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National Antimicrobial Resistance Monitoring System for Enteric Bacteria (NARMS) : human isolates final report, 2011
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    The primary purpose of the National Antimicrobial Resistance Monitoring System (NARMS) at the Centers for Disease Control and Prevention (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 U.S. Food and Drug Administration’s Center for Veterinary Medicine (FDA-CVM) (http://www.fda.gov/AnimalVeterinary/SafetyHealth/AntimicrobialResistance/NationalAntimicrobialResistanceMoni toringSystem/default.htm), and for resistance in enteric bacteria isolated from animals, conducted by the U.S. Department of Agriculture’s Agricultural Research Service (USDA-ARS) (http://www.ars.usda.gov/main/site_main.htm?modecode=66-12-05-08). Many NARMS activities are conducted within the framework of the Foodborne Diseases Active Surveillance Network (FoodNet), which is part of CDC’s Emerging Infections Program (EIP), and also with CDC’s Epidemiology and Laboratory Capacity (ELC) Program. In addition to surveillance of resistance in enteric pathogens, the NARMS program at CDC also conducts research into the mechanisms of resistance and performs susceptibility testing of isolates that caused outbreaks. Before NARMS was established, CDC monitored antimicrobial resistance in Salmonella, Shigella, and Campylobacter 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-Typhi Salmonella (refers to all serotypes other than Typhi, which causes typhoid fever) and Escherichia coli O157 isolates in 14 sites. In 1997, testing of clinical Campylobacter isolates was initiated in the five sites participating in FoodNet. Testing of clinical Salmonella enterica serotype Typhi and Shigella isolates was added in 1999. Since 2003, all 50 states have been forwarding all Salmonella ser. Typhi isolates and a representative sample of non-Typhi Salmonella, Shigella, and E. coli O157 isolates to NARMS for antimicrobial susceptibility testing, and 10 FoodNet states have been participating in Campylobacter surveillance. Since 2008, all 50 states have been forwarding every Salmonella Paratyphi A and C to NARMS for antimicrobial susceptibility testing. Beginning in 2009, NARMS also performed susceptibility testing on isolates of Vibrio species other than V. cholerae. NARMS participating public health laboratories were asked to forward every isolate of Vibrio species other than V. cholerae that they received to CDC for antimicrobial susceptibility testing. This annual report includes CDC’s surveillance data for 2011 for non-typhoidal Salmonella, typhoidal Salmonella, Shigella, Campylobacter, E. coli O157, and Vibrio species other than V. cholerae. Surveillance data include the number of isolates tested by NARMS for each pathogen, and the number and percentage of isolates that were resistant to each of the antimicrobial agents tested. Data for earlier years are presented in tables and graphs when appropriate. Antimicrobial classes defined by the Clinical and Laboratory Standards Institute (CLSI) are used in data presentation and analysis. This report uses the World Health Organization’s categorization of antimicrobials of critical importance to human medicine (Appendix A) in the tables that present minimum inhibitory concentration (MIC) and percent resistant tables. Suggested citation: CDC. National Antimicrobial Resistance Monitoring System for Enteric Bacteria (NARMS): Human Isolates Final Report, 2011. Atlanta, Georgia: U.S. Department of Health and Human Services, CDC, 2013.
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