Streptococcus pneumoniae infection

Epidemiology and Demographics
Until 2000, S. pneumoniae infections caused 60,000 cases of invasive disease each year and up to 40% of these were caused by pneumococci non-susceptible to at least one drug. These figures have decreased substantially following the introduction of the pneumococcal conjugate vaccine for children. In the year 2002, there were 37,000 cases of invasive pneumococcal disease. Of these, 34% were caused by pneumococci non-susceptible to at least one drug and 17% were due to a strain non-susceptible to 3 or more drugs. Prevalence of DRSP shows geographic variation.

CDC sponsors active, population-based surveillance in ten states. Laboratory-based reporting of DRSP has been mandated in several states. Several private-sector systems also track DRSP.

Transmission occurs from person-to-person.

Risk Factors
Persons who attend or work at child-care centers and persons who recently used antimicrobial agents are at increased risk for infection with DRSP.

Pathophysiology & Etiology
Streptococcus pneumoniae. Resistant to one or more commonly used antibiotics. Seven sero-types (6A, 6B, 9V, 14, 19A, 19F, and 23F) account for most DRSP.

History and Symptoms
Pneumonia, bacteremia, otitis media (OM), meningitis, peritonitis and sinusitis

Risk Stratification and Prognosis
Death occurs in 14% of hospitalized adults with invasive disease. Neurologic sequelae occur in meningitis patients. Hearing impairment can result from recurrent otitis media. Resistance has led to treatment failures.

Acknowledgements
The content on this page was first contributed by: C. Michael Gibson, M.S., M.D.