Abstract: | Objective To understand the change of antimicrobial resistance of clinical isolates in neurosurgical wards, and to provide basis for clinical rational antimicrobial use. Methods The results of bacterial cultures and drug sensitivity tests in vitro were collected from neurosurgical inpatients in our hospital from 2015 to 2018. The sensitivity data were statistically analyzed using software WHONET 5.6. Results From 2015 to 2018, a total of 2,123 non-repeating clinical isolates were isolated, including 1,563 Gram-negative (73.6%) and 560 Gram-positive (26.4%) strains. The specimens were mainly sputum (62.6%), urine (12.8%), cerebrospinal fluid (8.9%), and blood(8.6%). The top five isolated bacteria were Acinetobacter baumannii (20.3%), Klebsiella pneumoniae (16.4%), Pseudomonas aeruginosa (14.5%), Escherichia coli (8.9%), and Staphylococcus aureus (7.7%), respectively. The resistance rates of Acinetobacter baumannii to imipenem and meropenem both exceeded 65%. The resistance rate of Pseudomonas aeruginosa to carbapenems kept around 30%. For Klebsiella pneumoniae, the resistance rate to carbapenems stayed less than 30% between 2015 and 2016, which significantly increased in 2017 (41.3% for imipenem and 41.9% for meropenem), followed by drastically decline in 2018 (3.4% for imipenem and 3.4% for meropenem). Escherichia coli still showed relative low resistance rate to carbapenems (<3%). The resistance rate of Staphylococcus aureus to oxacillin decreased from 57.9% to 15.8%. No Staphylococcus aureus resistant to linezolid or vancomycin was found. Coagulase-negative Staphylococcus (CNS) was the first bacteria isolated from blood and cerebrospinal fluid samples. The detection rate of MRCNS was over 80%. Two strains of linezolid-resistant Staphylococcus were isolated from cerebrospinal fluid. Conclusion Acinetobacter baumannii, Klebsiella pneumoniae, and Pseudomonas aeruginosa were the main clinical isolates in neurosurgical wards. In recent years, the isolation rate of Klebsiella pneumoniae has increased significantly, so does the resistance rate of non-fermentative bacteria and Enterobacteriaceae to carbapenems. The detection rate of methicillin-resistant Staphylococcus aureus has decreased year by year. The prevention and control measures of nosocomial infections, the antimicrobial resistance surveillance, and the rational use of antimicrobial drugs should be |