Drug-resistant Streptococcus pneumoniae and Methicillin-resistant Staphylococcus aureus Surveillance1

Conference Summary Drug-resistant Streptococcus pneumoniae and Methicillin-resistant Staphylococcus aureus Surveillance 1 The Centers for Disease Control and Prevention (CDC) convened a conference on March 12–13, 2003, in Atlanta, Georgia, to discuss improving state-based surveillance of drug-resistant Streptococcus pneumoniae (DRSP) and methicillin-resistant Staphylococcus aureus (MRSA). The Council of State and Territorial Epidemiologists, the Association of Public Health Laboratories, and CDC co-sponsored the conference; 120 participants from 38 states attended. The conference was organized by the Divisions of Healthcare Quality Promotion and Bacterial and Mycotic Diseases, National Center for Infectious Diseases, CDC. Goals of the meeting included 1) reviewing the rationale for surveillance of DRSP and MRSA, 2) presenting scientific studies highlighting valid and meaningful methods of performing state-level surveillance, 3) sharing state-level surveillance experiences, and 4) identifying unmet needs of the state health departments in performing such surveillance. The primary theme of the conference general sessions was the public health impact of DRSP and MRSA and the need for accurate surveillance data to track and monitor resistance trends. S. pneumoniae is a major cause of respiratory infections in the United States. Since the early 1990s, the prevalence of resistance to single and multiple antibiotics has been increasing in pneumococci. Antimicrobial drug resistance in S. pneumoniae can vary among populations and is influenced by local prescribing practices and the prevalence of resistant clones. Conference pre-senters discussed the role of surveillance in raising awareness of the resistance problem and in monitoring the effectiveness of prevention and control programs. National-and state-level epidemiologists discussed the benefits of including state-level surveillance data with appropriate antibiotic use programs designed to address the antibiotic prescribing practices of clinicians. The potential for local surveillance to provide information on the impact of a new pneumococcal vaccine for children was also examined ; the vaccine has been shown to reduce infections caused by resistance strains Since the early 1990s, S. aureus infections resistant to oxacillin (MRSA) have increased steadily. Several scientists reported two recent changes in the epidemiology of MRSA: its emergence in persons without established risk factors and the emergence of vancomycin-resistant S. aureus (VRSA). These new developments underscore the need for scientifically valid, yet financially feasible, state-based surveillance that will aid in understanding the changing epidemiology of MRSA disease. Such understanding will allow effective implementation of MRSA prevention and control programs. Prevention programs will differ on the basis of which populations are most affected (long-term care, community, and hospice). …