all right our next pathogen that we are going to discuss is streptococcus pneumoniae so streptococcus demonier uh often causes pneumonia right as is in the name but what you may not realize is that streptococcus ammonia is the second common cause of bacterial meningitis the most common of course being niceria meningitidis or the most severe at least maybe not the most common but the most severe so unlike niceria all nicerious species this includes gonorrhea or meningitis are gram-negative diplococcus this is a gram-positive so this is a huge uh defining characteristic they're arranged in pairs known as diplococci or possibly in short chains there are 90 serotypes and current vaccination prevention guidelines i think have their vaccines have 20 to 30 to 60 of the serotypes depending on which vaccine you get it does have a capsule which reduces the immune system's ability to eradicate infection um that is its most virulent factor which means it's the factor that explains the most more morbidity or mortality uh it grows on mucosal surfaces and a lot of people have this as a natural part of their microflora and don't ever develop disease and then so this is a primary cause most common etiologic or primary cause of community associated or acquired pneumonia otitis media or ear infection and the most prevalent uh cause of bacterial meningitis this is specifically in israel uh niceria being the first early symptoms include chills high fever cough producing a pink or rusty colored sputum if left untreated uh sustained fever and chest pain lung pain will develop as well as sinusitis sinus infection endocarditis arthritis and again infection of the lungs when pneumococci migrate to the lungs they can cause pneumonia and can enter the bloodstream and cause bacteremia or septicemia worldwide uh distribution incidence of infection is highest in people under two and people over 60. so i commonly refer to this as the newly bred and the nearly dead so these are going to affect the polar opposites of the age spectrum so you have humans mice rats guinea pigs chimpanzees rhesus monkeys and mammals um the unknown infectious dose for humans because it is an opportunistic pathogen which means many people are going to carry a wide range of this organism on or in them um and so but we do have laboratory experimented levels that we've been used to kind of test on mice and simians primates uh infected cells can disseminate via microaerosol droplets creating coughing seizing person or person-to-person oral contact transmission is common very common but infection is infrequent as long as you're healthy uh not well-determined for incubation period but it's been speculated about one to three days in your compromised patients humans are often the reservoir all right it is located in the upper respiratory tract of healthy individuals no zoonosis no vector uh susceptible to penicillin tetracycline uh ceph tiaxine levo levoflovoxin erythromycin and fluoroquinolones um the bacteria displays full susceptibility to vancomycin and this is a tb drug right here that is often used for tuberculosis infection uh multi drug resistant pneumonia occurs and is emerging constantly here is a list of agents that common resistant patterns are found