摘要：There are comparatively little data on the incidence and morbidity from pneumococcal diseasein Australia and elsewhere. Available data suggest that the overall incidence of invasivepneumococcal disease in Australia is comparable with similar populations. Very high rates arereported in Central Australian Aborigines, similar to invasive Haemophilus influenzae type b(Hib) disease. Disease incidence is probably greatly underestimated by case ascertainment fromsterile site isolates alone. New diagnostic methods, such as serology to detect components of thepneumococcal cell wall, promise to significantly enhance detection of pneumococci as a causeof pneumonia, especially in childhood, but are epidemiologic rather than clinical tools. Resis-tance to penicillin and other antibiotics is an increasing problem wo rldwide, promoted byexcessive antibiotic use, especially in children. This has focused attention on vaccine preven-tion. Fortunately, antibiotic-resistant pneumococci appear to belong to a limited range ofserotypes, those commonly colonising children, in all areas so far studied. If conjugate pneu-mococcal vaccines prove to eradicate carriage, in a similar fashion to conjugate Hib vaccines,vaccination may be the major weapon against the spread of antibiotic-resistant pneumococcalinfection. Conjugate pneumococcal vaccines are now in large scale efficacy trials, with out-comes of bacteraemia (California) and otitis media (Finland). Results of these trials are eagerlyawaited
