MOLECULAR DIAGNOSTICS
Pneumococcal disease surveillance in an evolving epidemiological landscape
Pneumococcal disease, caused by Streptococcus pneumoniae remains a serious health issue. Here, Carolyn Moonen and Markus Meyer examine how recent technological advances in identification of bacterial isolates and their serotypes are improving disease surveillance and treatment.
Despite decades of research, vaccination programmes and improved clinical management, pneumococcal disease continues to pose a serious threat to global public health. The disease, caused by Streptococcus pneumoniae, can range from mild infections, such as otitis media and sinusitis, to severe and potentially life-threatening infections, including meningitis and pneumonia, and is a particular threat to young children, the elderly and immunocompromised individuals. Pneumococcal meningitis is fatal in around 15% of children, while a further 25% face long-term disabilities such as brain damage, hearing loss and seizures. Alongside this, 40,000 people in the UK are hospitalised with pneumococcal pneumonia annually, with a mortality rate of approximately 20% despite antibiotic treatment.1 Against this backdrop, effective
surveillance of S. pneumoniae is a key component to limit infection and protect public health. Accurate and timely identification of bacterial isolates and their serotypes is essential for tracking transmission and evaluating vaccine performance. Traditional microbiological methods, while reliable, can be time- consuming and resource-intensive, revealing the need for newer phenotype- based approaches, including Fourier- transform infrared (FTIR) spectroscopy, that can differentiate and classify strains at sub-species level and deliver information more rapidly.
Streptococcus pneumoniae in cerebrospinal fluid (fluorescent antibody [FA] staining).
Challenge of serotype diversity S. pneumoniae is a common bacterium that is transmited person-to-person via respiratory droplets and frequently colonises the mucosal surfaces of the nasopharynx, often without causing disease. Between 40-50% of healthy children and 20-30% of healthy adults carry the bacteria.2
However,
nasopharyngeal colonisation can be a precursor to the development of
both localised infections and invasive pneumococcal disease. In such cases, S. pneumoniae is disseminated beyond the upper respiratory tract, either by aspiration, bacteraemia or local spread. Although localised infections, such as otitis media and sinusitis, are usually mild and treatable, they can progress to life- threatening invasive diseases, including pneumonia and meningitis. The main virulence factor for
August 2026
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Dr MS Mitchell / Centers for Disease Control and Prevention
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