DRUG-RESISTANT STREPTOCOCCUS PNEUMONIAE THREAT LEVEL SERIOUS

900,000 3,600 Estimated Estimated infections in deaths 2014 in 2014

Streptococcus pneumoniae (pneumococcus) is a leading cause of bacterial pneumonia and meningitis in the United States. It also is a common cause of bloodstream infections, and ear and sinus infections.

WHAT YOU NEED TO KNOW INFECTIONS OVER TIME BY AGE ■■ Overall, there are more than 2 million pneumococcal Rates of antibiotic-resistant invasive pneumococcal infections infections each year in the United States, resulting in have decreased across age groups in the United States from more than 6,000 deaths and $4 billion in total costs. 2005 to 2017.

In more than 30% of infections, the bacteria are 15 PCV13: Children PCV13: Adults resistant to one or more clinically relevant antibiotics. ■■ Pneumococcal pneumonia leads to an estimated 12 150,000 hospitalizations for adults each year and accounts for $1.3 billion in direct medical costs (65% of direct costs for all adult pneumococcal 9 disease treatment).

■■ Drug-resistant S. pneumoniae is one of the only germs 6 listed in this report with an effective vaccine to

prevent infections, called pneumococcal conjugate people per 100,000 Infections vaccine (PCV). 3

0 2005 2007 2009 2011 2013 2015 2017

0–4 years 5–17 years 18–49 years 50–64 years 65+ years

8 PCV7 introduced PCV13 introduced

7

6

5

4

3

2 Invasive infections per 100,000 people per 100,000 infections Invasive 1

0 1998 2000 2002 2004 2006 2008 2010 2012 2014 2016

Any antibiotic* Penicillin Erythromycin 15 PCV13: Children PCV13: Adults

12

9

6 Infections per 100,000 people per 100,000 Infections 3 DRUG-RESISTANT STREPTOCOCCUS PNEUMONIAE 0 2005 2007 2009 2011 2013 2015 2017 VACCINE: AN EFFECTIVE TOOL INFECTIONS0–4 years OVER 5–17 years TIME 18–49 years BY ANTIBIOTIC50–64 years 65+ years Pneumococcal conjugate vaccine (PCV) helps prevent Antibiotic-resistant invasive pneumococcal infections have infections and slow the development of pneumococcal decreased in the United States since PCVs were introduced. resistance. PCV has reduced pneumococcal infections 8 caused by vaccine strains, most of which were resistant, PCV7 introduced PCV13 introduced by more than 90% in children. It has also decreased 7 the spread of resistant S. pneumoniae strains, because vaccinated people do not spread the bacteria. Blocking 6 the spread reduces resistant infections among children, 5 as well as adults, through vaccine indirect effects (or “herd immunity”). From 2000 to 2009, PCV7 provided 4 protection against seven pneumococcal strains. These strains caused more than 83% of the antibiotic-resistant 3 invasive infections in children prior to PCV7 introduction. 2 Beginning in 2010, use of PCV13 expanded that Invasive infections per 100,000 people per 100,000 infections Invasive protection to 13 strains, one of which—serotype 19A— 1 accounted for more than 30% of resistant infections prior 0 to PCV13 introduction. Since PCV introduction among 1998 2000 2002 2004 2006 2008 2010 2012 2014 2016 U.S. children in 2000, the rates of antibiotic-resistant invasive pneumococcal infections caused by vaccine Any antibiotic* Penicillin Erythromycin strains decreased by 97% among children younger than 5 years old and by more than 60% among adults. *Any antibiotic includes germs not susceptible (not sensitive) to at least one of the following antibiotics: penicillin, amoxicillin, erythromycin, cefotaxime, ceftriaxone, Achieving high vaccination coverage and encouraging cefuroxime, tetracycline, vancomycin, or levofloxacin. appropriate antibiotic use will slow the spread of pneumococcal resistance.

ONLINE RESOURCES

About Drug-resistant Pneumococcal Disease www.cdc.gov/Pneumococcal/Drug-Resistance.html

Bact Facts Interactive: Data from Active Bacterial Core Surveillance wwwn.cdc.gov/BactFacts/Index.html

This fact sheet is part of CDC’s 2019 Antibiotic Resistance Threats Report. The full report, including data sources, is available at www.cdc.gov/DrugResistance/Biggest-Threats.html. CS298822-A