Abstract: Background：There are few cases of children's meningitis caused by Streptococcus gallolytica (SG) at home and abroad, and the overall clinical characteristics are still unclear. Objective：To systematically review the clinical features of SG meningitis. DesignSystematic review. MethodsPubMed, Embase, Web of Science, CNKI, Wanfang, and VIP databases were searched for literature related to SG meningitis from the inception to November 9, 2022. Cases of bacterial meningitis infected by SG in children were included. Publication types of review and conference papers were excluded. The literature unable to get the full text or writing in other languages except Chinese and English was also excluded. Two investigators independently reviewed the literature, extracted literature features, clinical characteristics of cases, laboratory indexes, and antibiotic susceptibility of SG, and assessed the quality of the included literature. Main outcome measures Survival rate and complications. ResultsA total of 21 subjects from 17 literature were included in this systematic review, including 16 males, 4 females, and 1 case without reported gender. There were 3 premature infants, 16 fullterm infants, and 2 cases without reported gestational age. The age of onset was (14.5±16.6)d. There were 14 cases with fever, 17 cases with neurologic abnormality, 9 cases with gastrointestinal signs, 9 cases with respiratory symptoms, and 3 cases with tachycardia. CRP level increased in all 11 reported cases. Nine cases showed peripheral WBC counts below 4×109·L-1 and 6 cases had peripheral WBC counts above 10×109·L-1. CSF leukocyte counts increased in all patients. Eighteen cases reported CSF glucose level with 14 cases below 2.2 mmol·L-1, and 17 cases reported CSF protein concentration with 15 cases above 1 700 mg·L-1. Twenty cases were positive in 21 cases of CSF culture, 16 cases were positive in 18 cases of blood culture, 1 case was positive in 5 cases of urine culture, and 1 case was positive fecal culture. SGSP was found in 17 cases, SGSG in 2 cases, and SG in 2 cases. Twelve cases were treated with monotherapy (strains of 11 cases were susceptible to penicillin/ampicillin, 1 case was not reported), 9 cases were treated with 2 antibacterial agents ( strains in 8 cases were susceptible to penicillin/ampicillin, strains in 1 case was resistant), and the course of antibacterial agents was at least 14 days. Complications were reported in 6 cases, including 2 cases with ventricular hemorrhage, 2 cases with ventriculitis, 1 case with hydrocephalus, ventricular dilation, neuromotor delay, poor spontaneous motor mobilization, and hypertonia of the limbs, and 1 case with bilateral reduction in visual evoked potentials, subdural effusion, and seizure. ConclusionSG meningitis mainly occurred in infants under 2 months. Penicillins or cefotaxime could be selected for treatment and had good clinical outcomes.

Key words: Streptococcus gallolyticus, Streptococcus pasteurianus, Pediatric, Neonate, Infant, Meningitis