Bacterial Pharyngitis, Antimicrobial Susceptibility, and Associated Factors among Children at comprehensive specialized hospitals, Northwest Ethiopia

Abstract Background: Bacterial pharyngitis is a common childhood infection involving inflammation of the pharynx and tonsils. Compared to viral causes, it often presents more severely and can result in complications if untreated. However, data on its bacterial etiology, resistance patterns, and associated risk factors are limited in developing countries, including Ethiopia. Objective: To assess the prevalence, bacterial causes, antimicrobial susceptibility patterns, and risk factors of pharyngitis among children at comprehensive specialized hospitals, Northwest Ethiopia. Methods: A hospital-based cross-sectional study was conducted from June 1 to August 30, 2024, among 254 children aged ≤14 years. Throat swabs were collected and cultured following standard microbiological techniques. Bacterial identification was performed through colony morphology, Gram staining, and biochemical tests. Antimicrobial susceptibility was tested using the Kirby-Bauer disk diffusion method. Data were analyzed using SPSS version 27, and logistic regression identified significant risk factors (p ≤ 0.05). Results: The prevalence of culture-confirmed bacterial pharyngitis was 28.3% (95% CI: 22.5–33.9%). A total of 80 bacterial isolates were identified, predominantly Streptococcus pyogenes (35%), Staphylococcus aureus (32.5%), and Streptococcus pneumoniae (28.8%). High resistance was observed: S. pyogenes to ceftriaxone (64.3%) and chloramphenicol (53.6%); S. pneumoniae to penicillin (82.6%); and S. aureus to penicillin (80.8%) and tetracycline (57.7%). Overall, 41.3% of isolates exhibited multidrug resistance. Significant factors associated with bacterial pharyngitis included prior history of pharyngitis (AOR = 8.86), tonsillectomy (AOR = 5.65), contact with coughing individuals (AOR = 3.42), and weight loss (AOR = 2.58). Conclusion: Bacterial pharyngitis is prevalent among children in the study area, with a high burden of multidrug-resistant organisms. Routine use of culture and antibiotic susceptibility testing is essential to guide effective treatment and reduce resistance.