Abstract:Objective To investigate the change in distribution and antimicrobial resistance of bacteria isolated from cerebrospinal fluid (CSF) specimens in China. Methods According to China Antimicrobial Resistance Surveillance System(CARSS) technical program, data of bacteria isolated from CSF specimens and antimicrobial susceptibility testing results reported by CARSS member hospitals in 2014-2019 were analyzed with WHONET 5.6 software. Results From 2014 to 2019, a total of 99 741 strains of bacteria were isolated from CSF, the top 5 were coagulase negative Staphylococcus (49 902 strains, 50.0%), Acinetobacter baumannii (7 692 strains, 7.7%), Escherichia coli (5 561 strains, 5.6%), Klebsiella pneumoniae (4 653 strains, 4.7%), and Staphylococcus aureus (4 295 strains, 4.3%). Isolation rate of methicillin-resistant Staphylococcus aureus (MRSA) decreased from 48.2% in 2014 to 39.9% in 2019; isolation rates of penicillin-resistant Streptococcus pneumoniae (PRSP) maintained above 70%; resistance rates of Enterococcus faecium to most tested antimicrobial agents were higher than Enterococcus faecalis; resistance rates of most Escherichia coli strains to ceftriaxone were >60%, to carbapenems were low, but with an upward trend: resistance rates to meropenem and imipenem increased from 2.6% to 4.6% and from 1.7% to 4.5% respectively; resistance rate of Klebsiella pneumoniae to ceftriaxone was>50%, and to carbapenems increased rapidly: resistance rates to meropenem and imipenem increased from 13.1% to 30.9% and from 12.6% to 30.4% respectively. Resistance rates of Acinetobacter baumannii and Pseudomonas aeruginosa to meropenem had decreased tendency, from 74.2% to 71.7% and 32.6% to 27.8% respectively. Conclusion Antimicrobial resistance of clinical isolates of CSF is still high, surveillance on antimicrobial resistance is very important for the effective treatment of central nervous system infection.