NARMS sampling for resistant bacteria includes which of the following?

• A. Slaughterhouse fecal samples, swabs from county fair livestock facilities, testing conducted at restaurants by local departments of health
• B. Testing of cuts/ground product in the local store meat case, fecal samples submitted by physicians treating patients with suspected foodborne illness, slaughterhouse fecal samples
• C. Testing of on-farm fecal samples in feedlots and dairy operations, fecal samples submitted by physicians treating patients with suspected foodborne illness
• D. Testing of isolates from milk processing plants prior to pasteurization, slaughterhouse fecal samples, testing of cuts/ground product in the local store meat case

Answer: (B)

NARMS is built around three surveillance streams: isolates from humans, isolates from retail meat products, and isolates from animals at processing facilities. This combination shows how resistance appears across the actual food chain and in human cases.

The best option explicitly includes all three: retail meat (cuts/ground product in the store meat case), human clinical isolates (fecal samples from patients with suspected foodborne illness), and animal sources from the slaughterhouse (fecal samples). That trio matches how NARMS systematically collects data to monitor resistance in human infections, in foods people buy, and in the animal reservoirs that feed into the food supply.

Other options mix in sources not used by NARMS (such as county fair facilities or restaurant testing) or omit one of the core streams (retail meat or human isolates) or include dairy/milk-processing sources not part of the standard NARMS framework.