American Journal of Epidemiology Vol. 154, No. 11 : 1000-1005
Copyright © 2001 by The Johns Hopkins University School of Hygiene and Public Health
ORIGINAL CONTRIBUTIONS |
Evaluation of Innovative Surveillance for Drug-resistant Streptococcus pneumoniae
1 Epidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, GA.
2 Communicable and Environmental Disease Services, Tennessee Department of Health, Nashville, TN.
3 Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, TN.
4 Knox County Health Department, Knoxville, TN.
To monitor disease incidence and antibiotic resistance, effective, practical surveillance strategies are needed at the local level for drug-resistant Streptococcus pneumoniae (DRSP). Knox County, Tennessee, participates in three forms of DRSP surveillance: an active system sponsored by the Centers for Disease Control and Prevention (CDC; Atlanta, Georgia); a novel county-sponsored system; and conventional state-mandated reporting. Ascertainment of invasive S. pneumoniae infection cases by each system in 1998 was evaluated, and completeness of reporting, antibiotic resistance patterns, costs, and other attributes were compared. The county-sponsored system collects patient identifiers and drug susceptibility data directly from hospital laboratories, whereas the CDC-sponsored system performs medical chart abstractions and reference laboratory susceptibility testing. Similar numbers of invasive S. pneumoniae cases were detected by the county-sponsored (n = 127) and CDC-sponsored (n = 123) systems; these systems held >75% of all cases in common, and each system achieved >85% sensitivity. Conventional reporting contained 88% and 76% of the DRSP cases identified by the county- and CDC-sponsored systems, respectively, but did not capture infections produced by susceptible isolates. Both the county- and CDC-sponsored systems indicated that large proportions of isolates were resistant to penicillin and extended-spectrum cephalosporins. The county-sponsored DRSP surveillance system was inexpensive, simple to execute, and relevant to local needs.
community-acquired infections; drug resistance, microbial; epidemiologic methods; laboratories, hospital; microbial sensitivity tests; pneumococcal infections; population surveillance; Streptococcus pneumoniae
Abbreviations: ABCs, Active Bacterial Core surveillance; CDC, Centers for Disease Control and Prevention; DRSP, drug-resistant Streptococcus pneumoniae; MIC, minimum inhibitory concentration
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