Abstract
Streptococcus pneumoniae (the pneumococcus) remains one of the most common causes of bacterial community-acquired
pneumonia (CAP), encompassing infections mild enough to be treated on an outpatient
basis, as well as those requiring hospital care, or even intensive care unit admission.
This microorganism is associated with a significant burden of disease, causing substantial
morbidity and mortality worldwide, and generating considerable health-care costs.
The reason that pneumococcal CAP remains such a common cause of disease relates to
the presence of several risk factors for this infection in patients throughout the
world. Such risk factors include extremes of age, lifestyle factors, including smoking
and alcohol abuse, and various underlying comorbid conditions, including congenital
and acquired immunodeficiencies. This article will review various aspects of pneumococcal
CAP, including the burden of pneumococcal disease, risk factors for pneumococcal infection,
the occurrence of cardiovascular events in patients with pneumococcal CAP, the apparently
pivotal role of pneumolysin, a major virulence factor of the pneumococcus, in the
pathogenesis of severe infection and associated cardiac dysfunction, empiric antibiotic
treatment for pneumococcal CAP, as well as adjunctive therapies, specifically those
which target pneumolysin, and, finally, the mortality of such infections.
Keywords
antibiotics - adjuvant therapy - biomarkers - burden of disease - cardiac events -
community-acquired pneumonia - mortality - pneumococcus - pneumolysin -
Streptococcus pneumoniae
