Streptococcus pneumoniae - Revision history

Aidan: /* Management */

2026-01-28T19:44:26Z

Management

← Older revision		Revision as of 19:44, 28 January 2026
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	==Management==		==Management==

			* Often treated with [[Is treated by::Penicillin\|penicillin]] alone, though resistance exists
			* [[Is treated by::Ceftriaxone\|Ceftriaxone]] is quite reliable, as is [[Is treated by::cefazolin]]
			* [[Is treated by::Vancomycin]] is used for isolates resistant to beta-lactams

	{\| class="wikitable"		{\| class="wikitable"
	! rowspan="2" \|Scenario		! rowspan="2" \|Scenario

Aidan at 20:28, 25 February 2025

2025-02-25T20:28:25Z

← Older revision		Revision as of 20:28, 25 February 2025
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	*Essentially two forms of vaccine available in Canada		*Essentially two forms of vaccine available in Canada
	**Pneu-C-13: 13-valent pneumococcal conjugate vaccine (Prevnar-13)		*Pneu-C-20: 20-valent pneumococcal conjugate vaccine (Prevnar-20)
	***More immunogenic, but fewer serotypes		**More immunogenic but slightly fewer serotypes than polysaccharide
	***Routine childhood immunization, also used for immunocompromised adults		**Routine childhood immunization, also used for immunocompromised adults
		⚫	**Given at least 1 year after Pneu-P-23 (if given)
	***Includes serotypes: 4, 9V, 6B, 14, 18C, 19F, 23F, 1, 5, 7F, 3, 6A, and 19A
		⚫	*Pneu-P-23: 23-valent pneumococcal polysaccharide vaccine (Pneumovax)
⚫	***Given at least 1 year after Pneu-P-23
		⚫	**Less immunogenic than conjugate vaccine
⚫	**Pneu-P-23: 23-valent pneumococcal polysaccharide vaccine (Pneumovax)
			**Used in combination with Pneu-C-15 only when Pneu-C-20 is unavailable
⚫	***Less immunogenic, ~~but~~ ~~more~~ ~~serotypes~~
	***Routine immunization in elderly
	***Includes above serotypes (except 6A), plus 2, 8, 9N, 10A, 11A, 12F, 15B, 17F, 20, 22F, and 33F
	***Given at least 8 weeks after Pneu-C-13 and at least 5 years after most recent Pneu-P-23 (except HSCT patients)
	***Booster given at 5 years if they are at risk of poor antibody response

	{\| class="wikitable"		{\| class="wikitable"
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	\|<18		\|<18
	\|routine		\|routine
	\|2 to 4 doses PC-13, depending on age		\|2 to 4 doses PC-20, depending on age
	\|-		\|-
	\| rowspan="3" \|18-64		\| rowspan="3" \|18-64
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	\|-		\|-
	\|[[Tobacco use disorder\|smoking]], [[Alcohol use disorder\|alcohol]], injection drug use, homeless, long-term care facility		\|[[Tobacco use disorder\|smoking]], [[Alcohol use disorder\|alcohol]], injection drug use, homeless, long-term care facility
	\|1 dose PP-23		\|1 dose PC-20
	\|-		\|-
	\|high risk for invasive disease		\|high risk for invasive disease
	\|1 dose PP-~~23 ± booster at 5 years~~		\|1 dose PC-20
	\|-		\|-
	\| rowspan="2" \|≥18		\| rowspan="2" \|≥18
	\|immunocompromised		\|immunocompromised
			\|1 dose PC-20
	\|1 dose PC-13, followed in 8 weeks by 1 dose PP-23 with booster at 5 years
	\|-		\|-
	\|HSCT recipient		\|HSCT recipient
	\|3 doses PC-13 q4wk starting 3-9 months post-transplant~~, followed 6-12 months later by 1 dose PP-23 ± booster at 1 year~~		\|3 doses PC-20 q4wk starting 3-9 months post-transplant
	\|-		\|-
	\|≥65		\|≥65
	\|healthy, regardless of prior vaccination		\|healthy, regardless of prior vaccination
	\|1 dose PP-23		\|1 dose PC-20
	\|}		\|}

Aidan: /* Management */

2023-09-17T15:15:40Z

Management

← Older revision		Revision as of 15:15, 17 September 2023
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	\|≥4		\|≥4
	\|-		\|-
	\|Meningitic		\|Meningitic parenteral
	\|≤0.06		\|≤0.06
	\|		\|

