Pneumococcus infections: is the burden still as heavy?

The death rate of invasive pneumococcal infections decreased by 100 fold in one century. This tremendous improvement was due mainly to antibiotic use and multiple attempts at antipneumococcal vaccinations; thus, this was true only for developed countries. However, in France, the incidence has increased, over the last 10 years, in all age classes except for children vaccinated by the heptavalent pneumococcal conjugate vaccine. The incidence of these infections remains high, when associated to some risk factors such as HIV infection, malignant blood diseases, solid cancers, bronchial diseases, or alcohol abuse. The pneumococcal vaccine should be prescribed first to patients with those risk factors. A change of serotypes distribution has been observed in children with a decrease of vaccine serotypes and predominance of related or non-vaccine serotypes. This reflects the effectiveness of vaccination and the need of to regularly update the vaccine. Thus, pneumococcal infections have been increasing and vaccination should be more widely proposed.