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Acute bacterial meningitis is still considered one of the most dangerous infectious diseases in children. To investigate the prevalence and antibiotic resistance profiles of cerebrospinal fluid (CSF) pathogens in children with acute bacterial meningitis in Southwest China, CSF samples from 179 meningitis patients (3 days to 12 years old) with positive culture results were collected from 2012 to 2015. Isolated pathogens were identified using the Vitek-32 system. Gram stain results were used to guide subcultures and susceptibility testing. The antimicrobial susceptibility of isolates was determined using the disc diffusion method. Of the isolates, 50.8% were Gram-positive bacteria, and 49.2% were Gram-negative bacteria. The most prevalent pathogens were  E .  coli  (28.5%),  Streptococcus pneumoniae  (17.8%),  Staphylococcus epidermidis  (10.0%),  Haemophilus influenzae type b  (9.5%), and  group B streptococcus  (7.2%). In young infants aged ≤3 months,  E .  coli  was the organism most frequently isolated from CSF (39/76; 51.3%), followed by  group B streptococcus  (13/76; 17.1%) and  Streptococcus pneumoniae  (8/76; 10.5%). However, in young infants aged >3 months, the most frequently isolated organism was  Streptococcus pneumoniae  (24/103; 23.3%), followed by  Staphylococcus epidermidis  (18/103; 17.5%) and  Haemophilus influenzae type b  (16/103; 15.5%). Antimicrobial susceptibility tests indicated that for  E .  coli  isolates, the susceptibility rates to aminoglycosides ranged from 56.8% to 100.0%, among them, amikacin was identified as the most effective against  E .  coli . As for cephalosporins, the susceptibility rates ranged from 29.4% to 78.4%, and cefoxitin was identified as the most effective cephalosporin. In addition, the susceptibility rates of piperacillin/tazobactam and imipenem against E. coli were 86.3% and 100%. Meanwhile, the susceptibility rates of  Streptococcus pneumoniae  isolates to penicillin G, erythromycin, chloramphenicol, ceftriaxone and tetracycline were 68.8%, 0.0%, 87.5%, 81.3% and 0.0%, respectively. Gentamycin, ofloxacin, linezolid and vancomycin were identified as the most effective antibiotics for  Streptococcus pneumoniae , each with susceptibility rates of 100%. It was notable that other emerging pathogens, such as  Listeria monocytogenes  and  group D streptococcus , cannot be underestimated in meningitis.

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Prevalence and antibiotic resistance profiles of cerebrospinal fluid pathogens in children with acute bacterial meningitis in Yunnan province, China, 2012-2015