Few microorganisms can be credited with bringing so many contributions to the biomedical world and concomitantly inflicting so much pain as the pneumococcus. Streptococcus pneumoniae, one of the earliest pathogens characterized, contributed to the development of the Gram stain and the Quellung reaction; played pivotal roles in establishing fundamental biomedical concepts such as the chemical basis of inheritance; and enhanced understanding of the ability of proteins to function as virulence factors.1- 3 At the same time, its interaction with humankind has been compared with the Hundred Years' War.4 Pneumococcal pneumonia mortality rates were 25% to 35% and exceeded 80% in patients with bacteremia in the preantibiotic era,4 and S pneumoniae still remains the most common bacterial cause of community-acquired pneumonia worldwide.5 Between 20% and 30% of the strains isolated globally were recently reported to be multidrug-resistant,6 a finding that suggests major challenges for therapeutic management and public health.
Stein RA, Cosmineanu C. Pneumococcal Vaccines: The Impact of Conjugate Vaccine. JAMA. 2009;301(6):672-677. doi:10.1001/jama.2009.62