Table 3
Global examples of how “resistance” has been defined
Originator
Context
Resistance definition
Reference
National Antimicrobial Resistance
Monitoring System – EntericBacteria (NARMS)
Established in 1996 as collaboration between FDA Center
for Veterinary Medicine, U.S. Department ofAgriculture and the Centers for Disease Control andPrevention. Monitors changes in antimicrobial drugsusceptibilities of selected enteric bacteria inhumans, animals, and retail meats to a panel ofantimicrobial drugs important in human and animalmedicine. The ultimate goal is to prolong thelifespan of approved drugs by promoting prudent andjudicious use of antimicrobial drugs and to identifyareas for more detailed investigation
Clinical Breakpoints
(Clinical LaboratoryStandards Institute)
http://www.fda.
gov
/cvm/
narms_pg.html
European Union
To determine trends and sources of zoonoses, zoonotic
agents and antimicrobial resistance in the E.U
Epidemiological
cut-off values
Bronzwaer
(^2008
)
The Danish Integrated Antimicrobial
Resistance Monitoring andResearch Programme (DANMAP)
DANMAP, established in 1995 by the Danish government
as a coordinated national surveillance and researchprogramme for antimicrobial consumption andantimicrobial resistance in bacteria from animals, foodsand humans. Monitoring of antimicrobial resistanceis based on: human and animal pathogens, zoonoticbacteria and indicator bacteria
Epidemiological
cut-off values
http://www.
danmap.org
Enter-Net
Enter-net is administered by the European Centre for
Disease (ECDC) Prevention and Control; it is aninternational surveillance network for humangastrointestinal infections in Europe, coveringinfections with Salmonella, verocytotoxin-producingEscherichia coli O157 (VTEC) and Campylobacter.ECDC aims to maintain and develop further surveillanceactivities and international development in this area
Dependent on country but
varies across Europe
http://ecdc.
europa.eu/en/Activities/
Surveillance/Enter-net/
238 M. Martinez and P. Silley