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    Streptococcus pneumoniae

    John G. Bartlett, M.D.
    Streptococcus pneumoniae is a topic covered in the Johns Hopkins ABX Guide.

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    MICROBIOLOGY

    • Aerobic, Gram-positive diplococcus with 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 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 emergence of 19A strain and more recently serotypes 6C and 35. These serotypes are relatively non-susceptible to penicillin.

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    Last updated: December 7, 2015

    Citation

    Bartlett, John G. "Streptococcus Pneumoniae." Johns Hopkins ABX Guide, The Johns Hopkins University, 2015. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540523/all/Streptococcus_pneumoniae.
    Bartlett JG. Streptococcus pneumoniae. Johns Hopkins ABX Guide. The Johns Hopkins University; 2015. https://peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540523/all/Streptococcus_pneumoniae. Accessed March 24, 2019.
    Bartlett, J. G. (2015). Streptococcus pneumoniae. In Johns Hopkins ABX Guide. Available from https://peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540523/all/Streptococcus_pneumoniae
    Bartlett JG. Streptococcus Pneumoniae [Internet]. In: Johns Hopkins ABX Guide. The Johns Hopkins University; 2015. [cited 2019 March 24]. Available from: https://peds.unboundmedicine.com/pedscentral/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 - Bartlett,John,M.D. Y1 - 2015/12/07/ BT - Johns Hopkins ABX Guide UR - https://peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540523/all/Streptococcus_pneumoniae PB - The Johns Hopkins University DB - Pediatrics Central DP - Unbound Medicine ER -