National Antimicrobial Resistance Monitoring System for Enteric Bacteria (NARMS) : human isolates final report, 2006
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National Antimicrobial Resistance Monitoring System for Enteric Bacteria (NARMS) : human isolates final report, 2006

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      The National Antimicrobial Resistance Monitoring System (NARMS) for Enteric Bacteria is a collaboration among the Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA-CVM), and U.S. Department of Agriculture (USDA). The primary purpose of NARMS at CDC is to monitor antimicrobial resistance among foodborne enteric bacteria isolated from humans. Other components of the interagency NARMS program include surveillance for resistance in enteric bacterial pathogens isolated from foods, conducted by the FDA Center for Veterinary Medicine ( toringSystem/default.htm), and resistance in enteric pathogens isolated from animals, conducted by the USDA Agricultural Research Services (

      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 Surveillance Network (FoodNet). In addition to surveillance 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 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 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 a representative sample of non-Typhi Salmonella, Salmonella ser. Typhi, Shigella, and E. coli O157 isolates to NARMS for antimicrobial susceptibility testing, and 10 FoodNet states have been participating in Campylobacter surveillance.

      This annual report includes CDC’s surveillance data for 2006 for clinical non-Typhi Salmonella, Salmonella ser. Typhi, Shigella, Campylobacter and E. coli O157 isolates. Resistance trends and comparisons with previous years are included when appropriate. Antimicrobial subclasses defined by Clinical and Laboratory Standards Institute (CLSI) are used in data presentation and analysis. CLSI subclasses constitute major classifications of antimicrobial agents, e.g., aminoglycosides and cephalosporins.

      This report also includes World Health Organization’s categorization of antimicrobials of critical importance to human medicine (Table I) and data from the Escherichia coli Resistance Study, which is part of NARMS surveillance of commensal bacteria. Appendix A summarizes the Escherichia coli Resistance Surveillance Pilot Study conducted in 2006.

      Suggested citation: CDC. National Antimicrobial Resistance Monitoring System for Enteric Bacteria (NARMS): Human Isolates Final Report, 2006. Atlanta, Georgia: U.S. Department of Health and Human Services, CDC, 2009.

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