FDA Policy/General

Progress and Some Concerns in NARMS Report

David McFarland

— 1 min read
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The National Antimicrobial Resistance Monitoring System (NARMS) annual report for 2015 says that while overall resistance remains low for most human infections and there have been measurable improvements in resistance levels in some important areas, the system is “closely monitoring a few areas of concern.”

An agency news release says that major report observations were: 

  •          76% of Salmonella isolated from humans had no resistance to any of the 14 antimicrobial drugs tested;
  •          multidrug resistance increased from 9% to 12% of human Salmonella, driven largely by an increase in combined resistance to ampicillin, streptomycin, sulfonamides, and tetracycline among a particular Salmonella serotype;
  •          ceftriaxone resistance either continued to decline or remained low in nontyphoidal Salmonella from all NARMS sources except turkey hazard analysis and critical point control samples, where the 15.7% resistance in 2015 was the same as 2010 levels;
  •          while still rare, azithromycin resistance occurred in Salmonella, in some cases in strains with resistance to other antibiotics;
  •          erythromycin resistance in Campylobacter coli increased three- to five-fold between 2011 and 2015 in isolates from humans (2.7% to 12.7%) and from chicken carcasses (3.4% to 12.8%);
  •          transmissible quinolone resistance in Salmonella may be increasing — the underlying resistance traits reside on mobile genetic elements and therefore have the potential to be shared, either alone or together with other resistance genes, with susceptible strains of Salmonella; and
  • ·        from 2014 to 2015 there was a decline from 73% to 57% in the proportion of retail ground turkey Salmonella isolates resistant to at least one antimicrobial.

The release notes that the report covers a time prior to full implementation of an FDA guidance that sought to end use of medically important antibiotics in food-producing animals for growth promotion purposes and place the remaining therapeutic uses of the products under veterinary oversight by asking sponsors of affected products to voluntarily modify their product labeling. It says that all sponsors made the recommended changes by the 1/1/17 target date or, in some cases, voluntarily withdrew approved product applications.

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