ABCs Report: Streptococcus pneumoniae, 1997

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Active Bacterial Core Surveillance (ABCs): Emerging Infections Program Network

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ABCs Areas

California (San Francisco County); Connecticut; Georgia (20 county Atlanta area); Maryland (6 county Baltimore area); Minnesota (7 county Twin Cities area); Oregon (3 county Portland area); Tennessee (5 urban counties)

ABCs Population

The surveillance areas represent 16,073,596 persons. Source: U.S. Bureau of the Census, 1997

ABCs Case Definition

Invasive pneumococcal disease: isolation of Streptococcus pneumoniae from normally sterile site in resident of a surveillance area in 1997.

ABCs Methodology

Project personnel communicated at least monthly with contacts in all microbiology laboratories serving acute care hospitals in their area to identify cases. Standardized case report forms that include information on demographic characteristics, clinical syndrome, and outcome of illness were completed for each identified case. Pneumococcal isolates were collected and tested for susceptibility at reference laboratories using NCCLS methods. Regular laboratory audits assess completeness of active surveillance and detect additional cases.

All rates of invasive pneumococcal disease were calculated using U.S. Bureau of the Census postcensal population estimates for 1997. For national projections of cases, race and age-specific rates of disease were applied from the aggregate surveillance area to the age and racial distribution of the 1997 U. S. population. Cases with unknown race were distributed by area based on reported race distribution for known cases within the seven age categories.

Reported ABCs Profiles

Race	No.	(Rate^*)
White	2,394	(19.1)
Black	1,375	(49.3)
Other	64	(8.5

Unknown race (n=435) distributed among knowns.

^* Cases per 100,000 population for ABCs areas.

Ethnicity	No.	(Rate^*)
Hispanic	112	(16.2)
Non-Hispanic	1,552	------
Unknown	2,169	------

*Cases per 100,000 population for ABCs areas

Citation

Centers for Disease Control and Prevention. 1998. Active Bacterial Core Surveillance Report, Emerging Infections Program Network, Streptococcus pneumoniae, 1997.

Age (years)	Cases No. (Rate^*)	Deaths No. (Rate^*)
<1	320 (142.9)	9 (4.02)
1	396 (178.7)	2 (0.90)
2-4	208 (31.0)	1 (0.15)
5-17	137 (4.8)	4 (0.14)
18-34	379 (9.3)	21 (0.52)
35-49	764 (18.9)	67 (1.65)
50-64	510 (23.5)	59 (2.72)
≥ 65	1,119 (61.7)	200 (11.02)
Total	3,833 (23.8)	363 (2.26)

^*Cases or deaths per 100,000 population for ABCs areas

Syndrome	No.	(%^*)
Meningitis	183	(4.8)
Bacteremia without focus	1,506	(39.3)
Bacteremic pneumonia	2,011	(52.5)

^*Percent of cases

Antibiotic Susceptibility	S* %	I^† %	R^‡ %
Penicillin	75.0	11.4	13.6
Cefotaxime	87.0	7.9	5.1
Erythromycin	85.0	0.1	14.9
TMP/Sulfa	70.7	6.3	23.0
Ofloxacin	96.3	3.4	0.3
Vancomycin	100.0	0.0	0.0

Based on reference lab testing of 3,238 isolates.

^* Susceptible; ^† Intermediate; ^‡ Resistant

National Projections of Invasive Disease

Cases: 61,800 (23.1/100,000)
Deaths: 6,100 (2.27/100,000)

Healthy People 2010 Update

Objective: Decrease the incidence of invasive pneumococcal infections to 50 per 100,000 persons less than 5 years of age and to 46 per 100,000 persons aged 65 and older.