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Federal Report on Antimicrobial Trends Gets Interactive Update

The U.S. Food and Drug Administration has released its 2012-2013 National Antimicrobial Resistance Monitoring System (NARMS) Integrated Report. The new collection of data on antimicrobial resistance patterns in bacteria isolated from humans, retail meats and animals at slaughter includes interactive graphs.

NARMS is a partnership between FDA, the Centers for Disease Control and Prevention and the Department of Agriculture to track antibiotic resistance in foodborne Salmonella, Campylobacter, Enterococcus and E. coli bacteria.

FDA said that the report reveals “mostly encouraging findings, with some areas of concern.”

According to the new data, about 80 percent of human Salmonella isolates are not resistant to any of the tested antibiotics, a finding that has not changed in the past 10 years.

Multi-drug resistance in Salmonella has not changed in human, cattle or chicken isolates in the past decade either. The numbers of multi-drug resistant Salmonella isolates in retail chicken have gone down.

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NARMS interactive graphs of antimicrobial resistance among Campylobacter isolates, 1997-2013

Campylobacter jejuni resistance to the fluoroquinolone ciprofloxacin, the most common antibiotic used to treat human infection, was at its lowest level in retail chicken to date at 11 percent.

One concerning finding was that resistance in human isolates of a common Salmonella serotype called l 4,[5],12:i:- have more than doubled from 18 percent in 2011 to 46 percent in 2013.

There has also been an increase in multidrug resistance and ceftriaxone resistance in Salmonella serotype Dublin isolated from cattle and human sources.

Some things in the 2012-2013 Integrated Report have changed since last year. For one thing, the report used to be called the “Executive Summary.” The new report also covers multiple years, unlike previous reports (data released last year were for 2011 only).

In terms of content, it reflects the changes made to NARMS methodology. For example, testing now includes intestinal testing of food-producing animals presented for slaughter before they are exposed to in-plant processing, making them better indicators of the microbial status of animals in farm settings.

It also has a new format to communicate the complex information better. At last year’s NARMS Scientific Meeting, FDA Epidemiologist Heather Tate previewed the changes, saying that the new integrated report would be “less dense and more focused, more digestible to consumers of the data, less likely to be misunderstood or misinterpreted.”

The tables and graphs used to summarize the data are still available in the new report, but six interactive displays encompassing 14 different graphs have also been made available to help readers visualize the data. They detail the isolates for each pathogen by year from the date of initial testing through 2013:

  • Campylobacter Isolates: 1997-2013 graphs for C. jejuni and C. coli isolates from humans, retail chickens, and chicken HACCP
  • Salmonella Isolates: 1996-2013 graphs for all Salmonella isolates from humans; retail chicken, ground turkey, ground beef, and pork chops; and chicken, turkey, cattle, and swine HACCP
  • Salmonella Multidrug Resistance: 1996-2013 graphs for all Salmonella isolates from humans; retail chicken, ground turkey, ground beef, and pork chops; and chicken, turkey, cattle, and swine HACCP
  • Salmonella Serotypes: 1996-2013 graphs for Salmonella isolates from various sources broken down by serotype
  • E. coli isolates: 2002-2013 graphs for all E. coli isolates from chicken HACCP, and retail chickens, ground turkey, ground beef, and pork chops
  • Enterococcus Isolates: 2002-2013 graphs for isolates from chicken HACCP, and retail chickens, ground turkey, ground beef, and pork chops by Enterococcus species

FDA does note, however, that because antimicrobial resistance is so complicated, “it is difficult to draw meaningful conclusions by comparing just one year to another.” It’s best to look for patterns across several years.

“NARMS will also be critical in evaluating the effectiveness of FDA’s Guidance for Industry #213 and the agricultural objectives in the Administration’s National Action Plan for Combating Antibiotic-Resistant Bacteria,” FDA said, but the latest report still covers the time period before the December 2013 publication of Guidance #213.

Animal drug companies have agreed to withdraw production uses of antimicrobials in food-producing animals and place the remaining therapeutic uses of these products under veterinary oversight by December 2016.

Update: On August 19, CDC also released NARMS Now: Human Data, an interactive tool that makes it easier and quicker to find out how antibiotic resistance has changed over the past 20 years for Campylobacter, E. coli O157, Salmonella, and Shigella.

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