Objective: To probe into the clinical features and pathogenic bacteria characteristics of neonatal purulent meningitis. Methods: Clinical data of 437 neonates with purulent meningitis in Children’s Hospital of Chongqing Medical University from 2007 to 2018 were analyzed retrospectively. Results: There were 201 cases (46.0%) of fever

75 cases (17.2%) of convulsion

45 cases (10.3%) of increased intracranial pressure and 127 cases (29.1%) of abnormal muscle tone. The positive rate of cerebrospinal fluid culture was 6.9%

including 6 cases (6/11) of G- bacteria and 5 cases (5/11) of G+ bacteria. The positive rate of blood culture was 27.2%

including 70 cases (58.8%) of G- bacteria and 49 cases (41.2%) of G+ bacteria

Escherichia coli and Staphylococcus were the most common. The drug resistance rate of E. coli to ampicillin

cefotaxime and ceftriaxone was >70.0%

the drug resistance rate to piperacillin was 22.5%

and E. coli was sensitive to carbapenems. Staphylococcus was sensitive to vancomycin and linezolid

which showed higher rug resistance (from 57.1% to 100%) to other drugs. From 2007 to 2012

10 cases of G- bacteria and 9 cases of G+ bacteria were detected in blood culture. From 2013 to 2015

28 cases of G- bacteria and 21 cases of G+ bacteria were detected in blood culture. From 2016 to 2018

32 cases of G- bacteria and 19 cases of G+ bacteria were detected in blood culture. Conclusion: The clinical symptoms of purulent meningitis in neonates are atypical. Pathogenesis is common with E. coli and Staphylococcus

and the proportion of Gram-negative bacteria detected by blood culture is in an increasing tendency. E. coli is sensitive to carbapenem and piperacillin

while Staphylococcus is sensitive to vancomycin and linezolid

yet has a higher rate of resistance to other antibiotics.