Antimicrobial Resistance in Pneumococcal Carriage Isolates from Children in Southern Iran

Abstract

Background: Streptococcus pneumoniae is a major cause of severe infections in children, including pneumonia, meningitis, and bacteremia, leading to significant morbidity and mortality worldwide. Monitoring asymptomatic carriers is essential for the early detection of emerging resistance, preventing transmission, and guiding public health interventions, even in the absence of symptomatic disease. The emergence of antibiotic-resistant pneumococcal strains has complicated treatment, particularly in regions with a high disease burden. Objectives: This study aimed to determine the antibiotic resistance patterns of S. pneumoniae isolates from pediatric carriers in Bandar Abbas. Methods: This cross-sectional study was conducted among 390 children in Bandar Abbas. Nasopharyngeal swabs were collected and cultured for S. pneumoniae. Isolates were identified using standard microbiological techniques, and antimicrobial susceptibility testing was performed using the disk diffusion method. Results: Of the S. pneumoniae isolates recovered, 58.3% were classified as multidrug-resistant (MDR). Vaccinated children showed marginally lower MDR rates (52.6% vs. 60.2%, P = 0.22). Resistance rates were highest for clindamycin (58.3%), azithromycin (45.8%), and penicillin (41.7%). Significant risk factors for resistance included recent antibiotic use (P < 0.001), daycare or school attendance (P = 0.026), and exposure to household smoke (P = 0.048). Conclusions: The high prevalence of MDR S. pneumoniae in Bandar Abbas aligns with global concerns regarding rising resistance in pediatric populations. The findings highlight the urgent need for enhanced surveillance, improved antibiotic stewardship, and increased pneumococcal vaccination to curb resistance trends.