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Streptococcus pneumoniae

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*Streptococcus pneumoniae*, often called pneumococcus, is a significant human pathogen. It is a Gram-positive, spherical bacterium that typically lives in pairs, a form known as diplococci.

Streptococcus pneumoniae on agar plates
Streptococcus pneumoniae on agar plates

While many healthy people carry these bacteria in their respiratory tract, sinuses, or nasal cavity without symptoms, they can become dangerous to certain groups. People with weaker immune systems, such as the elderly and young children, are at higher risk. In these individuals, the bacteria can spread and cause serious invasive diseases.

The bacterium uses several mechanisms to survive within a human host. A primary tool is its polysaccharide capsule (CPS), which is a thick, outer layer of repeating sugar units. This capsule acts as a virulence factor by inhibiting phagocytosis. This means it prevents granulocytes, a type of white blood cell, from reaching and destroying the bacterial cell wall. The bacteria also use a process called phase variation to change their physical appearance. They can switch to a transparent phenotype with a thin capsule to better adhere to the nasopharynx. Alternatively, they can switch to an opaque phenotype with a thicker capsule to survive more effectively in the bloodstream.

There are many different versions of this bacterium, categorized into more than 100 known serotypes. These serotypes are determined by the chemical composition and quantity of the polysaccharide capsule they produce. These differences are important because they influence how much damage the bacteria cause, how common they are, and how well they resist drugs.

S. pneumoniae
S. pneumoniae

Scientists can distinguish *S. pneumoniae* from similar bacteria using specific laboratory tests. One method is the optochin test, as this bacterium is sensitive to the chemical optochin. Another method is the bile solubility test, which checks if the bacteria break apart when exposed to bile.

The history of studying this organism is linked to the very foundation of modern genetics. In 1881, George Sternberg and Louis Pasteur independently isolated the organism. It was later known as *Diplococcus pneumoniae* due to its appearance in Gram-stained sputum, before being renamed in 1974. In 1928, Frederick Griffith conducted a famous experiment using mice. He showed that harmless bacteria could be transformed into a lethal form by mixing them with heat-killed virulent bacteria. In 1944, researchers Oswald Avery, Colin MacLeod, and Maclyn McCarty proved that DNA was the substance responsible for this transformation. This discovery helped launch the molecular era of genetics.

*S. pneumoniae* can cause a wide range of infections with varying levels of severity. Pneumonia is the most common disease, causing fever, chills, and labored breathing. In the elderly, patients might show tachypnea, which is rapid and shallow breathing, before other symptoms appear. The bacteria can also cause meningitis, an infection of the brain and spinal cord. This can lead to severe disabilities, such as hearing loss or brain damage. Other infections include sepsis, which is an overwhelming body response to infection, and osteomyelitis, a rare bone infection. Less severe examples include otitis media (ear infections), sinusitis, and conjunctivitis.

The genetic makeup of the bacterium is quite complex. Its genome consists of a closed, circular DNA structure containing between 2.0 and 2.1 million base pairs. This genome includes a core set of 1,553 genes, along with 154 genes that contribute to its ability to cause disease. The bacteria also use a process called transformation to survive. This involves taking up DNA from their surroundings to repair damage. This process requires a special state called competence, which can be triggered by certain antibiotics. This ability to repair DNA helps the bacteria survive the oxidative stress produced by the human immune system.

To protect populations, scientists have developed two main types of vaccines. The pneumococcal polysaccharide vaccine (PPV23) uses the capsule to help the body create specific antibodies. However, this vaccine provides temporary immunity and requires a booster after five years. To better protect young children, the pneumococcal conjugate vaccine (PCV13) was developed. This vaccine creates a more enduring immune response by promoting interaction between B cells and T cells.

Diagnostic algorithm of possible bacterial infection
Diagnostic algorithm of possible bacterial infection

These medical advancements are essential for reducing the impact of this widespread pathogen.

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File:Streptococcus pneumoniae on agar plates.jpg
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Diagnostic algorithm of possible...
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