Aidan: /* Meningitis */

2022-07-19T14:25:27Z

Meningitis

← Older revision		Revision as of 14:25, 19 July 2022
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	===Meningitis===		===Meningitis===

	*Most common cause of meningitis in adults		*Most common cause of [[bacterial meningitis]] in adults
	*Acquired by hematogenous spread from nasopharynx, or direct invasion from sinuses		*Acquired by hematogenous spread from nasopharynx, or direct invasion from sinuses
	*May be secondary to otitis media or sinusitis		*May be secondary to otitis media or sinusitis

Aidan: /* Prevention */

2021-11-09T14:37:02Z

Prevention

← Older revision		Revision as of 14:37, 9 November 2021
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	*'''Conditions with high risk''' for invasive disease include (highest risk are bolded): [[CSF leak]], chronic neurologic conditions that impair clearance of oral secretions, cochlear implants, chronic heart disease, [[diabetes mellitus]], '''[[chronic kidney disease]]''', '''[[chronic liver disease]]''' including [[cirrhosis]], and chronic lung disease including [[asthma]] requiring medical care within past 12 months		*'''Conditions with high risk''' for invasive disease include (highest risk are bolded): [[CSF leak]], chronic neurologic conditions that impair clearance of oral secretions, cochlear implants, chronic heart disease, [[diabetes mellitus]], '''[[chronic kidney disease]]''', '''[[chronic liver disease]]''' including [[cirrhosis]], and chronic lung disease including [[asthma]] requiring medical care within past 12 months
	*'''Immunocompromising conditions''': [[hyposplenia]] (including [[sickle cell disease]], [[asplenia]], or splenic dysfunction), [[primary immunodeficiency]], therapeutic immune suppression (including [[corticosteroids]], [[chemotherapy]], [[radiation therapy]], and transplantation), [[HIV]], [[HSCT]], [[malignancy]], [[nephrotic syndrome]], [[solid organ transplantation]]		*'''Immunocompromising conditions''': [[hyposplenia]] (including [[sickle cell disease]], [[asplenia]], or splenic dysfunction), [[primary immunodeficiency]], therapeutic immune suppression (including [[corticosteroids]], [[chemotherapy]], [[radiation therapy]], and transplantation), [[HIV]], [[HSCT]], [[malignancy]], [[nephrotic syndrome]], [[solid organ transplantation]]

			=== Post-Exposure Management ===

			* Per Public Health Ontario, no specific management is required for close contacts
	{{DISPLAYTITLE:''Streptococcus pneumoniae''}}		{{DISPLAYTITLE:''Streptococcus pneumoniae''}}
	[[Category:Gram-positive cocci]]		[[Category:Gram-positive cocci]]

Aidan: Text replacement - "[[Cellular shape::" to "[[Shape::"

2020-10-14T12:21:50Z

Text replacement - "[[Cellular shape::" to "[[Shape::"

← Older revision		Revision as of 12:21, 14 October 2020
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	===Microbiology===		===Microbiology===

	*[[Stain::Gram-positive]], lancet-shaped [[~~Cellular shape~~::coccus\|diplococcus]]		*[[Stain::Gram-positive]], lancet-shaped [[Shape::coccus\|diplococcus]]
	*90+ serotypes, based on capsular polysaccharide that is bound to peptidoglycan		*90+ serotypes, based on capsular polysaccharide that is bound to peptidoglycan
	*Lab identification is based on catalase [[Catalase::negative]], [[Hemolysis pattern::α]] hemolysis of blood agar (from pneumolysin), [[Susceptible to::optochin]] susceptibility, and bile salt solubility		*Lab identification is based on catalase [[Catalase::negative]], [[Hemolysis pattern::α]] hemolysis of blood agar (from pneumolysin), [[Susceptible to::optochin]] susceptibility, and bile salt solubility

Aidan at 15:27, 13 September 2020

2020-09-13T15:27:21Z

← Older revision		Revision as of 15:27, 13 September 2020
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	*[[Stain::Gram-positive]], lancet-shaped [[Cellular shape::coccus\|diplococcus]]		*[[Stain::Gram-positive]], lancet-shaped [[Cellular shape::coccus\|diplococcus]]
	*90+ serotypes, based on capsular polysaccharide that is bound to peptidoglycan		*90+ serotypes, based on capsular polysaccharide that is bound to peptidoglycan
	*Lab identification is based on catalase-negative]], [[Hemolysis pattern::α ~~[[Catalase::hemolysis~~]] of blood agar (from pneumolysin), [[Susceptible to::optochin]] susceptibility, and bile salt solubility		*Lab identification is based on catalase [[Catalase::negative]], [[Hemolysis pattern::α]] hemolysis of blood agar (from pneumolysin), [[Susceptible to::optochin]] susceptibility, and bile salt solubility
	*Via transformation, bacteria can exchange genetic material with each other		*Via transformation, bacteria can exchange genetic material with each other

