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Due to how common pneumonia is among young children, and its high position as a common cause of under-5 mortality, pneumonia is already widely known by nursing and expecting mothers. However, they know little about streptococcus pneumoniae the causative agent. This is very important because streptococcus pneumoniae, also called pneumococci, also causes a wide range of infections.
What is Pneumococcus?
In the world of microscopes and microscopic organisms, pneumococcus belongs to the genus diplococcus. It is a pus-producing, gram-positive bacteria that are round-shaped. It has a diameter of 0.5-1.5 microns. Pneumococcus has no spore or flagella and it grows in the presence of little or no oxygen. It has capsules that are formed in the body. It is normally found in the nasopharyngeal cavity of the body. The pneumococcal bacterium is airborne and is prevalent during winter and early spring.
How Can a Newborn Get Infected?
Pneumococcal infections are not one-time infections. They can come as many times as possible. In most situations, any contact with any form of secretion (saliva or mucus) that contains the pneumococcal bacterium can infect a newborn.
According to research, newborns can contract pneumococcus during delivery. This happens when the amniotic membrane ruptures prematurely and bacteria of all kinds from the vaginal tract obtain a free pass to the baby.
Pneumococcus is mostly found in the nasal cavity of babies. If a nasopharyngeal sample is taken with a swab and viewed under a microscope it is common to visualize this organism, but these rarely cause any disease and are considered normal commensal organisms in these individuals. However, this means that pneumococcus can be contracted quite easily as it can be expelled from the nasal cavity and is therefore airborne.
Apart from the ways stated above, other means of contracting pneumococcus have not yet been well defined.
Are There Different Types of Pneumococcus?
Now that we know that this bacteria resides primarily in the nasopharyngeal region of the body, we should also know that it is broadly divided into two types. These types include:
- Pathogenic, and
However, the majority of pneumococcus are non-pathogenic; that is, non-disease causing.
What Diseases Can Pneumococcus Cause?
Never forget that pneumococcus is a bacterium with different types. This means that this single bacterium can lead to various diseases. Common diseases caused by pneumococcus include:
- Pneumococcal otitis media
When bacteria invade the meninges, bacterial meningitis occurs. This is every mother’s worst nightmare. It starts with a headache, a stiff neck, high fever, irritability, and restlessness. This disease can be deadly and sometimes leaves its victims with life-long intellectual or behavioral development issues. Some of these may include deafness, paralysis, mental retardation, palsy, or epilepsy seizures. Bacterial meningitis is treated with very potent antibiotics.
This is the most common pneumococcal infection. The high rate of neonatal mortality caused by pneumonia is not news to anybody, most especially pregnant and nursing mothers. Pneumonia has many causative agents, but it is majorly caused by pneumococcal bacteria. It begins with difficulty in breathing, cough, fever, and other symptoms. It is mostly treated with strong antibiotics.
Pneumococcal Otitis Media
This is an infection that occurs in the middle ear. It can also come with an upper respiratory tract infection. It is normally caused by a viral infection but bacterial infection by pneumococcus can occur as a superinfection and aggravates it at some point, making it more complicated. It is usually contracted by babies who receive bottle feeding instead of breastfeeding, and those who also live in environments or households where much smoking occurs. It starts with earache which can eventually lead to hearing loss, fever, sleeplessness, nausea, vomiting, and diarrhea. If not treated timely, it can lead to mastoiditis, peritonitis, labyrinthitis, brain abscess, and sometimes, but rarely, meningitis. It is normally treated with antibiotics, but once it starts affecting the brain, or causing meningitis, it becomes extremely difficult and slow to treat.
This is the presence of bacteria in the bloodstream. Pneumococcal bacteremia can lead to other diseases like meningitis, arthritis, and endocarditis. Newborns that have a suppressed immune system due to diseases like sickle-cell, cancer, etc., and those who have done a splenectomy are at a very high risk of getting infected. Most symptoms of this infection are low blood pressure, septic shock, shaking chills, nausea, fever, vomiting, abdominal pain, and tachypnea. Newborns that are infected have a high chance of dying within the first three days of this disease. This infection of the blood by bacteria is treated by cultured antibiotics.
