Streptococcus Pneumoniae is a bacterium that lives in the upper respiratory of the human body. This bacterium can cause many types of infections, which are secondary to the former infections such as otitis media, paranasal sinusitis, meningitis, etc. This bacteria is non-spore forming, non-motile, gram-positive of the firmicute phylum. It is also commonly known as pneumococcus. The streptococcus pneumonia shape is slightly pointed. The range of this bacteria can be many types ranges from 0.5mm to 1.25mm. Mostly they are found in short chains and always paired because they use fermentation to produce energy (glucose into lactic acid).
Other than these many other diseases can be caused by Streptococcus Pneumoniae-like brain abscesses, cellulitis, osteomyelitis, peritonitis, endocarditis, septic arthritis. Commonly this bacteria causes the severe disease to elderly people and children. It is also known as pneumococcus in medical microbiology. Many bacteria can cause lung disease pneumonia including streptococcus, chlamydia, Haemophilus, mycoplasma, staphylococcus, pseudomonas, some types of protozoans and fungus and various virus.
There are two forms of pneumonia can be seen in human body lobar pneumonia and bronchial pneumonia. Lobar pneumonia is most common in younger adults. Streptococcus causes 80% of lobar pneumonia of all the cases. A single lobe in the lungs is involved in lobar pneumonia, making the area a consolidated mass. Usually, it inhabits human beings and commonly inhabit areas with a temperature of 30-35 degrees Celcius which is called mesophilic.
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Types of infection by Streptococcus Pneumoniae
Many types of illness and infection can be caused by Streptococcus Pneumoniae. Some of the illnesses can be very important to treat fast as they are very life-threatening. Besides pneumonia, many other infections can be caused by it. Sinus infection, ear infection, meningitis (infection of the brain and spinal cord tissue), bloodstream infection called bacteremia can be caused by it.
Some of this infection can cause the germs to invade such places that are normally germ-free which is called invasive disease. An example of invasive disease is bacteremia, the bloodstream is invaded by pneumococcal bacteria that affect tissue and fluids of the brain and spinal cord causing meningitis. Further, this type of disease can be very dangerous, and requires immediate treatment with the help of doctors.
Risk Factors of Streptococcus Pneumoniae
The risk of getting pneumococcal disease is increased in some people than others. This disease tends to occur more in some patients at a certain age. Moreover, people having a medical condition have a great chance to develop this disease.
Children are the most common patient of pneumococcal disease. Children who are younger than 2 years, Children with leaks of cerebrospinal fluid and cochlear implants (leak of fluid that surround the brain and spinal cord), children with medical condition such as immune compromising condition, chronic kidney, heart, lung liver disease, sickle cell disease, HIV infection, diabetes are at increased risk of having pneumococcal disease.
Adults with age more than 65 are at great risk of developing pneumonia disease. Apart from that, it can increase the risk of adults with the age of 19 to 64 with some certain conditions such as:
- Immune system weakening conditions such as cancer, damaged spleen, HIV/ AIDS.
- People with CSF leaks (brain and spinal cord getting surrounded by escaped fluid).
- People with an addiction to smoking and drinking alcohol.
- Chronic illness or medical conditions such as asthma, lung disease, emphysema, chronic heart, liver, lung, kidney disease.
Apart from these, some other risk factors include influenza, normal spleen function absence.
Transmission of Streptococcus Pneumoniae
Streptococcus Pneumoniae transmission is very important for the survival of the organism. As the human body is the main host of this disease without this elimination of pneumococcus is likely to be eliminated. Healthy individuals who carry the organism in their nasopharynx, people with pneumococcal disease can transmission Streptococcus Pneumoniae through respiratory droplets. Risk factors of transmission are known very little but the known risk factors include a visit to the general practitioner about any disease of upper respiratory, number of siblings. Additionally, there are some places where the risk of transmission is high such as military camps, prisons, daycare centers.
Comparing with pulsed-field gel electrophoresis, Isolates recovered from a child attending daycare center and younger sibling not attending daycare center. It is found that a high level of genetic similarity with a younger sibling that was not attending and older sibling that was attending which proves that pneumococcal transmission is highly affecting the process.
In most cases, pneumococcus leads to asymptomatic colonization from the nasopharynx but sometimes newly acquired pneumococcus moves to the other part of the human body from the nasopharynx. Parts include lungs where it causes disease by evading the defense mechanism of the human hosts. Transmissions of asymptomatic from person to person are not visible because carriers are far exceeding symptomatic individuals. Asymptomatic colonization does not happen in any other respiratory disease such as measles, which is also transmitted by the same root and person to person as pneumococcus. From asymptomatic colonization to the risk of developing the pneumococcus disease is very high.
Types of pneumococcal serotypes
There are two types of pneumococcal serotypes such as 9A, 5,4 1 with high attack rates and 38, 20, 16F, 9N have low attack rates. Generally, attack rates are higher for short period carriers. Opaque to transparent colonies may vary even after having the same serotype in the pneumococcal variants, this is also known as phase variation.
In the progression of streptococcus from carriage to invasive disease, it is considered to be very important. Colonization of the nasopharynx develops the transparent form and from patients samples, the opaque form is developed. Transparent type phase variation can increase the pneumococcal invasion as much as six-fold into the human brain microvascular endothelial cells.
Symptoms of Streptococcus Pneumoniae
The most common form of pneumococcal disease is pneumococcal pneumonia. Many symptoms occur in the time of disease such as:
- Chest Pain
- Difficulty breathing
- Cough
- Fever and chills
- Confusion or low alertness
Pneumococcal meningitis the infection of the brain and spinal cord tissue got some symptoms such as:
- Stiff neck
- Headache
- Photophobia
- Confusion
- Fever
Low alertness, vomiting, poor eating, and drinking can be seen in babies suffering from meningitis. These are the common Streptococcus Pneumoniae symptoms.
