Fatal infection in adults by pneumolysin & autolysin producing, non-vaccine serotype Streptococcus pneumonia

The US advisory committee on invasive pneumococcal disease (ACIP) has recommended the use of 23 valent polysaccharide vaccine (PPSV23) and the PCV13 (conjugate vaccine) for use in the elderly population aged >65 yr7,20. [...]could presence of pneumolysin and autolysin genes in the isolates obtained from these patients have any diagnostic or prognostic indications? The two isolates from our patients had the lytA and ply genes, although we did not attempt to detect this from the patients' blood or body fluids. high level of clinical suscpicion with laboratory support by conventional blood culture, effective case management with appropriate antibiotics will decrease morbidity and mortality due to invasive pneumococcal disease in adults.