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FS-3.5 Data Details

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FS-3.5 Prevent an increase in the proportion of nontyphoidal Salmonella isolates from humans that are resistant to three or more classes of antimicrobial agents

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

Data Source: 
National Antimicrobial Resistance Monitoring System for Enteric Bacteria
Changed Since the Healthy People 2020 Launch: 
Yes
Measure: 
percent
Baseline (Year): 
10.8 (2006–08)
Target: 
10.8
Target-Setting Method: 
Maintain the baseline value.
Target-Setting Method Justification: 
Antimicrobial use in humans and food animals provides selective pressure that favors resistant bacteria. Preventing an increase in resistance to multiple antimicrobial agents is vital to preserving the efficacy of this agent. The target represents part of an effort to address increasing resistance to antimicrobial drugs.
Numerator: 

Number of non-typhoidal Salmonella isolates that are resistant to three or more classes of antimicrobial agents

Denominator: 

Number of non- typhoidal Salmonella isolates tested for resistance to three or more classes of antimicrobial agents

Comparable Healthy People 2010 Objective: 
Not applicable
Data Collection Frequency: 
Annual
Methodology Notes: 

    The primary objectives of NARMS are to:

    1. Monitor trends in antimicrobial resistance among foodborne bacteria from humans, retail meats, and animals
    2. Disseminate timely information on antimicrobial resistance to promote interventions that reduce resistance among foodborne bacteria
    3. Conduct research to better understand the emergence, persistence, and spread of antimicrobial resistance
    4. Assist the FDA in making decisions related to the approval of safe and effective antimicrobial drugs for animals

    In 1996, surveillance for Salmonella in NARMS began in 14 sites. Since 2003, all 50 states have been participating, which represent a population of approximately 321 million (US Census Bureau, 2015). Participating sites forward every Salmonella serotypes Typhi and Paratyphi A, every twentieth non-typhoidal Salmonella, every twentieth Shigella, and every twentieth E. coli O157 isolates received at their public health laboratories to NARMS at CDC for susceptibility testing.

    Susceptibility testing involves determination of minimum inhibitory concentrations for antimicrobial agents, including: ampicillin, amoxicillin-clavulanic acid, azithromycin, cefoxitin, ceftriaxone, chloramphenicol, ciprofloxacin, gentamicin, nalidixic acid, streptomycin, sulfisoxazole, tetracycline, and trimethoprim-sulfamethoxazole. Resistance in non-typhoidal Salmonella is used for this objective. Non-typhoidal Salmonella excludes the following typhoidal Salmonella serotypes: Typhi, Paratyphi A, Paratyphi B (i.e., tartrate negative isolates), and Paratyphi C. Tartrate positive Salmonella serotype Paratyphi B isolates are referred to as Salmonella serotype Paratyphi B var. L(+) tartrate+ and are not typically associated with typhoidal disease.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch: 
The criteria for measurement was changed as isolates resistant to three or more antimicrobial classes will be calculated using reduced susceptibility to ciprofloxacin,to define resistance to the quinolone class. NARMS will continue to use resistance criteria for other drug classes. Amikacin and kanamycin (aminoglycosides) and ceftiofur (cephalosporin), have been eliminated from the panel. Due to a change in the methodology the original baseline was revised from 10.6 (2006-08) to 10.8 (2006-08). The target was adjusted from 10.6 to 10.8 to reflect the revised baseline using the original target-setting method.

References

Additional resources about the objective

  1. National Antimicrobial Resistance Monitoring System

  2. National Antimicrobial Resistance Monitoring System for Enteric Bacteria