National Antimicrobial Resistance Monitoring System : Enteric Bacteria (NARMS) : 2013 human isolates final report
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National Antimicrobial Resistance Monitoring System : Enteric Bacteria (NARMS) : 2013 human isolates final report

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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 retail meats, conducted by the U.S. Food and Drug Administration’s Center for Veterinary Medicine (FDA-CVM) (, and for resistance in enteric bacteria isolated from food-producing animals, conducted by the U.S. Department of Agriculture’s Agricultural Research Service (USDA-ARS)

    ( and Food Safety and Inspection Service (USDA-FSIS) (

    Many NARMS activities are conducted within the framework of two CDC programs: the Foodborne Diseases Active Surveillance Network (FoodNet), which is part of CDC’s Emerging Infections Program (EIP), and the Epidemiology and Laboratory Capacity (ELC) Program. In addition to population-wide 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 of pathogens that have 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 ongoing monitoring of antimicrobial resistance among clinical isolates of non-Typhi Salmonella (refers to all serotypes other than Typhi, which causes typhoid fever) and Escherichia coli O157 in 14 sites. In 1997, testing of clinical isolates of Campylobacter was initiated in the five sites then participating in FoodNet. Testing of clinical Salmonella ser. Typhi and Shigella isolates was added in 1999. Starting in 2003, all 50 states forwarded 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 states now participating in FoodNet have been conducting Campylobacter surveillance. Since 2008, all 50 states have also been forwarding every Salmonella ser. 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. Public health laboratories are asked to forward every isolate of Vibrio species that they receive to CDC. All toxigenic V. cholerae isolates are tested for antimicrobial susceptibility by the National Enteric Laboratory Diagnostic Outbreak Team; results are available in the Cholera and Other Vibrio Illness Surveillance system (COVIS) reports beginning with the 2013 Annual Summary. NARMS conducts antimicrobial susceptibility testing for isolates of species other than V. cholerae; results are included in this report.

    This annual report includes CDC’s surveillance data for 2013 for nontyphoidal Salmonella, typhoidal Salmonella (serotypes Typhi, Paratyphi A, Paratyphi B [tartrate negative], and Paratyphi C), Shigella, Campylobacter, E. coli O157, and Vibrio species other than V. cholerae. Surveillance data include the number of isolates of each pathogen tested by NARMS 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.

    Suggested citation: CDC. National Antimicrobial Resistance Monitoring System for Enteric Bacteria (NARMS): Human Isolates Final Report, 2013. Atlanta, Georgia: U.S. Department of Health and Human Services, CDC, 2015.


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