A number of significant challenges remain with regard to the diagnosis, treatment, and prevention of
infections with Streptococcus pneumoniae (pneumococcus), which remains the most common bacterial
cause of community-acquired pneumonia. Although this infection is documented to be extremely
common in younger children and in older adults, the burden of pneumonia it causes is considerably
underestimated, since the incidence statistics are derived largely from bacteremic infections, because
they are easy to document, and yet the greater burden of pneumococcal pneumonias is non-invasive.
It has been estimated that for every bacteremic pneumonia that is documented, three nonbacteremic
infections occur. Management of these infections is potentially complicated by the
increasing resistance of the isolates to the commonly used antibiotics. Furthermore, it is well
recognized that despite advances in medical care, the mortality of bacteremic pneumococcal
pneumonia has remained largely unchanged over the past 50 years and averages approximately 12%.
Much recent research interest in the field of pneumococcal infections has focused on important
virulence factors of the organism, on improved diagnostic and prognostication tools, on defining risk
factors for death, on optimal treatment strategies involving both antibiotics and adjunctive therapies,
and on disease prevention. It is hoped that through these endeavors the outlook of pneumococcal
infections will be improved.