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Severe Community-Onset Staphylococcus aureus Infection Surveillance

NEW! Invasive Pneumococcal Disease in Children 5 Years After Conjugate Vaccine Introduction --- Eight States, 1998--2005


ABCs Pathogens

Group A Streptococcus
Group B Streptococcus
Haemophilus influenzae
Neisseria meningitidis
Streptococcus pneumoniae

Completed and Archived
ABCs Projects

Overview of Active Bacterial Core Surveillance
The California Emerging Infections Program (CEIP), one of eleven Emerging Infections Program sites, conducts surveillance for invasive bacterial diseases due to pathogens of public health importance. For each case of invasive disease in the study population, CEIP generates a case report with basic demographic information, and sends bacterial isolates from normally sterile sites to CDC for laboratory testing.

Objectives of ABCs
-Determine the incidence and epidemiologic characteristics of invasive disease due to Group A streptococcus, Group B streptococcus, Haemophilus influenzae, Neisseria meningitidis, Streptococcus pneumoniae, and Methicillin-resistant Staphylococcus aureus (MRSA) in several large populations.

-Determine molecular epidemiologic patterns and microbiologic characteristics of public health relevance for isolates causing invasive infections for select pathogens.

-Provide an infrastructure for further research, such as special studies aimed at identifying risk factors for disease, post-licensure evaluation of vaccine efficacy, and monitoring effectiveness of prevention policies.

Main Components of ABCs
The main components of Active Bacterial Core Surveillance are active laboratory based surveillance and special studies.

Case Definition
A case of invasive bacterial disease is defined as isolation of Haemophilus influenzae, Neisseria meningitidis, Group A streptococcus, Group B streptococcus, Listeria monocytogenes, or Streptococcus pneumoniae, or Methicillin-resistant Staphylococcus aureus (MRSA) from a normally sterile site in a resident of one of the surveillance areas. Normally sterile sites include: blood, cerebrospinal fluid, pleural fluid, peritoneal fluid, pericardial fluid, surgical aspirate, bone, or joint fluid.
Special circumstances also apply for Group A streptococcus and Group B streptococcus case definitions. Reports of Group A streptococcal tissue isolates known to have been collected during surgical procedures (e.g., muscle collected during debridement for necrotizing fasciitis) and Group A streptococcus from wound cultures of cases accompanied by necrotizing fasciitis or Streptococcal Toxic Shock Syndrome (STSS) are considered cases for surveillance purposes. Reports of placenta and/or amniotic fluid with group B streptococcus, when fetal death occurs, are also considered cases for surveillance.

ABCs Data Overview
Yearly surveillance reports for pathogens under surveillance are available in PDF format at the following link: http://www.cdc.gov/abcs/reports-findings/surv-reports.html

Current ABCs Projects (For completed and archived ABCs projects click here)
1. Active surveillance for invasive disease caused by Groups A and B Streptococci, Haemophilus influenzae, Neisseria meningitidis, Streptococcus pneumoniae, and MRSA.

2. Isolate collection and testing of all isolates of Group A streptococcus, Haemophilus influenzae, Neisseria meningitidis, and Streptococcus pneumoniae, and a subset of MRSA isolates.

3. Enhanced Surveillance for Invasive Early-Onset and Late-Onset Group B Streptococcal (EOGBS) and (LOGBS) Disease - Missed Opportunities for Prevention:

Since January 1, 1998 for all cases of invasive EOGBS (cases <7 days of age) and January 1, 2003 for LOGBS (cases 7- 89 days old) prenatal screening and other EOGBS/LOGBS risk factor information has been collected from both infant and maternal (labor and delivery) charts. The goal of this sub-study is to assess implementation of interventions to prevent perinatal transmission and risk factors for neonatal sepsis.

4. Active Surveillance for Pathogens Causing Neonatal Sepsis:

Expanded surveillance for all culture-confirmed cases of bacterial sepsis and/or meningitis (excluding coagulase-negative Staphylococcal and contaminants) in infants less than 30 days of age began March 1, 1998. For cases occurring on or after January 1, 2000, the case definition was modified to include only infants less than 7 days of age born at a surveillance area hospital. Data collected include labor and delivery, maternal risk factor information, and newborn clinical information abstracted from infant and maternal delivery charts.

5. Expanded Case Report Form for Invasive Pneumococcal Disease in Children:

Since January 1, 2000, demographic and vaccination history information has been collected from primary health care providers for all invasive pneumococcal infections in children 3 months to less than 5 years of age. Results from this expanded surveillance will enable the detection of pneumococcal conjugate vaccine failures or failures to vaccinate in this vulnerable population.


6. Assessing the Effectiveness of Tetravalent Meningococcal Conjugate Vaccine among Persons Aged 11-21 Years:

The purpose of this study is to conduct a case-control, retrospective study to evaluate the effectiveness of the tetravalent (A, C, Y, W-135) meningococcal conjugate vaccine (MCV4) against invasive meningococcal disease in persons 11-to 21-years-old. MCV4 was licensed based on safety and immunogenicity data, without data on clinical efficacy. In February 2005, MCV4 was recommended by the Advisory Committee on Immunization Practices (ACIP) of the CDC for routine use among young adolescents aged 11-12 years, for those adolescents who have not previously received MCV4 before high school entry, college freshmen living in dormitories, and other populations at increased risk. Study enrollment began January 1, 2006 and will continue through December 31, 2009.

For more details on ABCs projects, please visit the following links:

CDC's ABCs Website

http://www.cdc.gov/abcs/pathogens/pathogen-links.html

Community-Associated MRSA
http://www.cdc.gov/mrsa/index.html

Hospital Associated MRSA
http://www.cdc.gov/mrsa/index.html

Invasive MRSA Fact Sheet
http://www.cdc.gov/mrsa/statistics/MRSA-Surveillance-Summary.html
http://www.cchealth.org/topics/mrsa/

What is CDC doing about MRSA?
http://www.cdc.gov/mrsa/index.html

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