Methodology - Objectives

Overall Objectives

• To determine the incidence and epidemiologic characteristics of invasive disease due to Haemophilus influenzae, Neisseria meningitidis, group A Streptococcus, group B Streptococcus, Streptococcus pneumoniae and methicillin-resistant Staphylococcus aureus in multiple large diverse U.S. populations
• To determine molecular epidemiologic patterns and microbiologic characteristics of public health relevance for isolates causing the above invasive infections
• To provide an infrastructure for further research, such as special studies aimed at identifying risk factors for disease, post-licensure evaluation

Pathogen-Specific Objectives

Group A Streptococcus (GAS)

• To determine the distribution of emm types and the association between specific emm types and disease severity in order to guide vaccine development
• To track antimicrobial resistance among invasive GAS isolates
• To identify potentially modifiable risk factors for community-acquired GAS infections and to identify potentially preventable nosocomial GAS infections such as postpartum and post-surgical infections

Group B Streptococcus (GBS)

• To assess the impact of CDC prevention guidelines issued in 2002 recommending universal prenatal screening
• To determine the extent to which continuing cases of early-onset GBS disease are preventable through current prevention strategies
• To monitor the impact of intrapartum prophylaxis on resistance and non-GBS neonatal sepsis
• To identify serotypes responsible for disease in order to guide vaccine development
• To characterize invasive GBS disease epidemiology and trends in other age groups, particularly late-onset neonatal disease and adult disease.

Haemophilus influenzae

• Determine the incidence and epidemiologic characteristics of invasive Haemophilus influenzae disease
• Monitor impact of the Haemophilus influenzae type b vaccination program
• Detect possible emergence of disease due to non-b Haemophilus influenzae
• Determine appropriate verification and validation criteria for serotyping

Neisseria meningitidis

• To evaluate effectiveness of meningococcal conjugate vaccines and impact on disease burden and herd immunity
• To evaluate the impact of meningococcal conjugate vaccines including changes in molecular epidemiology
• To evaluate and validate molecular methods to determine or confirm serologic results
• To evaluate trends in molecular subtypes and the emergence of antimicrobial resistance

Streptococcus pneumoniae

• To track emerging antimicrobial resistance in pneumococcal isolates
• To evaluate the impact of new pneumococcal conjugate vaccines for infants on disease burden and on antimicrobial resistance
• To evaluate prevention among the elderly through pneumococcal polysaccharide vaccine use

Methicillin-resistant Staphylococcus aureus (MRSA)

• To determine the incidence and epidemiologic characteristics of invasive disease due to MRSA in diverse geographic areas and to categorize as healthcare-associated or community-associated
• To determine the molecular epidemiologic patterns and microbiologic characteristics of healthcare-associated and community-associated MRSA

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