In this issue of the European Respiratory Review, Ludwig et al. [1] present an article highlighting the continuous burden caused by invasive pneumococcal disease (IPD). Demographic changes due to the growing elderly population will further increase this problem. Bacterial infections of the upper and lower airways are most frequently caused by pneumococci in both adults and children, and pneumococci are an important cause of bacterial meningitis. Pneumococci carry a large armamentarium of pathogenesis factors enabling their translocation into the blood stream, i.e. bacteraemia, and which determine the amount of local tissue damage [2, 3]. These polygenic virulence capacities are the major cause of the high mortality of IPD. The mortality has not changed significantly in the past decades [4]. In addition to high mortality and morbidity, the IPD-induced healthcare costs are vast.
New antibiotics might not have a great effect. In some countries, the resistance of pneumococci …
