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Streptococcus pneumoniae is a topic covered in the Johns Hopkins ABX Guide.

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MICROBIOLOGY

  • Aerobic, Gram-positive diplococcus with a capsule.
  • Grows on blood agar.
  • Capsular swelling w/ application of Quelling antisera.
  • Serotypes: immunity is serotype-specific.
    • Abx resistance is often serotype-specific.
    • Serotype 19A and 19F has emerged as predominant pathogen following increased immunization.
  • Minimum inhibitory concentration (MIC) to penicillin (mcg/mL) breakpoints for non-CNS specimens.
    • Susceptible: 2 mcg/mL
    • Intermediate: 4 mcg/mL
    • Resistant: 8 mcg/mL
    • Previously were determined solely on the basis of possible meningeal disease.
      • New breakpoints above are based on anticipated respiratory or non-CNS isolates.
      • Susceptible breakpoint for meningitis caused by S. pneumoniae remains unchanged
        • S= 0.06 mcg/mL
        • I = 0.12 - 1.0 mcg/mL
        • R ≥ 2 mcg/mL
      • This now means that >95% of strains are sensitive to penicillin, and penicillin is the preferred drug.
  • Penicillin resistance is increasing due to "replacement strains" associated with extensive use of Prevnar (PCV-7, now PCV-13) vaccine with the emergence of 19A strain and more recently serotypes 6C and 35. These serotypes are relatively nonsusceptible to penicillin.

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Last updated: July 10, 2019

Citation

Auwaerter, Paul G, and John G Bartlett. "Streptococcus Pneumoniae." Johns Hopkins ABX Guide, The Johns Hopkins University, 2019. Johns Hopkins Guide, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540523/all/Streptococcus_pneumoniae.
Auwaerter PG, Bartlett JG. Streptococcus pneumoniae. Johns Hopkins ABX Guide. The Johns Hopkins University; 2019. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540523/all/Streptococcus_pneumoniae. Accessed July 19, 2019.
Auwaerter, P. G., & Bartlett, J. G. (2019). Streptococcus pneumoniae. In Johns Hopkins ABX Guide. Available from https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540523/all/Streptococcus_pneumoniae
Auwaerter PG, Bartlett JG. Streptococcus Pneumoniae [Internet]. In: Johns Hopkins ABX Guide. The Johns Hopkins University; 2019. [cited 2019 July 19]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540523/all/Streptococcus_pneumoniae.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Streptococcus pneumoniae ID - 540523 A1 - Auwaerter,Paul,M.D. AU - Bartlett,John,M.D. Y1 - 2019/07/10/ BT - Johns Hopkins ABX Guide UR - https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540523/all/Streptococcus_pneumoniae PB - The Johns Hopkins University DB - Johns Hopkins Guide DP - Unbound Medicine ER -