Streptococcus pneumoniae is an important global pathogen that causes a wide range of clinical disease in children and adults. Pneumococcal pneumonia is by far the common presentation of noninvasive and invasive pneumococcal disease and affects the young, the elderly, and the immunocompromised disproportionately. Patients with chronic pulmonary diseases are also at higher risk for pneumococcal infections. Substantial progress over the century has been made in the understanding of pneumococcal immunobiology and the prevention of invasive pneumococcal disease through vaccination.

 Currently, two pneumococcal vaccines are available for individuals at risk of pneumococcal disease: the 23-valent pneumococcal polysaccharide vaccine (PPV23) and the 13-valent pneumococcal protein-conjugate vaccine (PCV13). The goal of pneumococcal vaccination is to stimulate effective antipneumococcal antibody and mucosal immunity response and immunological memory. Vaccination of infants and young children with pneumococcal conjugate vaccine has led to significant decrease in nasal carriage rates and pneumococcal disease in all age groups.

 Recent pneumococcal vaccine indication and schedule recommendations on the basis of age and risk factors are outlined in this Focused Review. As new pneumococcal vaccine recommendations are being followed, continued efforts are needed to address the vaccine efficacy in the waning immunity of the ever-aging population, the implementation of vaccines using two different vaccines under very specific schedules and their real world clinical and cost effectiveness, and the development of next generation pneumococcal vaccines.

Streptococcus pneumoniae is an endemic global pathogen that causes a wide range of clinical disease in children and adults. Noninvasive pneumococcal disease encompasses otitis, sinusitis, and community-acquired pneumonia. As the name implies, pneumococcal pneumonia is a common presentation of noninvasive pneumococcal disease, resulting in 900,000 cases and 400,000 hospitalizations annually in the United States; mortality ranges from 5 to 7% .

Invasive pneumococcal disease implies invasion of pneumococcus into a normally sterile site, leading to complications such as bacteremia, empyema, meningitis, endocarditis, and osteomyelitis. The Centers for Disease Control and Prevention estimates an annual invasive pneumococcal disease incidence of 10.6/100,000 U.S. population, primarily occurring in adults. The majority of these cases start with streptococcal pneumonia as a primary focus. Pneumococcus is the most common cause of community-acquired pneumonia in adults, composing at least 25% of documented cases, with bacteremia present 20% of the time.

Conclusion

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