A new strategic plan from the Food and Drug Administration calls for enhanced monitoring of pathogens, including in animal feed and pet food, to combat antimicrobial resistance.

“Reducing human exposure to antimicrobial resistant microorganisms and their resistance determinants is key to reducing the burden of antimicrobial resistant infections, and food is a potential source of human exposure,” says the 2021-2025 plan for the National Antimicrobial Resistance Monitoring System.

An “important theme” in the plan is the “expansion of testing to examine resistance in animal pathogens and the environment,” according to the document.

Another important element of the plan is One Health, “a collaborative, multisectoral, and transdisciplinary approach to health — working at the local, regional, national, and global levels — with the goal of achieving optimal health outcomes recognizing the interconnection between people, animals, plants, and their shared environment.”

The NARMS program “examines bacteria isolated from humans (through CDC data), raw retail meats (through FDA data), and animals at slaughter (through USDA-FSIS data) to analyze and report on patterns of resistance to the most important antimicrobial agents,” FDA’s Center for Veterinary Medicine said in releasing the plan.

“Nontyphoidal Salmonella and Campylobacter are among the leading bacterial causes of foodborne illness in the United States and many other countries,” the strategic plan says.

“Each year these two pathogens alone are estimated to cause over 2.5 million illnesses in the U.S. resulting in nearly 40,000 hospitalizations and hundreds of deaths. Whereas most Salmonella and Campylobacter infections are self-limited, some require treatment with antimicrobial agents. Emergence of antimicrobial resistance in foodborne pathogens presents a challenge for treatment of infections that warrant antimicrobial therapy.”

FDA set a meeting for Oct. 13-14 to discuss the plan.

The goals of the new plan, along with some select elements of each, are below:

  • Enhance sampling for foodborne pathogens within a one health framework
    • Enhance and maintain routine resistance monitoring in select pathogens causing illness in food-producing and companion animals.
    • Implement geographically-representative monitoring including surface waters to establish baseline AMR data in aquatic ecosystems.
    • Initiate an AMR testing program for animal feed and pet food, including their ingredients, and share data in an integrated database and in NARMS reports.
  • Employ advanced technologies to better understand the evolution and spread of resistance among foodborne pathogens
    • Apply predictive resistance analytics, machine learning, and other bioinformatics tools to NARMS-related data to better understand the mechanisms, sources, and spread of resistance.
    • Optimize in vitro antimicrobial susceptibility testing to identify new resistance mechanisms.
    • Develop metagenomic approaches to characterize the resistome of animals, humans and environmental samples and to link resistance genes to their microbial source
  • Improve data sharing, communication, and collaboration
    • Deposit microbiological data into public databases and post timely web-based updates that describe emergent resistance phenomena for timely response by all stakeholders.
    • Engage with outside partners (e.g., WHO, Clinical and Laboratory Standards Institute, TATFAR, industry) to determine how resistance, whole genome sequence, and metagenomic data can be interpreted for appropriate responses.
    • Work with international partners to establish data quality standards, analytical protocols, and reporting formats for resistance and genome sequence information.
  • Conduct research to assess the sources and impact of resistance and the effectiveness of prevention practices for foodborne pathogens
    • Conduct studies to determine the burden and impact of antimicrobial resistance on human, animal and environmental health.
    • Conduct studies to determine risk factors for antimicrobial-resistant infections and to attribute infections to foods, animals, environmental and other sources.
    • Collaborate with partners to understand prevention practices including non-antimicrobial interventions (e.g., bacteriophages, vaccines, husbandry) and their impact on resistance

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