Background: A pneumococcal carriage surveillance study took place examining Jordanian children in urban and rural areas in the period 2015–2019. Objectives: To determine urban and rural differences in pneumococcal carriage rate, resistance, and serotypes among healthy Jordanian children from Amman (urban) and eastern Madaba (rural). Methods: Nasopharyngeal swabs (NP) were taken from 682 children aged 1 to 163 months. Pneumococcal identification, serotyping, and resistance were performed according to standard method. Results: The number of cases tested for Amman was 267 and there were 415 cases tested for eastern Madaba. Carriage rate for eastern Madaba was 39.5% and 31.1% for Amman. Predominant serotypes for eastern Madaba and Amman were 19F (21.3%; 15.7%), 23F (12.2%; 9.6%), 14 (6.7%; 2.4%), 19A (4.9%; 2.4%), and 6A (5.5%; 3.6%). Resistance rates for eastern Madaba and Amman were as follows: penicillin (95.8%; 81.9%), clarithromycin (68.9%; 59.0%), clindamycin (40.8%; 31.3%), and trimethoprim-sulfamethoxazole (73.2%; 61.4%). Coverage of PCV7, PCV13, and the future PCV20 for Amman was 42.2%, 48.2%, and 60.2%; for eastern Madaba, coverage was 50.0%, 62.2%, and 73.2%, respectively. In Amman 25.8% of children received 1–3 PCV7 injections compared to 1.9% of children in eastern Madaba. Conclusions: There were significant differences in carriage, resistance, and coverage between both regions. The potential inclusion of a PCV vaccination program for rural areas is essential.

Background: Pneumococcal carriage surveillance study took place in urban and rural areas for Jordanian children in the period 2015-2019. Objectives: Determine urban and rural differences in pneumococcal carriage rate, resistance, and serotypes from healthy Jordanian children of Amman (urban) and eastern Madaba (rural). Methods: Nasopharyngeal swabs (NP) were taken from 682 children aged 1 to 163 months. Pneumococcal identification, serotyping and resistance were done according to standard method. Results: Number of cases tested for Amman 267 and for eastern Madaba 415. Carriage rate for eastern Madaba was 39.5% and for Amman 31.1%. Predominant serotypes for eastern Madaba and Amman were 19F (21.3%; 15.7%), 23F (12.2%; 9.6%), 14 (6.7%; 2.4%), 19A (4.9%; 2.4%), 6A (5.5%; 3.6%). Resistance rates for eastern Madaba and Amman were: penicillin (95.8%; 81.9%), clarithromycin (68.9%; 59.0%), clindamycin (40.8%; 31.3%), and trimethoprim-sulfamethoxazole (73.2%; 61.4%). Coverage of PCV7, PCV13, and the future PCV20 for Amman were 42.2%, 48.2%, and 60.2%; and for eastern Madaba were 50.0%, 62.2%, and 73.2%, respectively. In Amman 25.8% have received 1-3 PCV7 injections compared to 1.9% in eastern Madaba. Conclusions: There was significant differences in carriage, resistance and coverage in both regions. The potential inclusion of PCV vaccination program for rural areas is essential.