Streptococcus pneumoniae Coinfection in COVID-19: A Series of Three Cases

Chaitanya Pal1, Paulina Przydzial1, Ogechukwu Chika-Nwosuh2

  • 1Department of Medicine, Newark Beth Israel Medical Center, New Jersey 07112, USA.

Case Reports in Pulmonology
|December 21, 2020
PubMed

Insights

Bacterial coinfections, like Streptococcus pneumoniae, can complicate SARS-CoV-2 infections, increasing mortality. Early pathogen testing is crucial for effective treatment, even with antimicrobial stewardship concerns.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Public Health

Background:

  • Bacterial coinfections frequently accompany respiratory viral illnesses, escalating mortality and morbidity.
  • The SARS-CoV-2 pandemic presents a significant global health crisis, with limited data on coinfection rates.
  • Previous pandemics highlight the severe impact of bacterial coinfections alongside viral outbreaks.

Observation:

  • Current literature indicates variable SARS-CoV-2 coinfection rates (1-8%) and suggests low rates of Streptococcus pneumoniae coinfection compared to influenza.
  • Despite this, three cases of SARS-CoV-2 infection complicated by Streptococcus pneumoniae coinfection were identified.
  • These cases underscore the potential for significant bacterial coinfections in COVID-19 patients.

Findings:

  • The presented cases highlight the occurrence of Streptococcus pneumoniae coinfection in patients with confirmed SARS-CoV-2.
  • This challenges the notion of negligible bacterial coinfection rates in the current pandemic.
  • Concomitant testing for common bacterial pathogens is essential for accurate diagnosis and treatment.

Implications:

  • These findings emphasize the need for vigilant diagnostic testing for bacterial coinfections in SARS-CoV-2 patients.
  • It supports the judicious use of antibiotics based on confirmed infections rather than empiric broad-spectrum use.
  • This approach is vital for optimizing patient outcomes and promoting antimicrobial stewardship.

Related Concept Videos

Pneumonia I: Introduction01:30

Pneumonia I: Introduction

Pneumonia is an acute respiratory infection that targets the lungs, specifically the alveoli. These tiny air sacs, essential for oxygen exchange, become engorged with pus and fluid, severely hindering breathing, decreasing oxygen absorption, and causing significant pain and discomfort during respiration.
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
Pneumonia II: Pathophysiology01:29

Pneumonia II: Pathophysiology

The pathophysiology of pneumonia involves the following steps:
Pneumonia III: Complications and Assessment01:30

Pneumonia III: Complications and Assessment

Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
Pneumonia IV: Management01:28

Pneumonia IV: Management

The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Atypical Pneumonia01:14

Atypical Pneumonia

Atypical pneumonia, often caused by Mycoplasma pneumoniae, is a form of pulmonary infection that differs from the classical presentation of bacterial pneumonia in both its cause and clinical symptoms. Mycoplasma pneumoniae is a pleomorphic bacterium notable for its lack of a rigid cell wall. This structural characteristic imparts resistance to beta-lactam antibiotics and significantly influences the bacterium’s behavior within the human host.Other pathogens responsible for the disease include...
Pneumonia I: Introduction01:29

Pneumonia I: Introduction

Pneumonia is an infection of the lower respiratory tract that leads to inflammation of the lung parenchyma, often resulting in the accumulation of inflammatory exudate in the alveoli and airways. Unlike the watery, low-protein fluid exudate in pulmonary edema, the exudate in this case is a thick fluid rich in immune cells, proteins, and debris produced during infection and inflammation.This impairs gas exchange and can lead to consolidation of lung tissue. The infection may be caused by a...