| 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,
and Streptococcus pneumoniae 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 s 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 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/ncidod/dbmd/abcs/survreports.htm
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
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.
7. Severe Community-Onset Staphylococcus
aureus Infection Surveillance:
Beginning September 1, 2008 we began conducting
laboratory-based surveillance for severe community-onset S.
aureus cases hospitalized within San Francisco County. Surveillance
is being implemented to identify persons 0-50 years old with
a sterile site or respiratory site S. aureus isolates, with
severe infections requiring hospitalization, but lacking established
risk factors for health care associated S. aureus. Established
risk factors include: a concurrent or recent stay in a hospital
or long term care facility; recent surgery or dialysis and/or
having a central vascular catheter, tracheotomy, gastrostomy,
foley catheter; or any hemodialysis access device in place at
time of admission/evaluation.
Findings from this surveillance system will help us to better
characterize persons with severe community-onset S. aureus infections
and determine the frequency of antecedent influenza-like illness
and influenza among persons presenting with severe S. aureus
respiratory disease. This information will aide the development
and implementation of effective interventions to prevent severe
S. aureus respiratory infections from developing, either related
to or independent of preceding ILI.
For
more details on ABCs projects, please visit the following links:
CDC's ABCs Website
http://www.cdc.gov/ncidod/dbmd/abcs/path-start.htm
MRSA
Prevention in Schools
http://www.cdc.gov/Features/MRSAinSchools/
http://www.cchealth.org/press_releases/mrsa_info_for_school_2007_10.php
Community-Associated MRSA
http://www.cdc.gov/ncidod/dhqp/ar_mrsa_ca.html
Hospital
Associated MRSA
http://www.cdc.gov/ncidod/dhqp/ar_mrsa.html
Invasive
MRSA Fact Sheet
http://www.cdc.gov/ncidod/dhqp/ar_mrsa_Invasive_FS.html
http://www.cchealth.org/topics/mrsa/
What
is CDC doing about MRSA?
http://www.cdc.gov/ncidod/dhqp/ar_mrsa_CDCactions.html
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