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  1. The National Antimicrobial Resistance Monitoring System

Panelist Comments on Questions Posed by NARMS

by Linda Youngman, Ph.D., Moderator

DR. YOUNGMAN: Now we get to the part where we start to talk about the panelists’ recommendations. And before I start that, I just want to say I have sensed over this past day and a half how much enthusiasm there is for NARMS from a lot of different people. And that is a good thing. I would like to build on that enthusiasm and just say that it is clear to me there are a lot of people who really are working very hard on NARMS and want it to become the best program it can possibly be. So we are really looking to your advice in helping us achieve that.

So if I can just run through the questions that we would like each of the panelists to consider individually. The first question that we posed to you was, is the current sampling process by FSIC adequate and effective for Salmonella surveillance? So this has to do with the animal isolates. Are these samples adequate and effective for campylobacter? There are possible concerns about campy dying. So are there better ways to get samples that are adequate and effective?

What other pathogens should or should not be isolated and susceptibility tested from the poultry rinsates? If additional sampling is suggested, please consider what we should stop doing since no additional funding is available for NARMS. So if we want to add new things, or embellish and existing program, it means that there are other things that we are already doing that we need to stop.

Are the current sampling strategies for the retail meat arm of NARMS adequate as currently conducted? Could we be doing a better job? Should we change our strategy on that?

Issue three, is reporting sufficient to be able to use data from the three arms effectively for public health surveillance? And how would you change the reports? So there are examples of reports out on the table here. So how would you change the reports to accomplish us being able to use data from the animals, from humans, from retail meat?

What should be retained, or what should be omitted, from future reports? How can we work toward those three reports being -- you know, for us to be able to use the data interchangeably between the three arms? What are the top three elements of a well coordinated collaboration for the molecular characterization of isolates from all three arms? We are doing that in all three arms so that we can demonstrate or refute a continuum from animal, food, and human origins for specific pathogens and/or resistant phenotypes.

The fifth question, how should NARMS be involved in international efforts? We heard a bit about that today and that is an area that is really critical to NARMS, in our opinion. And sixth, how do you suggest that we enhance and sustain funding for NARMS?

So, what I would like is to ask each panelist, in turn, if they could take say 15 minutes or so to respond to these six questions. I also want to start by thanking all of the presenters and attendees today, and the panelists. We really look forward to a vigorous discussion of the six questions that we posed, and also your comments on ways that we might be able to strengthen NARMS. We really want to do that, so we look forward to your comments today.

So if I could start with Sean Altekruse, if you could give us some of your comments on those six questions. Oh, sorry, did you have a comment before we started?

DR. KOTARSKI: Yes, I have a question about protocol. Would it be useful to go through one question at a time by the individual panelists, as opposed to going through all six over and over again?

DR. YOUNGMAN: We can do it that way if that is your preference. Okay, shall we start with the first question then?

DR. ALTEKRUSE: Could I make a suggestion related to protocol as well? And that is that since I am an FSIS employee, I think it might be interesting to hear from other members of the panel on this first issue before I said anything.


DR. VOGEL: I can start. Do you want to go this way?

DR. YOUNGMAN: All right, that is fine. Do you want to start Lyle?

DR. VOGEL: Before I start addressing the specific issue, I just want to get on the record that I hope whoever is looking at the transcript to develop the report for the Science Board will look at all the comments and questions that were asked by the panel members through yesterday and this morning. Because there were, I think, a lot of good points made on these issues, as well as others, by the panel members.

And I would hope that you don’t just concentrate on this session on developing the report for the Science Board, but look at the whole transcript for the whole two days.

DR. YOUNGMAN: Yes, that is a fair comment. We definitely will look at all the comments that have been made throughout the one and a half days.

DR. VOGEL: Thank you. And in that report -- I guess it is a protocol issue too -- is it possible that this panel can take a look at the draft of the report to the Science Board before it is submitted to make sure -- you know, sometimes I have trouble enunciating or making sure that I am saying things the way I really intend them to be meaningful. And I guess I would like to have an opportunity to make sure that my ideas and thoughts are captured correctly.

DR. YOUNGMAN: The plan is for the transcription of the day and a half’s proceedings to be put on our web page. And, certainly, you could have a look at that before it gets put on the web page to make sure we have accurately reflected what you said today.

DR. VOGEL: I am asking for a little more than that. For a look at the draft report for the Science Board.

DR. YOUNGMAN: I am not sure what the rules and regulations regarding that are. Certainly, if we can do, we will do.

DR. VOGEL: I appreciate the consideration of that.


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