The U.S. Food and Drug Administration, in cooperation with the Centers for Disease Control and Prevention (CDC) and the U.S. Department of Agriculture’s Food Safety and Inspection Service (USDA-FSIS), its partners in the National Antimicrobial Resistance Monitoring System (NARMS), released the 2016-2017 NARMS Integrated Summary. The new streamlined format will replace the annual NARMS Integrated Reports and enable NARMS partners to issue more timely public updates in the future. [Source: FDA 22 November 2019]
The NARMS Integrated Summary draws upon antimicrobial resistance patterns in bacteria isolated from humans (by CDC), raw retail meats (by FDA), and animals at slaughter (by USDA) to provide key takeaways on rates of resistance to the most important antimicrobial agents.
NARMS continues to share its data in interactive displays that allow users to access the full data set and explore the dynamics of antimicrobial resistance and the genes involved.
This 2016-2017 Integrated Summary is the first time NARMS has included data on animal pathogens from a pilot study with FDA’s Veterinary Laboratory Investigation and Response Network (Vet-LIRN). In addition, this summary is the first time that NARMS will provide genomic information for Campylobacter and E. coli retail meat and food animal isolates. Up to this point, this information was only available for Salmonella.
Findings
The points listed below describe a selection of notable observations from the 2016-2017 NARMS data:
1. Salmonella resistance to third-generation cephalosporins, fluoroquinolones, or azithromycin has increased. This is concerning as these drugs are considered first-line therapies to treat complicated infectious diarrhea in humans. The rise in Salmonella resistance to these drugs means that treatment with them may not always work.
2. No resistance to carbapenems was observed among Salmonella isolates from humans, retail meats, and animals. This is important as carbapenems are typically reserved to treat suspected multi-drug resistant infectious diarrhea. In the U.S., carbapenems are not used in food animal production, however due to their importance in human health, they are monitored by NARMS.
3. Rates of macrolide and fluoroquinolone resistance remain relatively unchanged in Campylobacter jejuni isolated from humans and chickens, and in Campylobacter coli isolated from cattle and swine. While it is positive that these rates of resistance did not increase, the rates of macrolide resistance in Campylobacter isolated from swine and fluoroquinolone resistance in Campylobacter isolated from cattle warrant further monitoring.
What’s Next
Moving forward, NARMS is adopting more efficient data reporting procedures to reduce the time between collecting a sample and publishing the results. For the NARMS bacteria, resistance can be accurately predicted from the whole genome sequence data. On a regular basis, predicted resistance data will be uploaded into NARMS Now, and the sequences will be added to the National Center for Biotechnology Information (NCBI) web database continuously.