Streptococcus pneumoniae is not part of the normal vaginal flora. However, transient colonisation can occur in 0.03 - .75% of pregnant women. While most colonised mothers are asymptomatic at delivery, pneumococcal chorioamnionitis, endometritis and bacteraemia can occur.
Streptococcus pneumoniae can also cause both early- and late-onset neonatal sepsis. This is uncommon, with reported rates 10 times less than infections due to group B streptococcus. S. pneumoniae accounts for only 1-11% of all neonatal septicaemias however, the rarity of vaginal carriage of this organism suggests a higher invasion-to-colonisation ratio than for group B streptococcus. The associated neonatal mortality rate has been estimated to be as high as 60%.
A case of pneumococcal chorioamnionitis will be presented. The discussion will focus on the identification and reporting of S. pneumoniae on genital cultures in pregnant women, treatment recommendations and the potential impact of intra-partum antibiotics and pneumococcal vaccines.