Other life-threatening diseases that are caused by pneumococcus include:
- Cellulitis (infection of the skin and its subcutaneous tissue)
- Osteomyelitis(inflammation and destruction of the bone)
- Arthritis (infection of the joint)
- Sepsis ( organ failure due to response to infection)
- Sinus infection ( inflammation of paranasal sinuses due to infection)
- Peritonitis( infection of the ascitic fluid. It can lead to very serious sequelae or death)
- Mastoiditis (it is the bacterial infection of the mastoid cells; majorly caused by otitis media)
- Endocarditis (it is the infection of the endocardium; it leads to impaired cardiac function).
What Are the Major Symptoms of Pneumococcal Infections?
Although pneumococcal infections are of various kinds, there are general symptoms that newborns that are infected display. These symptoms include:
- The lips of the baby become bluish or sometimes grayish.
- The baby’s breathing becomes strenuous
- The child breathes either extremely slowly or faster than usual
- The muscles under the sternum or around the clavicle seem to contract and relax at much more force.
- Nasal flares will also be seen on the baby’s face
What Treatment Can Be Given for pneumococcal infections?
There are very many pneumococcal infections that need different forms of treatment. Therefore, once an infection relating to pneumococcus is confirmed, the treatment should include:
- Diagnosis, which should be given by a doctor for the correct treatment to be given. Diagnosis aims to identify the type of infection. This is done by chest x-rays, blood bacterial culture, and sputum bacterial culture.
- Antibiotics are given if it is pneumonia that is caused by bacteria or mycoplasma infection. For other types of infection, antibiotics or another form of treatment will be given.
- While the baby is taking treatment, ensure that you clean up secretions immediately after they are noticed.
- Also, make sure that the baby receives fresh air during treatment.
- When necessary, ensure to give the baby bronchial spasmolysis and oxygen therapy.
During treatment, never stop the medication by yourself. Each drug or medication has its time frame before it starts to work. If the medications were not taken until the required time frame, the drug will not work as required or might not work at all.
How Can Pneumococcal Infection Be Prevented?
It should be emphasized that pneumococcus infections are not to be treated lightly. This is because pneumococcus is an invasive bacteria; it can spread to other parts of the body which are normally free of germs. This makes it a very serious and scary bacteria, therefore preventing the infection is always better than cure. The best way to prevent pneumococcus is by vaccination. There are two types of pneumococcal vaccination:
- Pneumococcal conjugate vaccine or PCV13 (for newborns and children. It prevents 13 types of common neonatal pneumococcal infections.) The proper way to give this vaccine is four doses of (0.5mL) 1M. The number of doses depends largely on the age of the child and other health conditions.
- Pneumococcal polysaccharide vaccine or PPSV23 (for adults and smokers)
If your baby was given this vaccine but developed an adverse reaction or developed an allergy, do not take it again. Also, if your baby has received the PCV7 or Prevnar vaccine, do not allow him to take the PCV13 vaccine. Lastly, if your baby has been given any vaccine that includes diphtheria toxoids, like DTaP, do not allow him to take the PCV13 vaccine.
What Groups of Babies Prone to Pneumococcal Infections?
Newborns have weak immune systems. However, not all are prone to pneumococcal infections. Pneumococcal infections mostly occur in babies that have:
- Sickle cell anemia
- Viral respiratory infections or other respiratory diseases
- Suppressed immune systems due to having no spleen, cancer, HIV, leukemia, or other conditions that suppress the immune system.
- Chronic cardiorespiratory diseases
- Cerebrospinal fluid leaks
- Nephrotic syndrome
- Cochlear implants
- Damaged respiratory epithelium due to viral infections or chronic bronchitis.
Pneumococcus or streptococcus pneumoniae is indeed the cause of many infections. Once unusual symptoms, especially bluish or grayish coloration of the baby’s lips, are noticed, the parents should reach out for a hospital as quickly as possible. This bacterium is very deadly because it is an invasive bacterium and can cause a wide range of serious illnesses. Therefore, parents should be very careful while taking care of their baby. If the household consists of smokers, the smoking activity should not be done where the child is staying. Newborns with other health issues and a suppressed immune system should be treated and cared for with extreme carefulness and attention. All these measures are to prevent or manage the dangerous streptococcus pneumoniae.