Active Bacterial Core surveillance

Active Bacterial Core surveillance
Name	Active Bacterial Core surveillance
Field	Public health surveillance, Infectious disease epidemiology
Synonyms	ABCs

Active Bacterial Core surveillance is a population-based, laboratory-initiated surveillance system operated by the Centers for Disease Control and Prevention in the United States. Established in the mid-1990s, it provides critical data on the incidence and trends of invasive bacterial infections of public health importance. The system's core function is to generate reliable estimates of disease burden, monitor antimicrobial resistance, and guide the development and evaluation of vaccines and other prevention policies.

Overview

This surveillance network represents a cornerstone of public health infrastructure for tracking serious bacterial diseases. It operates through a collaborative network of academic and state health department partners across multiple geographically defined sites. The data collected are instrumental for epidemiological analysis, informing national guidelines from the Advisory Committee on Immunization Practices, and assessing the real-world impact of immunization programs. By focusing on laboratory-confirmed invasive disease, it provides a high degree of diagnostic specificity and accurate incidence rates.

History and development

The program was launched in 1995, initially focusing on invasive disease caused by Streptococcus pneumoniae and group A *Streptococcus*. Its creation was driven by the need for robust data to assess the emerging threat of antibiotic resistance and to establish a baseline before the introduction of new conjugate vaccines. The system expanded over subsequent years, adding key pathogens like Neisseria meningitidis and group B *Streptococcus*. Significant milestones include its pivotal role in monitoring the impact of the 7-valent pneumococcal conjugate vaccine after its 2000 recommendation by the Advisory Committee on Immunization Practices.

Surveillance methodology

The system employs active, population-based surveillance within defined catchment areas encompassing millions of persons. Surveillance officers regularly contact all clinical laboratories in these areas to identify cases meeting the case definition, primarily isolation of a target bacterium from a normally sterile site. Data are collected through standardized case report forms and include demographic, clinical, and laboratory information, such as serotype and antimicrobial susceptibility testing results. This methodology minimizes reporting bias and allows for the calculation of precise incidence rates, which are then extrapolated to produce national estimates.

Pathogens monitored

The core pathogens under surveillance are selected for their public health severity, preventability, and potential for antimicrobial resistance. The primary bacterial species tracked include Streptococcus pneumoniae, *Streptococcus pyogenes*, *Streptococcus agalactiae*, Neisseria meningitidis, and Haemophilus influenzae. For certain pathogens like Streptococcus pneumoniae and Haemophilus influenzae, detailed serotyping is performed, which is crucial for evaluating vaccine effectiveness against specific strains. Surveillance for methicillin-resistant Staphylococcus aureus was also incorporated for a period.

Data utilization and public health impact

Findings from this system directly inform vaccine policy and treatment guidelines at the highest levels. Data on serotype distribution and invasive disease incidence were fundamental to the licensure and recommendation of successive pneumococcal conjugate vaccines. The system monitors the epidemiology of antimicrobial resistance, providing evidence for updates to clinical practice guidelines from entities like the Infectious Diseases Society of America. Reports and analyses are regularly published in journals such as the Morbidity and Mortality Weekly Report and the New England Journal of Medicine.

Program structure and collaboration

The program is coordinated by the Centers for Disease Control and Prevention's Division of Bacterial Diseases within the National Center for Immunization and Respiratory Diseases. Implementation relies on a network of state health departments and academic institutions serving as "Emerging Infections Program" sites. Key partners have included the California Department of Public Health, the Tennessee Department of Health, and researchers at Johns Hopkins University and the University of California, Berkeley. This collaborative model ensures both national standardization and local expertise in data collection and analysis.

Category:Centers for Disease Control and Prevention Category:Public health surveillance Category:Infectious disease epidemiology in the United States