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Active Bacterial Core Surveillance (ABCs)
A Core Component of the Emerging Infections Program

Purpose	To determine the incidence and epidemiologic characteristics of invasive bacterial disease, determine molecular epidemiologic patterns and microbiologic characteristics for isolates causing disease, and to provide an infrastructure for nested special studies to identify risk factors and to evaluate prevention policies.
Pathogens	Group A streptococcus, Group B streptococcus, Haemophilus influenzae, Neisseria meningitidis, and Streptococcus pneumoniae. Limited surveillance for invasive methicillin-resistanct Staphylococcus aureus will begin in 2004.
Population	Approximately 37.2 million in some or all counties in the following states: California, Colorado, Connecticut, Georgia, Maryland, Minnesota, New Mexico, New York, Oregon, and Tennessee.
Case Definition	Isolation of one of the five bacterial pathogens from a normally sterile site in a resident of the surveillance population.
Methodology	Active laboratory-based surveillance of invasive disease in area residents. Collection of demographic, clinical data, and bacterial isolates. Regular laboratory audits to assess completeness of active surveillance and detect additional cases. Collaboration between state health departments, academic investigators, and CDC.
Disease Burden	Group A streptococcus -- 3.2 cases per 100,000; approximately 9,100 cases and 1,350 deaths annually in the United States Group B streptococcus -- 7.0 cases per 100,000; approximately 20,300 cases and 2,050 deaths annually in the United States Haemophilus influenzae -- 1.3 cases per 100,000; approximately 3,850 cases and 600 deaths annually in the United States Neisseria meningitidis -- 0.6 cases per 100,000; approximately 1,450 cases and 150deaths annually in the United States Streptococcus pneumoniae -- 13.0 cases per 100,000; approximately 37,250 cases and 5,250 deaths annually in the United States
Challenges	Increasing antimicrobial resistance; aging population.
Opportunities	Measuring impact of newly licensed pneumococcal conjugate vaccine on disease and drug resistance; harnessing molecular techniques to characterize bacterial isolates.