Streptococcus pneumonia infection also known as pneumococcal disease is an infection caused by Streptococcus pneumonia bacteria. These bacteria can affect to the different parts of the body causing different signs and symptoms depending on the site of infection. Pneumonia i.e., infection of the lungs, ear infections, sinus infections, meningitis i.e., infection of the covering around the brain, spinal cord and bacteremia covering blood stream infection. Streptococcus pneumoniae is communicable and spread from the infected person through coughing, sneezing, and close contact. The symptoms include fever, cough, shortness of breath, chest pain, stiff neck, confusion and disorientation, sensitivity to light, joint pain, chills, ear pain, sleeplessness, and irritability. In extreme cases Streptococcus pneumoniae infection can cause brain damage, hearing loss and death. Streptococcus pneumoniae infection mainly tends to occur in the elderly or in people with serious underlying medical conditions. Groups such as children under 2 years of age, children in childcare and Torres Strait Islander people. Streptococcus pneumoniae infection is usually diagnosed by microscopic examination and growth of bacteria from blood, sputum or other specimens. PCR (polymerase chain reaction) testing in a pathology laboratory is also used.
In 2005, we estimated pneumococcal disease caused 136,000 deaths (46,000-253,000) comprising 10% of deaths in Indian children aged 1-59 months. The death rate for pneumococci was 106 per 100,000 (36-197), and more than two thirds of pneumococcal deaths were pneumonia-relate. Across regions, pneumococcal mortality ranged from 51-141 deaths per 100,000 1-59 months children and was highest in the Central and Eastern regions >50% of pneumococcal deaths occurred in four states with reported low rates of antibiotic use3: Bihar, Madhya Pradesh, Rajasthan, and Uttar Pradesh. The national rates of pneumococcal pneumonia, meninges, and NPNM were: 89.2 (30.7 – 164.6), 9.9 (3.9 – 18.3), and 5.4 (0.9 – 12.4), respectively. Across states, the distribution of pneumococcal pneumonia is similar to the distribution for all-syndrome pneumococcal mortality. Most pneumococcal meninges deaths occurred in Uttar Pradesh, Maharashtra, West Bengal and Bihar and together comprise 50% of the 12,800 deaths estimated for India. According to Figure 3, the places where PCV could have the greatest impact are the states with the lowest immunization coverage. Assuming PCV use at current rates of DPT3 coverage levels, PCV use in high-medium pneumococcal mortality states with >50% immunizaKon coverage including Chhattisgarh, Orissa, Karnataka, Haryana, West Bengal and Gujarat could have a sizeable impact on the naKonal burden of pneumococcal disease. If PCV is introduced similar to Hib vaccine, then the two lowest pneumococcal mortality states, Kerala and Tamil Nadu would be the first to receive vaccine. Symptoms widely vary in patients with pneumococcal pneumonia, mild illness to febrile pneumonia to respiratory distress requiring ICU-level care.
Factors such as age, type of symptoms, and duration of symptoms, underlying or chronic illness, and compliance with treatment, appropriate home care and potential for worsening disease are considered in determining the need and level of hospitalization. Most hospitalized should be treated with parenteral antibiotics in addition to medications for pulmonary symptoms, pain medications, intravenous fluids or parenteral or enteral nutrition, oxygen, and additional medications, as indicated on an individual basis. The use of steroids in adult patients with bacterial meningitis is recommended with caution, as they may decrease CSF antibiotic concentration; patients with meningitis treated with steroids should be monitored closely. Steroids can be considered prior to antibiotic therapy in children aged 6 weeks and older with pneumococcal meningitis. They should be given before or at the time of first dose of antibiotics. Intravenous fluids, parenteral or enteral nutrition, and other medications should be used as indicated clinical instances. A patient with pneumococcal bacteremia is treated with appropriate antibiotics. Children who undergo workup to rule out serious bacterial illness but who are not treated initially with antibiotics and whose cultures subsequently grow S pneumoniae are often asymptomatic and have negative repeat blood culture findings at follow-up. Repeat blood cultures should always be obtained in patients with S pneumoniae bacteremia. Patients with cardiac, skin or soft-tissue, bone, and joint infections with S pneumoniae should usually be admitted to the hospital for observation, intravenous antibiotic therapy, expedition of further workup and evaluation of location.