Streptococcus pneumoniae
Streptococcus pneumoniae is a topic covered in the Johns Hopkins ABX Guide.
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MICROBIOLOGY
- Aerobic, Gram-positive diplococcus [Fig 1] with a capsule.
- Grows on blood agar.
- Capsular swelling w/ application of Quelling antisera [Fig 2].
- Serotypes: immunity is serotype-specific.
- Abx resistance is often serotype-specific.
- Serotypes 19A and 19F have 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.
-- To view the remaining sections of this topic, please log in or purchase a subscription --
MICROBIOLOGY
- Aerobic, Gram-positive diplococcus [Fig 1] with a capsule.
- Grows on blood agar.
- Capsular swelling w/ application of Quelling antisera [Fig 2].
- Serotypes: immunity is serotype-specific.
- Abx resistance is often serotype-specific.
- Serotypes 19A and 19F have 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: March 8, 2020
Citation
Auwaerter, Paul G. "Streptococcus Pneumoniae." Johns Hopkins ABX Guide, The Johns Hopkins University, 2020. Johns Hopkins Guide, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540523/all/Streptococcus_pneumoniae.
Auwaerter PG. Streptococcus pneumoniae. Johns Hopkins ABX Guide. The Johns Hopkins University; 2020. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540523/all/Streptococcus_pneumoniae. Accessed August 14, 2022.
Auwaerter, P. G. (2020). Streptococcus pneumoniae. In Johns Hopkins ABX Guide. The Johns Hopkins University. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540523/all/Streptococcus_pneumoniae
Auwaerter PG. Streptococcus Pneumoniae [Internet]. In: Johns Hopkins ABX Guide. The Johns Hopkins University; 2020. [cited 2022 August 14]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540523/all/Streptococcus_pneumoniae.
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T1 - Streptococcus pneumoniae
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Y1 - 2020/03/08/
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