Streptococcus pneumonia

Most common bacterial cause of meningitis, otitis media, and community acquired pneumonia.

Causes most of the cases of bacterial pneumonia in infants and young children.

Most serious type of pneumococcal infection.

Invasive disease from this agent is a major cause of illness and death, with an estimated 43,500 cases and 5000 deaths in 2009 in the US.

A leading cause of death and complications in adults with HIV infection.

Risk of invasive infection with this agent 30-100 times in patients with HIV compared to control patients

Recurrent infections common with this organism in HIV patients with up to 25% having and additional episode in the subsequent 12 months.

Mortality of invasive infections with HIV is at least 8% (Grau I).

Mortality of Streptococcal meningitis in African populations with HIV is approximately 50% (Scarborough M).

Invasive pneumococcal disease is complicated by antimicrobial resistance.

Antibiotic resistance rising among pneumococcal isolates over the last 20 years.

When utilization of penicillin decreases the sensitivity of pneumococcal isolates increases suggesting that antibiotics only be used when treatment studies suggest benefit.

S pneumoniae conjugate vaccine has greatly reduced the frequency of invasive disease caused by this agent.

Higher rates of infection among infants, young children and elderly.

The risk of invasive pneumococcal disease is greatest among the individuals with congenital or acquired immunodeficiency, abnormal innate immune responses, HIV, functional or anatomic asplenia, American Indian children and Alaskan native children.

Increased use of alcohol and smoking increases the risk for invasive pneumococcal disease.

Urinary pneumococcal antigen test effective in identifying S. pneumoniae for 75% of patients having pneumococcal pneumonia (Sorde R et al).

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