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National Antimicrobial Resistance Monitoring System for Enteric Bacteria (NARMS) : human isolates final report, 2004
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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), 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 human enteric bacterial pathogens isolated from foods, conducted by the FDA Center for Veterinary Medicine (http://www.fda.gov/cvm/narms_pg.html), and resistance in human enteric pathogens isolated from animals, conducted by the USDA Agricultural Research Services (http://www.ars- grin.gov/ars/SoAtlantic/Athens/arru/narms.html).

    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 human non-Typhi Salmonella and Escherichia coli O157 isolates in 14 sites. In 1997, testing of human Campylobacter isolates was initiated in the five sites participating in FoodNet. Testing of human Salmonella Typhi and Shigella isolates was added in 1999. Since 2003, all 50 states have been forwarding a representative sample of non-Typhi Salmonella, Salmonella 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 human surveillance data for 2004 for non-Typhi Salmonella, Salmonella Typhi, Shigella, and E. coli O157. Resistance trends and comparisons to previous years are included when appropriate. Antimicrobial subclasses defined by the 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 a section on the Enterococci Resistance Study, which is part of NARMS surveillance on commensal bacteria. Data from the 2004 Enterococci Resistance Study are presented, as are 2001–2003 data when reference to previous years is appropriate. In addition, Appendix A summarizes the Escherichia coli Resistance Surveillance Pilot Study conducted in 2004.

    Suggested citation: CDC. National Antimicrobial Resistance Monitoring System for Enteric Bacteria (NARMS): Human Isolates Final Report, 2004. Atlanta, Georgia: U.S. Department of Health and Human Services, CDC, 2007.

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