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. Temporal trends of serotypes from invasive pneumococcal disease (IPD) in Spain from 1979 to September 2007 under antibiotic and vaccine pressure were analyzed.
A significant trend in pneumococcal conjugate 7-valent vaccine (PCV7) serotypes (except serotype 4) was found, whereby the prevalence increased from the early 1980s and decreased in the 2000s for all but serotype 23F, which began decreasing in the late 1980s. Among the major non-PCV7 serotypes, a significant decrease was observed for serotypes 1, 5, and 7F in the 1980s. From the late 1990s, serotypes 1, 5, 6A, 7F, and 19A increased significantly, while serotypes 3 and 8 showed similar but nonsignificant trends over time. The incidence of IPD cases was 10.7/100,000 for the period 1996 to 2006, with reporting coverage ranging from 18% to 43%. A significant decrease in IPD incidence due to PCV7 serotypes was observed, while the incidence of non-PCV7 serotypes increased, with the consequence that there was no clear pattern in the overall incidence of IPD. Penicillin nonsusceptibility was correlated with the proportion of PCV7 serotypes. Erythromycin nonsusceptibility increased in association with long-half-life macrolide consumption and then decreased in 2004 to 2007. The increase in PCV7 serotypes and antibiotic nonsusceptibility related to antibiotic consumption in the 1980s and 1990s was reversed in the 2000s, probably as a result of PCV7 immunization. The decrease in IPD incidence due to PCV7 serotypes was mirrored by an increase in that of non-PCV7 serotypes. The impact of various preventive/therapeutic strategies on pneumococcal evolution is serotype dependent, and the dynamics remain unpredictable. 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. Major research on Streptococcus pneumonia infection is been done in Spain by Wellcome Trust Sanger Institute.