Animal & Veterinary
NARMS 2004 Executive Report - Introduction
A. Executive Report
This report summarizes in an integrated format, National Antimicrobial Resistance Monitoring System data on Salmonella and Campylobacter isolates recovered in 2004 from food animals at federally inspected plants, retail meats, and humans. The report also includes susceptibility data on Escherichia coli isolates recovered from retail meats and chickens in 2004. For comparison purposes, summary data from prior years are included.
Suggested Citation: FDA. National Antimicrobial Resistance Monitoring System – Enteric Bacteria (NARMS): 2004 Executive Report. Rockville, MD: U.S. Department of Health and Human Services, Food and Drug Administration, 2008.
B. NARMS Program
The National Antimicrobial Resistance Monitoring System – Enteric Bacteria (NARMS) is a national public health surveillance system in the United States that tracks changes in the susceptibility of certain enteric bacteria to antimicrobial agents of human and veterinary medical importance. The NARMS program was established in 1996 as a collaboration between three federal agencies: the U.S. Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), and the U.S. Department of Agriculture (USDA). NARMS also collaborates with scientists involved in antimicrobial resistance monitoring in other countries, including Canada, Denmark, France, Germany, Greece, Italy, Mexico, the Netherlands, Norway, Sweden, and the United Kingdom, so that information can be shared on the global dimensions of antimicrobial resistance in foodborne bacteria.
NARMS monitors antimicrobial susceptibility among enteric bacteria from humans, retail meats, and food animals. Surveillance is conducted for two categories of enteric bacteria: zoonotic bacterial pathogens (Salmonella and Campylobacter) and other bacteria (Escherichia coli and Enterococcus). Salmonella was chosen as the sentinel pathogen for the NARMS program at its inception in 1996. Campylobacter was later added, followed by E. coli and Enterococcus. Monitoring of E. coli and Enterococcus isolates was added due to their ubiquitous presence in animals, foods, and humans and their potential to serve as reservoirs of antimicrobial resistance genes for bacterial pathogens. NARMS also examines Salmonella and Campylobacter isolates for genetic relatedness using pulsed-field gel electrophoresis (PFGE). In addition, NARMS conducts epidemiologic and microbiologic research studies. These studies may include isolates of a particular serotype or those exhibiting a particular resistance pattern or they may focus on improving the culture, isolation, or antimicrobial susceptibility testing methodology of target bacteria. Comprehensive annual NARMS reports are published by CDC, FDA, and USDA. In addition, NARMS data and directed research studies are reported at scientific meetings and published in peer-reviewed scientific journals.
As a public health monitoring system, the primary objectives of NARMS are to:
- Provide data on the extent and temporal trends of antimicrobial resistance in zoonotic foodborne bacterial pathogens and select commensal organisms to veterinarians, physicians, public health authorities, and other stakeholders
- Provide a platform for research studies to better understand the emergence and spread of antimicrobial resistance and assist in the development of science-based strategies to contain or mitigate resistance
- Assist the FDA in making decisions related to the approval of safe and effective drugs for humans and animals, as well as to promote judicious use of antimicrobial drugs
C. NARMS Components
The NARMS program has three components or “arms” which are briefly described below.
1. Human Component
The human component of NARMS was launched in 1996 within the framework of CDC’s Emerging Infections Program and the Foodborne Diseases Active Surveillance Network (FoodNet). Antimicrobial susceptibility testing of NARMS human isolates is performed at CDC’s
laboratories in the National Center for Zoonotic, Vector-Borne, and Enteric Diseases (NCZVED) in Atlanta, Georgia.
The program initially included non-Typhi Salmonella and E. coli O157:H7 isolates from 14 state and local health departments. It later expanded to include additional bacteria and testing sites. In 1997, testing was expanded to include monitoring of resistance among Campylobacter isolates from humans in five sites participating in FoodNet. In 1999, testing of Salmonella Typhi and Shigella isolates was added. Since 2003, all 50 states have been forwarding to CDC a representative sample of non-Typhi Salmonella, Salmonella Typhi, Shigella, and E. coli O157 isolates for antimicrobial susceptibility testing. Testing of Campylobacter also expanded over time and in 2004, 10 FoodNet states participated in Campylobacter surveillance.
An enterococci resistance study began in 2001 to monitor antimicrobial resistance among enterococci isolated from human stool samples. Stool samples were collected from outpatients at four sites and healthy volunteers at one site. An E. coli component was added to the study in 2004. Stool specimens for the E. coli study were from outpatients at two sites.
2. Retail Meat Component
The retail meat component of NARMS was launched in 2002, following a 15-month pilot study in Iowa. Retail meat surveillance is conducted through an ongoing collaboration between FDA’s Center for Veterinary Medicine (CVM), CDC, and FoodNet laboratories. Participating FoodNet sites purchased chicken breasts, ground turkey, ground beef, and pork chops at retail stores and cultured them for Salmonella and Campylobacter. Four sites also cultured retail meats for E. coli and Enterococcus. Bacterial identification and antimicrobial susceptibility testing of retail meat isolates was performed at CVM’s Office of Research in Laurel, Maryland.
3. Animal Component
The animal component of NARMS was launched in 1997 after pilot studies were conducted in 1995 and 1996. Antimicrobial susceptibility testing of animal isolates is conducted at the USDA’s Agricultural Research Service (ARS) Bacterial Epidemiology and Antimicrobial Resistance Research Unit at the Russell Research Center in Athens, Georgia.
Salmonella isolates recovered from chickens, turkeys, cattle, and swine at slaughter were submitted to the NARMS program through the USDA Food Safety and Inspection Service (FSIS) Pathogen Reduction/Hazard Analysis and Critical Control Point (PR/HACCP) verification testing program. Salmonella isolates from USDA baseline studies, ready-to-eat sampling programs, and diagnostic and on-farm sources were also tested, but data on these isolates are not included in this report. The program was later expanded to include monitoring of resistance among Campylobacter (1998), E. coli (2000), and Enterococcus (2003) isolates from chicken carcass rinsates collected at slaughter for the PR/HACCP verification testing program.
D. Links to Additional Information
Additional information about NARMS, including comprehensive annual reports for each NARMS component, can be found on the CDC, FDA, and USDA websites listed below. The FDA website also contains a link to this Executive Report and the NARMS 2003 Executive Report.
Information about the Foodborne Diseases Active Surveillance Network (FoodNet) can be found on the following CDC website: http://www.cdc.gov/foodnet/