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The National Antimicrobial Resistance Monitoring System strategic plan 2021-2025
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August 13, 2020
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Alternative Title:NARMS
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Description:Antimicrobial resistance (AMR) has been ranked by the World Health Organization as one of the top global health challenges. Reducing human exposure to antimicrobial resistant microorganisms and their resistance determinants is key to reducing the burden of antimicrobial resistant infections, and food is a potential source of human exposure. An antimicrobial resistance monitoring system is required to track resistance among different population groups and in different settings over time, detect new resistance types, reveal the underlying determinants of resistance in different microorganisms, and measure the effectiveness of interventions.
The National Antimicrobial Resistance Monitoring System (NARMS) was established in 1996 as a collaboration of the U.S. Centers for Disease Control and Prevention (CDC), the U.S. Department of Agriculture (USDA), the U.S. Food and Drug Administration (FDA), and state and local health departments. NARMS currently tracks resistance in enteric bacteria from humans, retail meats, and food-producing animals at the time of slaughter. Nontyphoidal Salmonella and Campylobacter are among the leading bacterial causes of foodborne illness in the United States and many other countries. Each year these two pathogens alone are estimated to cause over 2.5 million illnesses in the U.S. resulting in nearly 40,000 hospitalizations and hundreds of deaths. Whereas most Salmonella and Campylobacter infections are self-limited, some require treatment with antimicrobial agents. Emergence of antimicrobial resistance in foodborne pathogens presents a challenge for treatment of infections that warrant antimicrobial therapy.
A review of NARMS by the NARMS Review Subcommittee of the FDA Science Board was completed in 2017 and presented at the NARMS public meeting in October of that year. This review evaluated the status of the NARMS program and made recommendations for its strategic direction with an emphasis on a One Health model of monitoring. One Health is defined as a collaborative, multisectoral, and transdisciplinary approach — working at the local, regional, national, and global levels — with the goal of achieving optimal health outcomes recognizing the interconnection between people, animals, plants, and their shared environment. Given the complex interplay of humans, livestock, pets, wildlife, and the environment, the adoption of a One Health approach to addressing resistance has gained acceptance worldwide. The WHO/OIE/FAO tripartite collaboration on AMR recommends that countries develop national AMR action plans, including AMR surveillance, in accord with the One Health paradigm. The updated U.S. action plan to combat antimicrobial resistance will adopt a One Health approach.
Following the NARMS Review Subcommittee recommendations to incorporate the three major domains of the One Health model (humans, animals, environment), an important theme of this strategic plan is the expansion of testing to examine resistance in animal pathogens and the environment.
NARMS-Strategic-Plan-2021-2025
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Content Notes:Background -- NARMS Accomplishments, 2012-2019 -- Strategic Goals and Objectives -- Challenges and Opportunities -- Links to Additional Information.
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