Blood infection named pneumococcal bacteremia symptoms include
- Fever
- Chills
- Low alertness
The body’s life-threatening and overwhelming response from an infection can cause sepsis. Which can lead to organ failure, tissue damage, and even can cause death. The symptoms are:
- Extreme pain and discomfort
- Sweaty and clammy skin
- Confusion and disorientation
- High heart rate
- Fever, feeling very cold, shivering.
- Breath difficulty
Otitis media, another disease that can happen from pneumococcus bacteria. It can cause infection up to half of the middle ear. Symptoms include:
- Sleepiness
- A red, swollen eardrum
- Ear pain
- Fever
Complications of Streptococcus Pneumoniae
Most of the infections that are caused by Streptococcus Pneumoniae are mild but some of the infections can be deadly such as hearing loss and brain damage.
Bacteremia
Blood gets infected by this type which is an invasive pneumococcal disease. Thus, for this bloodstream infection 1 out of 100 children under 5 years old die. The chance of death is even high among elderly patients.
Pneumonia
This infection can cause mild to deadly illnesses to people of all ages. This is a lungs infection which can cause some complications such as:
- Airway blockage allows the air into the lungs, collection of the abscess into the lungs, collapse within the lungs.
- Sac around the heart getting inflammation.
- Space between membranes gets infected which surrounds the lungs and chest cavity.
Meningitis
Streptococcus Pneumoniae meningitis is a very common infection that can be caused by infection of the tissue of the brain and spine. It is the most deadly type of infection, it kills 1 out of 15 children younger than 5 years old. Other problems such as hearing loss or development delay can cause by it. The risk of developing meningitis is greatly high among elders or older people.
Pneumonia is a non-invasive pneumococcal pneumonia disease that can cause the death rate of 5 out of 100. The rate may get higher among elderly patients. If there is no bacteremia or empyema in pneumococcal pneumonia it is considered to be non-invasive. However, the mild and most common forms of pneumococcal disease are Sinus and ear infections. Children with repeated ear infections may need ear tubes.
Diagnosis of Streptococcus Pneumoniae
Some non-invasive disease caused by Streptococcus Pneumoniae is not a problem if diagnosed slowly. But Streptococcus Pneumoniae diagnosis might be needed immediately if the disease is invasive as it can be deadly. It is very important to know if the disease is caused by Streptococcus Pneumoniae as the treatment can change accordingly. Antibiotics can help prevent, any illness caused by it.
What doctors suggest
The doctor will ask some questions about symptoms and medical history to determine if the disease is related or caused by Streptococcus Pneumoniae. The doctor can order some laboratory tests if he suspects the disease is invasive. It will help the doctor to confirm if the cause of the illness is pneumococcus by identifying the bacteria in the blood sample. Also to determine which type of bacteria is causing the infection, growing it in the laboratory is very important. It will also help to choose the antibiotic that will help best.
Method
The method for non-invasive Streptococcus Pneumoniae in adults can also include a urine test. That can help the diagnosis along with identifying the source of infection. Physical exam findings and medical history of the patient helps to diagnose other types of disease caused by streptococcus infections such as sinus and ear infections. Some of the times doctors take a sample of the cerebrospinal fluid by using a lumbar puncture.
Collecting blood can easily identify if the infection is done by bacteria as the blood turn green from red from the hemolytic properties of bacteria. It is more efficient to use modern techniques as the growth of bacterial culture can take time.
Detection of the parts of the bacterium of streptococcus is the first technique known as antigens in urine. Several bodily fluids can be detected by C polysaccharide, which is the main component of the bacterial cell wall. The presence of specific antigens can be tested by immunochromatography and diagnosis can be done knowing the bacterial culture.
An assay based on the detection of Streptococcus Pneumoniae specific DNA sequences is the second technique. This test minimizes the risk of error by using DNA high specifically. Moreover, these can be performed very quickly.
Treatments of Streptococcus Pneumoniae
Streptococcus Pneumoniae treatments are very important and ignoring it can cause serious health problems even death. Very effective against pneumococcus and the first choice of treatments of bacterial infections is Antibiotics. With the strain of infected patients, the treatment of the infection can vary. Some strains of Streptococcus Pneumoniae disease have resistance against some specific antibiotics and for that reason treating with those antibiotics will not affect patients. During diagnosis, the doctor will make a judgment about the course of treatment based on the findings of susceptibility to antibiotics.
Vaccination
Vaccination is a preferable way to treat diseases because vaccination is considered better than a cure. For Streptococcus Pneumoniae mainly two vaccines are used and the mechanism of both are the same which is provoking the immune response by delivering antigens. The introduction of the vaccines helped in another way rather than combating the Streptococcus Pneumoniae spread, which is locating missing antigens that the body supposed to sensitize.
Antibiotic treatment
For invasive infections of Streptococcus Pneumoniae requires antibiotic treatment. Further, this includes broad-spectrum antibiotics. The results of antibiotic sensitivity can change the antibiotic treatment. Moreover, broad-spectrum bacteria work against a very wide range of bacteria and many infections.
There are many vaccines to combat against any infection of Streptococcus Pneumoniae but the most common two vaccines that are used in meningitis, sepsis. Conjugate vaccines and polysaccharide vaccines, they are given under the skin or in muscle by injection.
Conclusion
Infections from the Streptococcus Pneumoniae can be both mild and deadly. Some of the conditions need immediate medical emergencies.
