Streptococcus pneumoniae (the pneumococcus) is the leading vaccine-preventable cause of death in children and adults. The management of pneumococcal infections is complicated by the development of resistance to antimicrobials. Risk factors for increased resistance include young age, isolation from the upper respiratory tract, hospitalisation, residence in an urban area, day care attendance, previous exposure to antibiotics, female gender, exposure to specific serotypes and clones, HIV infection and exposure to a class of drug to which resistance can be easily selected from a susceptible population of organisms. Conjugate pneumococcal vaccine affords protection from resistant strains belonging to vaccine serotypes, but resistance is emerging in non-vaccine types.
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