The Tennessee Department of Health (TDH) is a long-term participant and leader in the NARMS (RFS) program. TDH feels that the expansion of the retail food arm of NARMS is critical step in conducting surveillance for antimicrobial resistance (AR) in the food chain and for monitoring the impact of recent national initiatives including important regulatory changes in the use of antimicrobials in food animals. Use of antimicrobials in food animal production creates selective pressure that enables antimicrobial resistant bacteria to matriculate into the food supply and ultimately cause human infections. Of concern, antibiotic resistant infections are accompanied by more severe illnesses, more deaths, higher healthcare costs, and increased harm to society. We feel that surveillance is critical ?data-for-action? to understand the sources of AR and multi-drug resistance (MDR) in the food supply chain and to combat this public health problem. Tennessee embraces the goal of the NARMS food surveillance program to improve the detection of and surveillance for AR among enteric bacteria in raw retail meat commodities through this cooperative funding agreement (FOA # PAR-16-099, CFDA # 93.876). Tennessee will participate fully in all project components including purchase of approved meats, testing by NARMS protocols, shipment of isolates and meta data, and continued activity in the NARMS working group. Additionally, Tennessee anticipates participating in any future pilot activity or expansion to other meats or commodities. Tennessee capacity for testing meats has translated to increased ability to assess isolates and their link to human clusters, as well as more proficiency in testing meats during outbreaks and quickly characterizing the AR properties to inform the public heath investigation. Tennessee will participate fully in all NARMS RFS activities and follow the accepted protocols during the 5 year period. Our strategy include: 1. Maintain sampling and reporting with a continuous quality improvement paradigm in RFS. 2. Foster partnership among Tennessee, federal, state, local, and external partners. 3. Enhance outbreak investigation response and reporting. 4. Sustain and enhance NARMS laboratory diagnostic capacity. 6.Improve laboratory coordination, outreach, and information flow. 7. Maintain and exchange integrated surveillance information system. Tennessee's expectations and outcomes, strategies and activities, and collaborative activities will continue throughout the 5 year period with continued funding.
A comprehensive approach must address AR in humans, food animals, and retail meat. Tennessee has proven performance and desires to partner with FDA and other RFS sites to enhance the program. We hope that our response to this FOA will be favorably considered.
