What is Streptococcus pneumoniae (S. pneumoniae)?

From the Guidelines

Pneumoniae, specifically Streptococcus pneumoniae, is a gram-positive, facultative anaerobic bacterium that can cause pneumococcal infections, including pneumonia, which is a leading cause of illness and death worldwide, particularly among young children, persons with underlying chronic systemic conditions, and the elderly. According to the most recent study 1, pneumococcal infections can range from mild to severe and can be caused by various serotypes of Streptococcus pneumoniae. The infection can be classified into invasive pneumococcal disease (IPD) and noninvasive disease, with pneumococcal pneumonia being the most common type of pneumococcal disease in adults.

Some key points to consider when dealing with pneumoniae include:

• Pneumococcal infections can be prevented through vaccination, with current pneumococcal vaccines using pneumococcal capsular polysaccharides as antigens to generate serotype-specific antibodies 1
• Treatment of pneumococcal pneumonia typically includes antibiotics, such as amoxicillin or azithromycin, although resistance to these antibiotics is a growing concern 1
• The susceptibility of Streptococcus pneumoniae to penicillin is currently defined by the National Committee for Clinical Laboratory Standards (NCCLS), with susceptible isolates being inhibited by 0.06 mg/mL or less 1
• The use of pneumococcal conjugate vaccine (PCV) and pneumococcal polysaccharide vaccine (PPSV) can help prevent pneumococcal disease, with the Advisory Committee on Immunization Practices recommending vaccination for all persons aged 19 years and older 1

The most effective way to prevent pneumococcal disease is through vaccination, with the Advisory Committee on Immunization Practices recommending vaccination for all persons aged 19 years and older. This is supported by the most recent study 1, which highlights the importance of vaccination in preventing pneumococcal disease. Additionally, good hygiene practices and avoiding smoking can also help prevent pneumonia. Treatment of pneumococcal pneumonia should be guided by the results of susceptibility testing, with the use of antibiotics such as amoxicillin or azithromycin being effective against susceptible isolates 1.

From the Research

Definition of Pneumoniae

• Streptococcus pneumoniae is a type of bacteria that is the most common cause of pneumonia, as well as other infections such as sinusitis, otitis media, and meningitis 2.
• It is a significant public health concern due to its high prevalence and the increasing rate of antibiotic resistance, particularly to penicillin and other beta-lactam antibiotics 3, 4.

Risk Factors and Clinical Features

• The incidence of pneumococcal disease is highest in children under 2 years of age and adults over 65 years of age, as well as in individuals with chronic heart and lung disease, cigarette smokers, and those with asplenia 2.
• The clinical presentation of pneumococcal pneumonia can vary, and diagnosis is often made through blood culture, Gram's stains, and sputum culture, although a urinary antigen test may also be used in adults 2.

Treatment and Antibiotic Resistance

• Penicillin (penicillin G/amoxicillin) is the drug of choice for treating pneumococcal infections that are fully sensitive or have moderately decreased susceptibility to penicillin, while cefotaxime and ceftriaxone are alternative options for cases with higher levels of resistance 2, 3.
• The emergence of antibiotic-resistant strains of S. pneumoniae has led to the development of new treatment options, including fluoroquinolones, streptogramins, and oxazolidinones 4, 5.
• Ceftriaxone, a third-generation cephalosporin, has been shown to be effective against S. pneumoniae and is often used in the treatment of community-acquired and nosocomial infections 6.