Objective: To investigate the pathogens distribution and drug resistance of children with bacterial meningitis in Suzhou. Methods: Retrospective analysis was performed on cerebrospinal fluid culture results of children with bacterial meningitis hospitalized in Children’s Hospital of Soochow University from 2011 to 2019

pathogens distribution and drug resistance in children at different ages were summarized. Results: Among 535 children

162 strains were positive

with a positive rate of 30.3%. The main pathogens were Streptococcus pneumoniae (42 strains

25.9%)

Streptococcus agalactiae (39 strains

24.1%) and Escherichia coli (36 strains

22.2%). The positive rate of 1 to 3 years old group was 53.6%

higher than that of other age groups (P<0.05). The age of children in the Gram-negative bacilli group was statistically significantly different from that in the Gram-positive cocci group and the Gram-positive bacilli group (P<0.05)

indicating that children with younger age were more likely to be infected with Gram-negative bacilli. S. agalactiae and E. coli were the main bacterial pathogens in the neonatal group

the pathogens of infants aged from 29 d to 1 year were various

mainly S. pneumoniae

S. agalactiae and E. coli

while S. pneumoniae was the predominant pathogen in children aged more than 1 year. The positive rate of bacteria detection in children who used antibiotics before cerebrospinal fluid culture was lower than that in children who did not (P<0.05). S. pneumoniae and S. agalactiae were 100% sensitive to vancomycin and linezolid. The resistance rate of S. pneumoniae to penicillin was 85.7%. The resistance rates of E. coli to ampicillin

cefotaxime and ceftriaxone were 66.7%

53.8% and 38.7%

respectively. The sensitive rates of E. coli to carbapenems (meropenem

imipenem and ertapenem) and enzyme-added antibiotics (piperacillin/tazobactam and cefoperazone/sulbactam) were 100%. Conclusion: S. pneumoniae

S. agalactiae and E. coli are the common pathogens for bacterial meningitis in children in Suzhou. The distribution of bacteria varies in different age groups. Antibiotics should be reasonably chosen according to the results of bacterial culture and drug sensitivity tests.