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Developing a Pilot Environmental Effort for National Antimicrobial Resistance Monitoring System (NARMS)
Citation:
Garland, J., A. Franklin, M. Bagley, S. Keely, N. Brinkman, M. Jahne, L. Boczek, C. Nietch, AND R. Mitchell. Developing a Pilot Environmental Effort for National Antimicrobial Resistance Monitoring System (NARMS). FDA CVM AMR Forum, NA, Virtual, November 04, 2021.
Impact/Purpose:
Share the rationale and current status of our efforts to devleop an interagency AMR monitoring effort with the group (FDA-CVM) funding the IAA.
Description:
Antimicrobial resistance (AMR) has been identified as one of the top medical issues worldwide, leading many countries to place greater emphasis on combating resistant bacteria through a multipronged, coordinated approach. A consensus has emerged among the greater public health profession to adopt an interdisciplinary one health model of infectious disease monitoring and control. The One Health paradigm recognizes 1) that human and animal health are linked to environmental health, and 2) the need to better understand the role of the environment in the spread of disease. The urgency of resistance requires that all available expertise, infrastructure, and resources are garnered and that government agencies collaborate in new ways to help combat this global health threat. Many groups urged the Federal Government to establish a national surveillance system in the United States to monitor antimicrobial resistance in zoonotic bacteria from both food animals and humans. In response, in 1996, FDA’s Center for Veterinary Medicine (CVM) initiated the National Antimicrobial Resistance Monitoring System (NARMS) for enteric pathogens in collaboration with the Center for Disease Control (CDC) and the United States Department of Agriculture (USDA). Following recommendations of the FDA Science Board in 2017, NARMS has been transitioning to an integrated, One Health model of surveillance to include animal pathogens and environmental testing. Currently, NARMS monitors antimicrobial drug resistance in enteric bacteria collected from humans, retail meats, and animals. With this Interagency Agreement, we propose to add geographically dispersed testing of surface waters differentially impacted by urban and rural environments. This will help the agencies better assess and prevent waterborne risks associated with AMR pathogens in surface water, drinking water, irrigation, and water reuse. Because work will be coordinated with CDC, USDA, and FDA, analyses will provide a fuller picture how resistant strains are related spatially and temporally. Through a focused research study, EPA will be able to identify trends and hot spots for AMR, which may ultimately impact pre-treatment programs, best practices, and risk management in surface waters and drinking source waters, which includes reuse. Together, this effort will aid the broader national efforts to combat antimicrobial resistant bacteria.