Active Bacterial Core Surveillance (ABCs) is a critical component of the Emerging Infections Program (EIP) in the United States. Operated by the Centers for Disease Control and Prevention (CDC) in partnership with state health departments and academic institutions, ABCs provides essential data on bacterial pathogens of public health significance. This comprehensive guide explores the structure, objectives, methodology, and impact of ABCs, highlighting its role in combating bacterial diseases.

1. Introduction to Active Bacterial Core Surveillance (ABCs)

1.1. What is ABCs?

ABCs is a population-based, active surveillance system that tracks invasive bacterial infections caused by specific pathogens. It collects data on incidence, clinical outcomes, and bacterial isolates, enabling effective public health interventions.

1.2. Objectives

  • Monitor Disease Trends: Assess the burden of bacterial diseases over time.
  • Guide Vaccine Policies: Provide data to inform vaccine development and implementation.
  • Support Antimicrobial Stewardship: Track antibiotic resistance patterns.
  • Facilitate Public Health Research: Generate data for studies on prevention and treatment.

1.3. Key Pathogens Under Surveillance

  • Streptococcus pneumoniae (pneumococcus)
  • Group A Streptococcus (GAS)
  • Group B Streptococcus (GBS)
  • Haemophilus influenzae
  • Neisseria meningitidis
  • Bordetella pertussis (in some sites)

2. Structure and Methodology

2.1. Surveillance Sites

ABCs operates in 10 geographically diverse sites across the United States, collectively covering approximately 44 million people (about 13% of the U.S. population).

2.2. Data Collection

  • Case Identification: Hospitals, laboratories, and healthcare providers report invasive bacterial infections.
  • Laboratory Confirmation: Isolates are submitted to reference labs for species identification, serotyping, and antimicrobial susceptibility testing.
  • Clinical Data: Detailed patient information, including demographics, clinical outcomes, and risk factors, is collected.

2.3. Population-Based Approach

Data are extrapolated to represent the broader U.S. population, ensuring national relevance.

3. Key Pathogens Monitored by ABCs

3.1. Streptococcus pneumoniae

  • Impact: Leading cause of bacterial pneumonia, meningitis, and bloodstream infections.
  • ABCs Contributions: Provided critical data to support the introduction of pneumococcal conjugate vaccines (PCVs).

3.2. Group A Streptococcus (GAS)

  • Impact: Causes a range of illnesses, from strep throat to invasive infections like necrotizing fasciitis.
  • ABCs Contributions: Tracks emerging strains and antibiotic resistance.

3.3. Group B Streptococcus (GBS)

  • Impact: Leading cause of neonatal sepsis and meningitis.
  • ABCs Contributions: Informs guidelines for maternal screening and intrapartum antibiotic prophylaxis.

3.4. Haemophilus influenzae

  • Impact: Causes meningitis, bloodstream infections, and respiratory illnesses.
  • ABCs Contributions: Demonstrated the impact of the Haemophilus influenzae type b (Hib) vaccine.

3.5. Neisseria meningitidis

  • Impact: Causes meningitis and meningococcemia, with high mortality rates.
  • ABCs Contributions: Tracks serogroup distribution and informs vaccination strategies.

3.6. Bordetella pertussis (in selected sites)

  • Impact: Causes whooping cough, particularly severe in infants.
  • ABCs Contributions: Provides data to evaluate vaccine effectiveness and outbreak dynamics.

4. Data Utilization

4.1. Vaccine Development and Implementation

  • Data from ABCs played a pivotal role in introducing and expanding the use of vaccines, such as PCVs and Hib vaccines.
  • Monitors the long-term impact of vaccination programs.

4.2. Antimicrobial Resistance

  • Tracks trends in antibiotic resistance among bacterial pathogens.
  • Supports efforts to promote appropriate antibiotic use and develop new treatments.

4.3. Epidemiological Studies

  • ABCs data have been used in numerous studies to understand disease risk factors, clinical outcomes, and healthcare utilization.

5. Achievements of ABCs

5.1. Reduction in Disease Burden

  • Documented dramatic declines in invasive diseases caused by Streptococcus pneumoniae and Haemophilus influenzae following vaccine implementation.

5.2. Enhanced Outbreak Response

  • Provided rapid data to guide public health responses during meningococcal and pertussis outbreaks.

5.3. Global Impact

  • ABCs methods and findings have influenced international surveillance systems and vaccine strategies.

6. Challenges and Future Directions

6.1. Emerging Pathogens

  • Need for expanded surveillance to include other bacterial pathogens of public health importance.

6.2. Vaccine Hesitancy

  • Addressing declining vaccine uptake in certain populations.

6.3. Antimicrobial Resistance

  • Strengthening efforts to combat resistance through better data and public health interventions.

6.4. Leveraging Technology

  • Using advanced molecular techniques, such as whole-genome sequencing, to improve pathogen characterization.
  • Integrating electronic health records for more efficient data collection.

7. Global Relevance

Although ABCs is a U.S.-based system, its findings have global implications. Collaborations with international organizations, such as the World Health Organization (WHO), ensure that lessons learned are applied worldwide to reduce the burden of bacterial diseases.

Active Bacterial Core Surveillance (ABCs) is a cornerstone of public health efforts to combat invasive bacterial infections. By providing high-quality, population-based data, ABCs supports vaccine development, tracks antimicrobial resistance, and informs public health policies. As bacterial pathogens continue to evolve, ABCs remains a vital tool in safeguarding global health.

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Last Update: December 28, 2024