Epidemiology and Drug Resistance of Pathogens Isolated from Cerebrospinal Fluids at a Children’s Medical Center in Eastern China During 2006–2020

Dan Li,1,&ast; Xin Zhang,2,3,&ast; Yunzhong Wang,2 Jian Xue,2 Xueqiang Ji,2 Xuejun Shao,2– 4 Yang Li2– 4 1Department of Clinical Laboratory, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215004, People’s Republic of China; 2Department of Clinical Laboratory, Children’s Hospital of Soochow University, Suzhou, Jiangsu, 215025, People’s Republic of China; 3Institute of Pediatric Research, Children’s Hospital of Soochow University, Suzhou, Jiangsu, 215025, People’s Republic of China; 4Clinical Medical College of Pediatrics, Soochow University, Suzhou, Jiangsu, 215025, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yang Li; Xuejun Shao Email 11418092@zju.edu.cn; xjshao@suda.edu.cnObjective: 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