DOI: 156-161

Pages: https://doi.org/10.36347/sjams.2026.v14i02.009

Background: Streptococcus pneumoniae remains a leading cause of morbidity and mortality worldwide, with antimicrobial resistance (AMR) posing a significant threat to effective treatment. This study aimed to analyze the demographic characteristics, temporal trends, and molecular resistance profiles of S. pneumoniae detected in cerebrospinal fluid in Niger from 2018 to 2025. Methods: A retrospective analysis was conducted on 712 S. pneumoniae-positive cerebrospinal fluid (CSF) samples collected across various regions. Resistance markers were detected by PCR, and patient sociodemographic data were extracted from the National Reference Laboratory database of Centre de Recherche Médicale et Sanitaire (CERMES). Results: The study population had a median age of 10 years, with a male predominance (63.1%). The 0-2 years age group was the most affected (18.0%). Geographically, the Zinder region accounted for the highest number of cases (31.7%). A notable increase in detected cases was observed from 2020 onwards, peaking in 2024. The overall prevalence of resistance genes was highest for PSDP (penicillin-susceptible, dose-dependent phenotype, 33.0%) and tetM (28.0%). A striking temporal trend was the dramatic increase in tetM prevalence, rising from 3.8% in 2019 to 43.9% in 2024. Conversely, PSDP prevalence peaked in 2020 (72.7%) before declining.Conclusion: Our findings reveal a shifting landscape of S. pneumoniae AMR in Niger, characterized by a concerning and rapid emergence of tetracycline resistance mediated by the tetM gene. The sustained burden of disease, particularly in young children and specific geographic hotspots like Zinder, underscores the urgent need for enhanced molecular surveillance, robust antimicrobial stewardship programs, and targeted public health interventions to mitigate the spread of resistant strains.