Submitted to: Meeting Abstract
Publication Type: Proceedings
Publication Acceptance Date: 4/10/2007
Publication Date: 4/10/2007
Citation: Cray, P.J. 2007. Narms update – animal arm. Food and Drug Administration Science Board Meeting. April 10, 2007. Rockville, MD. Interpretive Summary:
Technical Abstract: In the 1990’s, Because of the public health concerns associated with the use of antimicrobials in livestock were increasing, and the potential utility of antimicrobial susceptibility testing for monitoring trends in antimicrobial resistance development was recognized. To meet this challenge, an antimicrobial resistance-monitoring program was initiated by the Food and Drug Administration’s (FDA) Center for Veterinary Medicine in collaboration with other agencies, in particular as a post-marketing activity to help ensure the continued safety and efficacy of veterinary antimicrobials, especially fluoroquinolones. This program was developed as a post-marketing activity to help ensure the continued safety and efficacy of veterinary antimicrobials, especially fluoroquinolones. Thus, in 1996, FDA, the Department of Agriculture (USDA), and the Centers for Disease Control and Prevention (CDC) initiated the National Antimicrobial Resistance Monitoring System - Enteric Bacteria (NARMS) to prospectively monitor changes in antimicrobial susceptibilities of zoonotic pathogens from human and animal diagnostic specimens, from healthy farm animals, and from raw product collected from federally inspected slaughter and processing plants. Non-typhoid Salmonella was selected as the sentinel organism. Additional organisms were added to the program, and NARMS currently monitors antimicrobial susceptibility in non-typhoid Salmonella, Escherichia coli, Campylobacter, and Enterococcus in humans and animals. Salmonella Typhi and Listeria, Vibrio and Shigella isolates collected from humans are also tested by CDC and the program has expanded to include testing of isolates from retail meat (FDA). The animal arm of NARMS resides at the USDA-Agricultural Research Service (ARS) laboratory in Athens, Georgia, while the human arm resides at the CDC in Atlanta, Georgia, and the retail arm resides at the FDA-OR in Laurel, Maryland. Objectives: The goals and objectives of the monitoring program are to: • provide descriptive data on the extent and temporal trends of antimicrobial susceptibility in Salmonella and other enteric organisms from the human and animal populations; • facilitate the identification of resistance in humans and animals as it arises; • provide timely information to veterinarians and physicians; • prolong the life span of approved drugs by promoting the prudent and judicious use of antimicrobials; and • identify areas for more detailed investigation. Program information may be accessed at: http://www.fda.gov/cvm/narms_pg.html. Additional information on results from the animal isolate testing, including percent resistance by animal species for each year testing has been conducted, can be found at http://www.ars.usda.gov/Main/docs.htm?docid=6750. Impact: Use of the information will be targeted to redirecting drug use to diminish the development and spread of resistance. Outbreak investigations and field studies will be initiated as a result of major shifts or changes in resistance patterns in either animal or human isolates, since the information generated from NARMS, or any monitoring system, is descriptive only and does not address attribution and/or etiology of observed changes. Research will fill known information gaps and clarify observational discrepancies. In addition, the NARMS isolates are invaluable for other research areas including development of diagnostic tests, the study of molecular mechanisms of resistance, gene flow and population genetics, and for virulence and in vivo colonization studies. An up-to-date review of the data will be presented.