　ARGs　in　E.　faecium.　Bacteria　with　ARGs　were　detected　in　50%　(140/280)　bronchoalveolar　lavage　fluid　(BALF)　and　50.5%　(48/95)　sputum　samples,　which　were　significantly　higher　than　in　blood　and　cerebrospinal　fluid　(CSF)　samples.　Conclusion:　High　level　of　bacteria　with　ARGs　was　observed　in　clinical　samples,　especially　BALF　and　sputum　samples　from　ICU　admission　patients　with　pulmonary　infection　in　Mainland,　China.　And　C.　striatum　resistant　to　MSLB　and/or　phenicol,　multi-drug　resistance　A.　baumannii　and　E.　faecium　were　the　lead　bacteria.