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Table of Contents
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Introduction to NARMS
The National Antimicrobial Resistance Monitoring System – Enteric Bacteria (NARMS) was established in 1996 as a collaborative effort between the Food and Drug Administration's Center for Veterinary Medicine (FDA CVM), U.S. Department of Agriculture (USDA), and the Centers for Disease Control and Prevention (CDC). The NARMS program monitors changes in antimicrobial drug susceptibilities of selected enteric bacterial organisms in humans, animals, and retail meats to a panel of antimicrobial drugs important in human and animal medicine. Bacterial isolates are collected from human and animal clinical specimens, from healthy farm animals, and raw product from food animals. Retail meats collected from grocery stores were recently added to NARMS sampling. The primary objectives of NARMS include:
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To provide descriptive data on the extent and temporal trends of antimicrobial drug susceptibility in Salmonella and other enteric bacterial organisms from human and animal populations, as well as retail meats.
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To facilitate the identification of antimicrobial drug resistance in humans, animals, and retail meats as it arises;
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To provide timely information to veterinarians and physicians on antimicrobial drug resistance patterns.
Additionally, NARMS provides a national source of enteric bacterial isolates that are invaluable for research such as diagnostic test development, discovering new genes and molecular mechanisms associated with resistance, studying mobile gene elements, and for virulence and colonization studies.
The ultimate goal of these activities is to prolong the lifespan of approved drugs by promoting prudent and judicious use of antimicrobial drugs and to identify areas for more detailed investigation.
NARMS Program Highlights
The NARMS program consists of three areas or arms:
A pilot study of animal feed ingredients is also included in NARMS. Human-origin isolates are submitted by state and local public health laboratories across the country. All testing of human isolates is conducted at the National Center for Infectious Disease (NCID), CDC, in Atlanta , Georgia . Animal specimens for NARMS are collected from federally inspected slaughter and processing facilities, from healthy animals on farms, and from Veterinary Diagnostic Laboratories including USDA's National Veterinary Services Laboratories. These samples are then tested for antimicrobial drug susceptibility at the USDA, Agricultural Research Service's (ARS) Russell Research Center in Athens , Georgia . Animal and human isolates currently monitored in NARMS are non-typhoid Salmonella , Campylobacter , E. coli , and Enterococci. CDC also tests additional human isolates including Salmonella typhi, Listeria and Shigella . Susceptibility testing of Salmonella , Campylobacter , E. coli , and Enterococci isolates from Retail Meats and Animal Feed Ingredients is conducted at FDA, CVM's Office of Research Lab in Laurel , MD.
When the NARMS program began in 1996, Salmonella was the sentinel organism tested. NARMS results for Salmonella are available since 1997. The program has adapted to antimicrobial drug resistance research needs by adding different species of bacteria and antimicrobial drugs for evaluation. Campylobacter , E. coli , and Enterococci organisms were added to the testing program over time. Examples of program evolution include the following:
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In 2001, the NARMS program was expanded to include a pilot study of isolates from retail meats samples collected across the state of Iowa . Testing of Salmonella, Campylobacter , E. coli , and Enterococci isolates from the pilot study was conducted at the CVM's Office of Research Laboratory in Laurel , Md.
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In 2001, Listeria and Vibrio were added to list of human isolates tested by CDC.
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In January 2002, a FoodNet Retail Meat Surveillance study began in collaboration with states participating in the FoodNet program.
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A pilot study of animal feed ingredients collected at rendering plants across the country was also started in 2002.
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In January 2003, collection of human samples was expanded to all 50 states including three local health departments ( District of Columbia , Los Angeles County and New York City ).
The CDC and USDA provide the NARMS results annually in comprehensive summary reports. These reports are available on the CDC, USDA, and FDA/CVM web sites (see NARMS Data section below). An annual report describing results of the retail meat and animal feed ingredient testing is also planned. In addition, periodic public meetings are held to present NARMS results and provide a forum for presentation of other related antimicrobial resistance research.
