Streptococcus pneumoniae: Resistance update and treatment options

Streptococcus pneumoniae is a major worldwide bacterial pathogen responsible for a variety of infections including pneumonia, bacteremia, otitis media, meningitis, sinusitis, and other infections. It is the most common pathogen causing bacterial community-acquired pneumonia (CAP) (1). Pneumococcal pneumonia has always been responsible for significant morbidity and mortality. In the pre-antibiotic era, it carried a 25% to 35% case fatality rate, which increased to 80% if bacteremia was present (2). Following the introduction of penicillin, mortality rates were reduced to below 10% (3). Sixty years later, mortality rates still remain around 12% for all hospitalized patients (1) and up to 25% for those with bacteremia (1,4). The continued significant mortality of pneumococcal disease despite the advances in antimicrobial therapy and intensive care management over the past half-century underscores the innate pathogenicity of this organism.