ObjectiveTo investigate the isolation and drug resistance change trend of pathogens isolated from cerebrospinal fluid (CSF) of neurosurgical patients in Beijing Tian Tan Hospital. MethodsPathogens and antimicrobial susceptibility of pathogens from CSF specimens of neurosurgical patients from August 1997 to August 2013 were analyzed. ResultsA total of 2 732 isolates of pathogens were detected,grampositive  and gramnegative  bacteria accounted for 71.23%(n=1 946 ) and 28.77%(n=786 ) respectively. The top three isolated bacteria were Staphylococcus spp. (n=1 751,64.09%), Acinetobacter spp. (n=254, 9.30%), and Enterococcus spp. (n= 172, 6.30%). Grampositive bacteria were the major isolated pathogens, detection rate of methicillinresistant Staphylococcus aureus (MRSA) and methicillinresistant coagulasenegative Staphylococcus (MRCNS) was 74.34% and 80.73% respectively; gramnegative bacteria increased gradually in recent years. All Staphylococcus spp.  isolates were highly sensitive to vancomycin and linezolid（＞90%） . The overall antimicrobial susceptibility rate of gramnegative bacteria decreased, susceptibility rates of Acinetobacter spp. to imipenem and meropenem was 51% and  44% respectively. ConclusionThe major pathogens causing intracranial infection in neurosurgical patients are grampositive bacteria, the detection rates of MRSA and MRCNS are high; gramnegative bacteria, especially extensively drugresistant Acinetobacter spp. shows an increasing tendency in recent years.