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The National Antimicrobial Resistance Monitoring System (NARMS) : 

The National Antimicrobial Resistance Monitoring System (NARMS) Dr. David G. White Center for Veterinary Medicine U.S. FDA Food Safety Summit on Attributing Illness to Food April 5th, 2007

NARMS: 

The National Antimicrobial Resistance Monitoring System (NARMS) is a national collaborative network between the FDA, CDC and USDA as well as public health laboratories in all 50 states and local health departments in three major cities NARMS was developed to monitor changes in susceptibility/resistance of select zoonotic bacterial pathogens and commensal organisms recovered from animals, retail meats and humans to antimicrobial agents of human and veterinary importance NARMS monitors susceptibility/resistance phenotypes using three testing sites including: FDA/CVM (retail meat and poultry) CDC (humans) USDA (animal/slaughter) NARMS

NARMS/Retail Meats Sampling: 

NARMS/Retail Meats Sampling 10 FoodNet sites Similar sampling scheme Random sampling of stores Each site purchases 10 packages each of chicken breasts, pork chops, ground turkey, and ground beef All ten sites culture meat and poultry rinsates for Salmonella and Campylobacter In addition, four sites (GA, MD, OR and TN) culture rinsates for E. coli and Enterococcus Isolates are sent to FDA-OR for confirmation of identification and antimicrobial susceptibility testing

NARMS Retail meats sampled : 

NARMS Retail meats sampled 2002, 6 states; 2003, 8 states; 2004, 2005 and 2006, 10 states 2002 2003 2004 2005 2006 Chicken breast 616 897 1172 1194 1068 Ground turkey 642 857 1165 1195 1056 Ground beef 642 880 1186 1196 1070 Pork chop 613 899 1176 1196 1062 Total 2513 3533 4699 4781 4256* Salmonella and Campylobacter *Preliminary data for 2006

NARMS/Retail food preliminary data Salmonella 2002 - 2006 : 

NARMS/Retail food preliminary data Salmonella 2002 - 2006 2002, 6 FoodNet sites, n = 153 2003, 8 FoodNet sites, n = 212 2004, 10 FoodNet sites, n = 324 2005, 10 FoodNet sites, n = 353 2006, 10 FoodNet sites, n = 290* Preliminary data

Slide6: 

Total Number of Salmonella and Serotypes Isolated in 2004 NA = not applicable

Slide7: 

Top 5 Serotypes among Human and Retail Poultry Isolates, 2004 *S. Typhimurium includes Typhimurium var. 5- Other top 10 serotypes that are common among human and retail poultry isolates: Human and Chicken Breast S. Enteritidis S. Montevideo Human and Ground Turkey S. Saintpaul

Slide8: 

a=previously copenhagen NARMS Slaughter Salmonella Data

Slide9: 

Antimicrobial Resistance Phenotypes among Salmonella Isolates: NARMS, 2004 *No CLSI breakpoint All isolates were susceptible to amikacin * N = 2097 isolates; Human, n = 1798; Chicken breast, n = 157; Ground turkey, n = 142

Gentamicin and Ceftiofur Resistance among Salmonella by Source, NARMS 2004: 

Gentamicin and Ceftiofur Resistance among Salmonella by Source, NARMS 2004 GENR = 57 isolates; TIOR = 106 isolates N = 2097 isolates; Human, n = 1798; Chicken breast, n = 157; Ground turkey, n = 142

Gentamicin and Ceftiofur Resistance among Salmonella Typhimurium by Source, NARMS 2004: 

Gentamicin and Ceftiofur Resistance among Salmonella Typhimurium by Source, NARMS 2004 GENR = 9 isolates; TIOR = 41 isolates N = 437 isolates; Human, n = 386; Chicken breast, n = 49; Ground turkey, n = 2 2.1% 2% 4.4% 49%

Gentamicin and Ceftiofur Resistance among Salmonella Heidelberg by Source, NARMS 2004: 

Gentamicin and Ceftiofur Resistance among Salmonella Heidelberg by Source, NARMS 2004 GENR = 20 isolates; TIOR = 14 isolates N = 162 isolates; Human, n = 94; Chicken breast, n = 31; Ground turkey, n = 37

NARMS/PulseNet: 

NARMS/PulseNet Salmonella and Campylobacter isolates undergo further molecular characterization PFGE analysis Follow CDC guidelines for PFGE analysis Data is shared with PulseNet CVM PulseNet database has more than 7,000 data entries, including 4,015 Salmonella 432 E. coli 2,646 Campylobacter 69 Vibrio Isolates can be used for future research projects biosource tracking experiments Virulence studies Antimicrobial resistance studies

NARMS Executive Reports: 

NARMS Executive Reports First Executive NARMS report released summarizes 2003 data from FDA, USDA, CDC in single report Link on CVM’s Web site www.fda.gov/cvm Working on 2004 report

Evaluating the Safety of Antimicrobial New Animal Drugs with Regard to Their Microbiological Effects on Bacteria of Human Health Concern, GFI #152: 

Evaluating the Safety of Antimicrobial New Animal Drugs with Regard to Their Microbiological Effects on Bacteria of Human Health Concern, GFI #152 Part of human food safety evaluation on antimicrobial use impacts on resistant pathogenic, zoonotic bacteria (e.g. Salmonella, E. coli, Campylobacter, etc.). October 23, 2003 Human exposure through ingestion of animal-derived food Approach applies to therapeutic and non-therapeutic antimicrobial drugs intended for food-producing animals Qualitative risk assessment approach Based on OIE Ad Hoc Group on Antimicrobial Resistance process Possible risk management steps range from denying the drug approval application to approving the application under various use conditions that assure the safe use of the product

Slide16: 

FDA Dr. Beth Karp Dr. Elvira Hall-Robinson Dr. Heather Harbottle Dr. Patrick McDermott Dr. Terry Proescholdt Dr. Robert Walker Dr. Antoinette Walker Dr. Marleen Wekell CDC Lauren Stancik-Rosenthal Felicita Medalla Dr. Tom Chiller Dr. Fred Angulo Dr. Ezra Barzilay Dr. Jean Whichard FDA Jason Abbott Sherry Ayers Karen Blickenstaff Sonya Bodeis-Jones Peggy Carter Patti Cullen Linda English Sharon Friedman Althea Glenn Susannah Hubert Stuart Gaines Shawn McDermott Sadaf Qaiyumi Amanda Stearns FoodNet EIP funded sites CDC PulseNet USDA - Dr. Paula Fedorka-Cray Acknowledgements

Thank You: 

Thank You Go to the CVM Website for the most current information www.fda.gov/cvm For the invitation to this valuable meeting Appreciate this chance to participate