NARMS Data
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NARMS Executive Report
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Human - CDC NARMS Human Data
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Animal – USDA NARMS Animal Data
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Retail Meat
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NARMS Retail Meat Annual Report, 2006 (NOTE: The full 2006 report is approximately 4.5 megabytes and has been broken down to allow easier access to tables, figures, and appendices. It takes between 8-11 minutes to download a one megabyte file using the average dial up internet connection.)
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NARMS Retail Meat Annual Report, 2005 (NOTE: The full 2005 report is approximately 11 megabytes and has been broken down to allow easier access to tables, figures, and appendices. It takes between 8-11 minutes to download a one megabyte file using the average dial up internet connection.)
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NARMS Retail Meat Annual Report, 2004 (NOTE: The full 2004 report is approximately 82.2 megabytes and has been broken down to allow easier access to tables, figures, and appendices. It takes between 8-11 minutes to download a one megabyte file using the average dial up internet connection.)
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NARMS Retail Meat Annual Report, 2003 (NOTE: The full 2003 report is approximately 50.1 megabytes and has been broken down to allow easier access to tables, figures, and appendices. It takes between 8-11 minutes to download a one megabyte file using the average dial up internet connection. All the tables, figures, appendices are provided in Adobe Arobat file format (.pdf))
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NARMS Retail Meat Annual Report, 2002
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Iowa Pilot Study
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FoodNet Retail Meat
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Animal Feed Ingredient Data - (will be posted at a future date)
NARMS Public Meetings
Science Board to the Food and Drug Administration, Public Advisory Committee Meeting
Gaithersburg Hilton, Gaithersburg, MD
December 3, 2007
FDA Science Board Advisory Committee Subcommittee Public Meeting on NARMS
April 10, 2007
Expert Reviews on the NARMS Program, June 23-24, 2005
The National Antimicrobial Resistance Monitoring System (NARMS) program was developed in 1996 to monitor changes in susceptibility of select bacteria to antimicrobial agents of human and veterinary importance and is a collaboration between three federal agencies including FDA’s Center for Veterinary Medicine (CVM), the Centers for Disease Control and Prevention (CDC) and the U.S. Department of Agriculture (USDA). NARMS also collaborates with antimicrobial resistance monitoring systems in other countries, including Canada, Denmark, France, the Netherlands, Norway, Sweden and Mexico so that information can be shared on the global dissemination of antimicrobial resistant foodborne pathogens.
Epidemiological and microbiological research studies are conducted within each agency or between agencies on isolates of special interest such as those of a particular serotype or expressing a particular resistance pattern. Currently each NARMS agency prepares a comprehensive annual report with a large quantity of data available on each agencies website. Data and targeted research studies are reported at scientific meetings and published in peer reviewed scientific journals.
The NARMS program is yielding information that is valuable in identifying the source and magnitude of antimicrobial resistance in the food supply and is important for the development of public health recommendations for the use of antimicrobial drugs in humans and food animals. Since its inception in 1996, NARMS continues to expand and improve. On June 23-24, 2005, CVM met with outside experts in Rockville, Maryland to obtain individual authoritative opinions on key elements and future directions of the NARMS program.
FDA has already begun implementation of several of these recommendations. In addition, NARMS is currently being reviewed by the FDA Science Board in FY 2006.
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2004 National Antimicrobial Resistance Monitoring System – Enteric Bacteria (NARMS) Scientific Meeting, March 4-5, Decatur , Ga.
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2002 National Antimicrobial Resistance Monitoring Systems (NARMS) Scientific Meeting, Hilton Head, SC, November 19-22, 2002
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2001 National Antimicrobial Resistance Monitoring System (NARMS) Scientific Meeting; Public Meeting, March 15 and 16, 2001 Rockville , Md.
NARMS Presentations
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Presentations from the FDA sponsored NARMS Scientific Meeting, March 2001
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Presentations from the CDC sponsored NARMS Scientific Meeting, March 2004
NARMS Publications
NARMS Point of Contact
Dr. David G. White
Director, National Antimicrobial Resistance Monitoring System (NARMS)
U.S. Food and Drug Administration
Center for Veterinary Medicine
Email: David.White@FDA.HHS.GOV
Web Page Updated by hd - October 10, 2008, 2:33 PM ET
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