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Thorax 1999;54:929-937 ( October )

Review series

Lung infections  5

Streptococcus pneumoniae

J R Catterall

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	Introduction

Streptococcus pneumoniae was identified as a major respiratory pathogen shortly after its isolation in 1881.¹ Despite a century of intensive study, and antibiotics which readily kill the organism, respiratory tract infections caused by the pneumococcus remain a formidable problem. S pneumoniae is the commonest cause of community acquired pneumonia, accounting for up to 70% of cases in hospital.^2 3 Pneumococcal pneumonia is associated with bacteraemia more frequently than other bacterial pneumonias⁴ and mortality from bacteraemic pneumococcal pneumonia during the first few days of hospitalisation has changed little since the pre-antibiotic era.^5 6 There is also evidence, from the UK and other countries, that the number of cases of pneumococcal bacteraemia is rising.^7 8 In the third world five million children under the age of five die each year from acute lower respiratory tract infections in which S pneumoniae is probably the primary agent,⁹ and patients with HIV infection and AIDS also have a . . . [Full text of this article]

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