NARMS in Action

Purpose

  • NARMS scientists track and study changes in antimicrobial resistance among several bacteria.
  • NARMS data are used to help guide efforts to prevent and reduce the spread of resistance and resistant bacteria.
  • This page includes stories illustrating some of the important work that NARMS and its partners have done.

Stories

The Clinical & Laboratory Standards Institute announces clinical breakpoints for azithromycin for Shigella

Clinical Laboratory Standards Institute logo plus cover of M100 publication
The Clinical & Laboratory Standards Institute provides standards and guidelines for medical professionals.

The Clinical & Laboratory Standards Institute published azithromycin breakpoints for Shigella, based on research findings by CDC scientists and partners. This means clinical labs can now test whether Shigella causing a patient's illness is resistant to azithromycin. This breakthrough will improve patient care and decision-making about antibiotics.

Keep Reading: Learn more about this important development, the extensive research and collaboration that went into it, and how it helps doctors and their patients.

Advancing public health through integrated surveillance

Logo for the National Antimicrobial Resistance Monitoring System, with three equilateral triangles taking the place of the A in NARMS.
NARMS continues to adapt to address emerging resistance threats, changes in clinical diagnostic practices, and new technologies.

Scientists from CDC, FDA, and USDA published an article that describes how the first two decades of NARMS (1996–2016) contributed to our understanding of antimicrobial resistance in bacteria transmitted commonly through food. The article shows how such a program can have broad positive impacts on public health.

Technologies, such as whole genome sequencing, are providing an unprecedented level of detail about bacteria that help NARMS track resistance trends and mechanisms and help solve outbreaks caused by resistant bacteria.

See Also: Learn more about how NARMS uses a collaborative, One Health approach to monitor antimicrobial resistance and conduct applied research.

Tracking antimicrobial resistance in dangerous bacteria that affect people and cattle

Cow standing in a flat field of grasses and flowers. Cow is facing forward with its tongue out.
NARMS data are helping refine our understanding about increasing antibiotic resistance in Salmonella Dublin.

CDC estimates that Salmonella bacteria cause 1.35 million human illnesses in the United States every year. Most people get better quickly, but the outcome can be worse for those infected with Salmonella Dublin, a type of Salmonella usually found in cattle.

Salmonella Dublin causes rare but severe disease in humans. Salmonella Dublin illnesses in the United States have been linked to raw dairy products and beef products. In the last decade, more than half of Dublin infections have been resistant to seven antibiotic classes and clinical outcomes have worsened.In this study, CDC investigators use data from NARMS to track resistant Salmonella Dublin infections in people.

Keep Reading: Learn more about how Salmonella Dublin infections have increased in incidence, antimicrobial resistance, and clinical severity.

Linking antimicrobial-resistant Salmonella infections and international travel

Silhouette of a traveler in an airport, walking with a rolling suitcase behind them as a plane takes off in the background.
Resistance to ciprofloxacin in Salmonella is a growing concern because it limits treatment options for invasive disease.

Antimicrobial resistance in other parts of the world affects treatment options in the United States. Two studies explore this link for Salmonella resistant to quinolones, a class of antibiotics commonly used to treat Salmonella infections:

Identifying the source of a foodborne outbreak

Stacked Petri dish culture plates with various types of growth media.
Salmonella Typhimurium is found in diverse agricultural niches and is typically among the top serotypes associated with salmonellosis each year.

It can be difficult to find the source of a foodborne outbreak, especially when the outbreak is caused by Salmonella serotype Typhimurium, which can contaminate many different kinds of foods. A 2014 study looked at the genes that code for antimicrobial resistance in Typhimurium and the plasmids (structures inside some cells that can carry and spread resistance genes) that carry them as clues about the sources of outbreaks.

The authors examined resistance plasmids found in Salmonella Typhimurium isolated from retail meat, food animals, and humans. They found one type of plasmid in chicken and a different one in beef, but both types of plasmids were found in Typhimurium causing human infections. This shows that the type of plasmid may provide clues into the source of human infections.

See Also: Learn more about how bacterial genetic testing can help disease detectives find the source of an outbreak and stop it in its tracks.

Resistance to antimicrobials leads to serious illness and longer hospitalizations

Empty hospital bed in a room with a chair, table, and medical equipment next to it.
Understanding the relationship between resistance and clinical outcomes is important, because more than 250,000 resistant Salmonella infections are estimated to occur among U.S. patients.

Antimicrobials should not be used unnecessarily on the farm, in hospitals, or in other healthcare settings. For years, public health experts have warned about the consequences of antimicrobial overuse and growing antimicrobial resistance.

The inappropriate use of antimicrobials in humans and food animals in addition to other factors can result in resistant bacteria, which can cause more severe patient outcomes.

See Also: Read a study showing that people who get ill from antimicrobial-resistant strains of Salmonella are more likely to have severe outcomes and to be hospitalized for their illness.
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About the National Center for Emerging and Zoonotic Infectious Diseases