Objective: To investigate the epidemiology and drug resistance of pathogens isolated from cerebrospinal fluid samples at a children’s medical center in eastern China and provide the basis for anti-infection treatments.
Methods: In all, 307 non-duplicated strains of pathogens were isolated from cerebrospinal fluid samples in the Children’s Hospital of Soochow University from January 2006 to December 2020. Mass spectrometry was used for pathogen identification. The VITEK 2 Compact system and Kirby-Bauer method were applied to determine antimicrobial susceptibility.
Results: Among the 307 isolates, gram-positive bacteria, gram-negative bacteria and fungi accounted for 60.26%, 34.53%, and 5.21%, respectively. The most prevalent pathogens were Streptococcus pneumoniae  (26.06%), Escherichia coli  (20.20%) and Streptococcus agalactiae  (17.26%). The number of isolates was highest in winter. The most prevalent gram-positive bacterium in children < 6 months old was Streptococcus agalactiae , while Streptococcus pneumoniae  was the most in children were > 6 months old. The drug resistance of gram-positive bacteria, fungi and Haemophilus influenza  were not high. In addition, 35 strains of gram-negative bacteria produced extended-spectrum β-lactamases (ESBLs) and 6 strains were identified as multidrug-resistant (MDR) bacteria. These strains showed much higher resistance to the antibiotics than other strains.
Conclusion: Cases of meningitis among children have increased in the past 15 years and MDR bacteria were also identified. The emergence of MDR bacteria is a cause for great concern and requires further investigation.
Keywords: cerebrospinal fluids, infection, children, drug resistance, epidemiology