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	*Diagnostic yield in CSF decrease significantly 4 hours after administration of antibiotics		*Diagnostic yield in CSF decrease significantly 4 hours after administration of antibiotics

	== Management ==		==Management==
	{\| class="wikitable"		{\| class="wikitable"
	! rowspan="2" \|Scenario		! rowspan="2" \|Scenario

Aidan at 15:26, 13 September 2020

2020-09-13T15:26:47Z

@@ Line 7: / Line 7: @@
 *Via transformation, bacteria can exchange genetic material with each other
-====Susceptibility testing====
+===Antibiotic Resistance===
 *'''[[Penicillin]]''' resistance
@@ Line 39: / Line 33: @@
 ==Clinical Manifestations==
-===Asymptomatic carriage===
+===Asymptomatic Carriage===
 *4-10% in the general adult population, usually lasting several weeks
 *Highest in children, up to 30-60% depending on the situation, lasting up to 6 months
-===Otitis media===
+===Otitis Media===
 ===Sinusitis===
@@ Line 61: / Line 55: @@
 *CSF leaks and other defects predispose to infection
 *Diagnostic yield in CSF decrease significantly 4 hours after administration of antibiotics
 ==Prevention==

Aidan: /* Vaccination */

2020-08-23T21:11:05Z

Vaccination

← Older revision		Revision as of 21:11, 23 August 2020
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	***Includes serotypes: 4, 9V, 6B, 14, 18C, 19F, 23F, 1, 5, 7F, 3, 6A, and 19A		***Includes serotypes: 4, 9V, 6B, 14, 18C, 19F, 23F, 1, 5, 7F, 3, 6A, and 19A
	***Given at least 1 year after Pneu-P-23		***Given at least 1 year after Pneu-P-23
	**Pneu-C-23: 23-valent pneumococcal polysaccharide vaccine (Pneumovax)		**Pneu-P-23: 23-valent pneumococcal polysaccharide vaccine (Pneumovax)
	***Less immunogenic, but more serotypes		***Less immunogenic, but more serotypes
	***Routine immunization in elderly		***Routine immunization in elderly

Aidan: /* Vaccination */

2020-08-23T21:06:17Z

Vaccination

← Older revision		Revision as of 21:06, 23 August 2020
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	\|}		\|}

		⚫	*'''Conditions with high risk''' for invasive disease include (highest risk are bolded): [[CSF leak]], chronic neurologic conditions that impair clearance of oral secretions, cochlear implants, chronic heart disease, [[diabetes mellitus]], '''[[chronic kidney disease]]''', '''[[chronic liver disease]]''' including [[cirrhosis]], and chronic lung disease including [[asthma]] requiring medical care within past 12 months
	*Conditions with high risk for invasive disease include (highest risk are bolded):
		⚫	*'''Immunocompromising conditions''': [[hyposplenia]] (including [[sickle cell disease]], [[asplenia]], or splenic dysfunction), [[primary immunodeficiency]], therapeutic immune suppression (including [[corticosteroids]], [[chemotherapy]], [[radiation therapy]], and transplantation), [[HIV]], [[HSCT]], [[malignancy]], [[nephrotic syndrome]], [[solid organ transplantation]]
⚫	**[[CSF leak]], chronic neurologic conditions that impair clearance of oral secretions, cochlear implants, chronic heart disease, [[diabetes mellitus]], '''[[chronic kidney disease]]''', '''[[chronic liver disease]]''' including [[cirrhosis]], and chronic lung disease including [[asthma]] requiring medical care within past 12 months
⚫	**'''Immunocompromising conditions'''~~, including~~ [[hyposplenia]] (including [[sickle cell disease]], [[asplenia]], or splenic dysfunction), [[primary immunodeficiency]], therapeutic immune suppression (including [[corticosteroids]], [[chemotherapy]], [[radiation therapy]], and transplantation), [[HIV]], [[HSCT]], [[malignancy]], [[nephrotic syndrome]], [[solid organ transplantation]]
	{{DISPLAYTITLE:''Streptococcus pneumoniae''}}		{{DISPLAYTITLE:''Streptococcus pneumoniae''}}
	[[Category:Gram-positive cocci]]		[[Category:Gram-positive cocci]]