National Antimicrobial Resistance Monitoring System for Enteric Bacteria (NARMS) : human isolates final report, 2009
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National Antimicrobial Resistance Monitoring System for Enteric Bacteria (NARMS) : human isolates final report, 2009

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      The National Antimicrob ial Resistance Monitoring System (NARMS) for Enteric Bacteria is a collaboration among the Centers for Disease Control and Prevention (CDC). U.S. Food and Drug Administration's Center for Veterinary Medicine (FDA-CVM), and U.S. Department of Agriculture (USDA). The primary purpose of NARMS at CDC is to monitor antimicrobial resistance among enteric bacteria isolated from humans. Other components of the interagency NARMS program include surveillance for resistance in enteric bacteria isolated from foods, conducted by the FDA-CVM (http://w'ww.fda.qov/AnimaIVeterinarvISafetvHealth/AnlimicrobialResistance/NationalAntimicrobialResistanceMoni toringSystemldefault.htm ), and resistance in enteric bacteria isolated from animals, conducted by the USDA Agricultura l Research Service (http:/ main.htm?modecode=66-12-05-08).

      Many NARMS activities are conducted within the framework of CDC's Emerging Infections Program (EIP), Epidemiology and Laboratory Capacity (ELC) Program, and the Foodborne Diseases Active Surve illance Network (Food Net). In addition to surve illance of resistance in enteric pathogens, the NARMS program at CDC also includes public health research into the mechanisms of resistance, education efforts to promote prudent use of antimicrobial agents, and studies of resistance in commensal organisms.

      Before NARMS was establ ished, CDC monitored antimicrobial resistance in Sa/monella, Shigella , and Campy/obacter through periodic surveys of isolates from a panel of sentinel counties. NARMS at CDC began in 1996 with prospective monitoring of antimicrobial resistance among clinical non-typhoidal Sa/monella and Escherichia coli 0 157 isolates in 14 sites. In 1997, testing of clinical Campy/obacter isolates was initiated in the five sites participating in Food Net. Testing of clinica l Salmonefla enterica serotype Typhi and Shigella isolates was added in 1999. Since 2003, all 50 states have been forwarding a representative sample of non-typhoidal Sa/manella, Salmonella ser. Typhi, Shigella , and E. coli 0 157 isolates to NARMS for antimicrobial susceptibi lity testing, and 10 FoodNet states have been participating in Campy/obactersurveillance. Since 2008, ali SO states have been forwarding every Sa/monella Paratyphi A and C to NARMS for antimicrobial susceptibil ity testing.

      This annual report includes CDC's surveillance data for 2009 for non-typhoidal Salmonella, typhoidal Salmonella, Shigella, Campy/obaeter and E. coli 0157 isolates. Data for earlier years are presented in tables and graphs when appropriate. Antimicrobial classes defined by Clinical and Laboratory Standards Institute (CLSI) are used in data presentation and analysis. CLSI classes constitute major classifications of antimicrobial agents, e.g., aminoglycosides and cephems.

      This report also includes the World Health Organization's categorization of antimicrobials of critical importance to human medicine (Table 1). The table includes only antimicrobials that are tested in NARMS.

      Suggested citation: CDC. National An timicrobial Resistance Monitoring System for Enteric Bacteria (NARMS): Human Isolates Final Report, 2009. Atlanta, Georgia: U.S. Department of Health and Human Services, CDC, 2010.

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