The epidemiology of community acquired bacteremic pneumonia, due to Streptococcus pneumoniae, in the Top End of the Northern Territory, Australia-Over 22 years

► Pneumococcal disease continues to cause substantial morbidity and mortality throughout the world. ► We describe the epidemiology of blood culture positive S. pneumoniae community-acquired pneumonia (CAP) in a hospital cohort from the Northern Territory of Australia. ► In this cohort, males and Indigenous patients were over represented. ► There was no decline in disease incidence following the introduction of the 23-valent pneumococcal polysaccharide vaccine. ► Consumption of alcohol to excess, diabetes, age greater than 45, Indigenous status and smoking are independent risk factors for S. pneumoniae CAP.