Alaska Invasive Bacterial Disease Surveillance Report Streptococcus pneumoniae – 2014

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Background

AIP has conducted statewide surveillance of invasive Streptococcus pneumoniae since 1986.  Beginning in January 2007, invasive S. pneumoniae became a reportable condition to the State of Alaska Division of Public Health (DPH).  Reports of cases of disease caused by this organism are shared between AIP and DPH.

Population

The population of the State of Alaska in 2014 was 737,354; 143,367 (19%) were Alaska Native people.  Source:  AK Dept. of Labor & Workforce Development population estimates.

Case Definition

An isolate of Streptococcus pneumoniae from a normally sterile site that has been taken from a resident of Alaska.

Methods

Participating laboratories send isolates recovered from sterile sites to the AIP laboratory in Anchorage; materials and forms for isolate shipment and data collection are provided to each laboratory by AIP.  Demographic and clinical information on the cases are collected from a review of medical records.  Annually, AIP asks that each laboratory review their records and provide information on any cases that may have been overlooked.

Invasive Streptococcus pneumoniae Cases by Race – Alaska, 2014

Race Cases
n (%)
Age Adjusted Rate* % Male Deaths
n (%)
Alaska Native 36 (42) 27.8 67% 5 (14)
Non-Native† 49 (58)† 7.4 61% 6 (12)
Total 85 64% 11 (13)

*Cases per 100,000 per percent distribution of Alaska 2010 population
†Includes 3 cases for which race was unknown

Invasive Streptococcus pneumoniae, Cases & Rates by Age Group & Race – Alaska, 2014

Alaska Native Non-Native
Age (years) No. Cases Rate* No. Cases Rate*
<2 4 70.1 4 25.9
2-4 2 21.5 1 4.4
5-18 0 0 0 0
19-54 10 15 14 4.6
55-64 10 74.6 14 16.6
65+ 10 100.6 16 26.1
Total 36 25.1 49 8.3

*Cases per 100,000 population

Invasive Streptococcus pneumoniae, Clinical Presentations – Alaska, 2014

No. %*
Pneumonia with bacteremia 56 66
Bacteremia 20 24
Empyema 2 2
Meningitis 1 1

*Percent of cases

Antibiotic Resistance in Invasive Streptococcus pneumoniae Isolates – Alaska, 2014

Antibiotic S*% I†% R‡%
Penicillin 88 4 8
TMP-sulfa 88 9 3
Erythromycin 76 0 24
Ceftriaxone 93 4 3
Tetracycline 92 0 8
Chloramphenicol 96 0 4
Vancomycin 100 0 0
Levofloxacin 100 0 0
Clindamycin 92 0 8

*Susceptible, †Intermediate, ‡Resistant based on year 2014 CLSI definition

Proportion of Invasive Isolates Contained in the PCV13 Vaccine by Age Group – Alaska, 2014

Age (yrs) Total (%)
<2 0 (0%) of 8
2-4 2 (67%) of 3
5+ 10 (16%) of 74
Total 12 (14%) of 85