{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T05:13:29Z","timestamp":1783660409118,"version":"3.55.0"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"\n Background<\/jats:title>\n The etiological profile and antimicrobial resistance (AMR) patterns of pediatric bacterial meningitis (PBM) are region-specific and dynamic. With limited data from Southwest China, this 7-year study aimed to characterize the pathogens and their AMR profiles to guide empirical therapy and infection control strategies.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We retrospectively analyzed children diagnosed with PBM who had positive cerebrospinal fluid (CSF) cultures at Kunming Children\u2019s hospital from September 2018 to September 2025. Clinical characteristics, laboratory findings, pathogen distribution, and antibiotic susceptibility were assessed. Risk factors for refractory meningitis and ICU admission were analyzed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 258 children (58.1% male; median age 17.0 months) were included. Gram-negative bacteria (GNB) accounted for 26.7% of cases. A significant portion (43.0%) had prior neurosurgery. Overall, 281 non-duplicate pathogens were isolated, with Gram-positive bacteria predominating (203\/281, 72.2%) and Gram-negative accounting for the remaining 78 (27.8%). Overall, the three most common pathogens were coagulase-negative Staphylococci (CoNS) (37.0%, 104\/281),\n Streptococcus pneumoniae<\/jats:italic>\n (\n S. pneumoniae<\/jats:italic>\n ) (16.7%, 47\/281), and\n Escherichia coli<\/jats:italic>\n (\n E. coli<\/jats:italic>\n ) (12.5%, 35\/281). Notably, pathogen distribution varied significantly with age:\n E. coli<\/jats:italic>\n was predominant in infants (&lt;12 months), while\n S. pneumoniae<\/jats:italic>\n was more common in preschool children. Antimicrobial resistance was highly prevalent: The methicillin-resistant rate in CoNS was alarmingly high at 88.2%. Among GNB, fluoroquinolone resistance was the most dominant phenotype, detected in 74.3% of\n E. coli<\/jats:italic>\n isolates. The detection rate of ESBL-producing\n E. coli<\/jats:italic>\n fluctuated widely (0%-83.3%) during the study period. Difficult-to-treat resistance was less common, observed in 5.7% (2\/35) of\n E. coli<\/jats:italic>\n isolates. Complications including hydrocephalus (26.4%) and subdural effusion (24.4%) were frequent.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n In this cohort with a high proportion of post-neurosurgical cases (43.0%), CoNS was the most common pathogen (37.0%), with a methicillin resistance rate of 88.2%. Continuous and dynamic monitoring of the epidemic trends of pathogens and the resistance rates of antibacterial drugs is of vital importance for the treatment of PBM.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1842744","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T04:23:54Z","timestamp":1783657434000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Bacterial spectrum and antimicrobial resistance of cerebrospinal fluid pathogens in pediatric bacterial meningitis: a 7-year study in Southwest China with emphasis on post-neurosurgical cases"],"prefix":"10.3389","volume":"16","author":[{"given":"Yanjun","family":"Wang","sequence":"first","affiliation":[{"name":"Pediatric Intensive Care Unit, Kunming Children\u2019s Hospital, Children\u2019s Hospital Affiliated to Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangling","family":"Dong","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit, Kunming Children\u2019s Hospital, Children\u2019s Hospital Affiliated to Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cuifen","family":"Li","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit, Kunming Children\u2019s Hospital, Children\u2019s Hospital Affiliated to Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiyan","family":"Lv","sequence":"additional","affiliation":[{"name":"Pediatrics Department of Yuanjiang County Hani, Yi and Dai Autonomous County People\u2019s Hospital","place":["Yuxi, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiong","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of emergency, Kunming Children\u2019s Hospital, Children\u2019s Hospital Affiliated to Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuo","family":"Kong","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit, Kunming Children\u2019s Hospital, Children\u2019s Hospital Affiliated to Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Honglin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of emergency, Kunming Children\u2019s Hospital, Children\u2019s Hospital Affiliated to Kunming Medical University","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina61061089","article-title":"A retrospective study on the prevalence and antimicrobial susceptibility of Gram-positive cocci in a pediatric department: a single-center report from Egypt","volume":"61","author":"AbdelHalim","year":"2025","journal-title":"Medicina"},{"key":"B2","doi-asserted-by":"publisher","first-page":"S140","DOI":"10.1093\/cid\/ciz478","article-title":"Declines in pediatric bacterial meningitis in the Republic of Benin following introduction of pneumococcal conjugate vaccine: epidemiological and etiological findings, 2011-2016","volume":"69","author":"Agossou","year":"2019","journal-title":"Clin. 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