NARMS Report Provides Good News … and Bad News
Updated: Nov 22, 2018
As everyone is aware antibiotic resistance continues to be a very hot topic both politically and with the public. From a public health perspective, concern around antibiotic resistance is well founded, and we need to find solutions that address overuse in both humans and animals.
Like many things, the US government tracks our trends for antibiotic resistance through the National Antimicrobial Resistance Monitoring System (NARMS) program. The latest FDA/CDC/USDA report on antimicrobial resistance provided a bit of a good news/bad news account of status. In general, the 2015 National Antimicrobial Resistance Monitoring System (NARMS) Integrated Report, which highlights antimicrobial resistance patterns in bacteria isolated from humans (by CDC), raw retail meats (by FDA), and animals at slaughter (by USDA) showed that overall resistance remains low for most human bacterial infections and there have been measurable improvements in resistance levels in some important areas, however there are a few areas of concern which NARMS is continuing to closely monitor.
The good news was that
From 2014 to 2015, the proportion of retail ground turkey Salmonella isolates resistant to at least one antimicrobial declined from 73% to 57%. Historically, the majority of isolates from turkey sources have been resistant to at least one antimicrobial.
76% of Salmonella isolated from humans had no resistance to any of the 14 antimicrobial drugs tested.
Ceftriaxone resistance either continued to decline or remained low in nontyphoidal Salmonella from all NARMS sources except turkey HACCP samples, which held the same 15.7% resistance in 2015 as in 2010.
On the other hand, however,
Multidrug resistance (MDR) increased from 9% to 12% of human Salmonella, driven largely b
The report also provides information derived from whole genome sequence data about resistance genes for all Salmonella and some Campylobacter isolates and includes NARMS Now, a set of interactive data tools that allow users to explore the dynamics of antibiotic resistance and the genes involved.
Additionally, whole genome sequencing was recently incorporated into NARMS enabling all the known resistance genes to be tracked over time. NARMS research shows that antibiotic resistance can be predicted reliably from the genomic sequence, so FDA also is developing data visualization tools to make these large data sets easier to understand.
It also is important to note that the report covers a time period prior to full implementation of FDA's Guidance for Industry #213, which sought to end the use of medically important antibiotics in food-producing animals for growth promotion purposes by placing the remaining therapeutic uses under veterinary oversight and asking the product sponsors to voluntarily modify their product labeling. In fact, NARMS data will be critical in evaluating the effectiveness of the guidance, as well as the agricultural objectives of the National Action Plan for Combating Antibiotic-Resistant Bacteria. NARMS data also inform FDA’s approval of safe and effective new antimicrobial drugs for animals, and help CDC and USDA investigate foodborne illness outbreaks.
NARMS has data on more than 185,000 isolates that can be downloaded in an accessible format, for which the NARMS teams continue to develop new tools to enable users to explore them according to their own interests. Other tools are being developed by CDC to enable state laboratories to quickly identify resistance patterns in outbreak strains.
The move toward “Antibiotic Free” and “No Antibiotics Ever" meat and poultry is clear evidence that purchase decisions by consumers are being driven by these factors.
Unfortunately, I think consumers totally misunderstand this whole issue and are confusing residual residue of antibiotics in meat with the overall use of antibiotics. But the public demand around the use of antibiotics in animals is driving marketing, margins and, thus, the direction of meat and poultry companies. While the challenges to the meat and poultry industry are significant, these trends are not slowing yet.
If the overall use of antibiotics in meat and poultry are reduced as result of this consumer pressure without harming animals, then that will help continue to push down antibiotic resistance. However, what is constantly missing in this dialogue with consumers is the use of antibiotics in humans, and how that contributes to overall antibiotic resistance. It is not fair to lay the blame for antibiotic resistance solely at the feet of the meat and poultry industry, and one can only hope that, in time, the human factor will be recognized.
FDA Updates FSMA Webpages
FDA has published a new web page that lists compliance dates for rules that form the foundation of the Food Safety Modernization Act. The Compliance Dates webpage includes a graphic timeline listing key compliance dates by year. Additionally, the web pages for the preventive controls rules for human food and for animal food – which had the first major compliance dates -- have been updated.
About The Acheson Group (TAG)
Led by Former FDA Associate Commissioner for Foods Dr. David Acheson, TAG is a food safety consulting group that provides guidance and expertise worldwide for companies throughout the food supply chain. With in-depth industry knowledge combined with real-world experience, TAG's team of food safety experts help companies more effectively mitigate risk, improve operational efficiencies, and ensure regulatory and standards compliance. www.AchesonGroup.com