Infections caused by Streptococcus pneumoniae (also known as pneumococci) pose a threat to human health. Pneumococcal infections are the most common cause of milder respiratory tract infections, such as otitis and sinusitis, and of more severe diseases, including pneumonia (with or without septicaemia) and meningitis. The introduction of pneumococcal conjugate vaccines in the childhood vaccination programme in many countries has led to a notable decrease of severe invasive pneumococcal disease in vaccinated children. However, infections caused by non-vaccine types have concurrently increased, causing invasive pneumococcal disease in unvaccinated populations (such as older adults), which has hampered the effect of these vaccines. Moreover, emerging antibiotic resistance is threatening effective therapy. Thus, new approaches are needed for the treatment and prevention of pneumococcal infections, and recent advances in the field may pave the way for new strategies. Recently, several important findings have been gained regarding pneumococcal epidemiology, genomics and the effect of the introduction of pneumococcal conjugate vaccines and of the COVID-19 pandemic. Moreover, elucidative pathogenesis studies have shown that the interactions between pneumococcal virulence factors and host receptors may be exploited for new therapies, and new vaccine candidates have been suggested. In this Review, we summarize some recent findings from clinical disease to basic pathogenesis studies that may be of importance for future control strategies.

由肺炎链球菌（也称为肺炎球菌）引起的感染对人类健康构成威胁。肺炎球菌感染是较轻的呼吸道感染（如中耳炎和鼻窦炎）和更严重疾病（包括肺炎（伴或不伴败血症）和脑膜炎）的最常见原因。许多国家在儿童疫苗接种计划中引入肺炎球菌结合疫苗，导致接种疫苗的儿童患严重侵袭性肺炎球菌疾病的发病率显著减少。然而，由非疫苗类型引起的感染同时增加，在未接种疫苗的人群（如老年人）中导致侵袭性肺炎球菌疾病，这阻碍了这些疫苗的效果。此外，新出现的抗生素耐药性正在威胁有效的治疗。因此，需要新的方法来治疗和预防肺炎球菌感染，该领域的最新进展可能为新策略铺平道路。最近，关于肺炎球菌流行病学、基因组学以及引入肺炎球菌结合疫苗和 COVID-19 大流行的影响，已经获得了几项重要发现。此外，阐明性的发病机制研究表明，肺炎球菌毒力因子和宿主受体之间的相互作用可用于新疗法，并且已经提出了新的候选疫苗。在本综述中，我们总结了从临床疾病到基本发病机制研究的一些最新发现，这些发现可能对未来的控制策略具有重要意义。