title: The antimicrobial resistance monitoring and research (ARMoR) program: the US Department of Defense response to escalating antimicrobial resistance.
abstract: Responding to escalating antimicrobial resistance (AMR), the US Department of Defense implemented an enterprise-wide collaboration, the Antimicrobial Resistance Monitoring and Research Program, to aid in infection prevention and control. It consists of a network of epidemiologists, bioinformaticists, microbiology researchers, policy makers, hospital-based infection preventionists, and healthcare providers who collaborate to collect relevant AMR data, conduct centralized molecular characterization, and use AMR characterization feedback to implement appropriate infection prevention and control measures and influence policy. A particularly concerning type of AMR, carbapenem-resistant Enterobacteriaceae, significantly declined after the program was launched. Similarly, there have been no further reports or outbreaks of another concerning type of AMR, colistin resistance in Acinetobacter, in the Department of Defense since the program was initiated. However, bacteria containing AMR-encoding genes are increasing. To update program stakeholders and other healthcare systems facing such challenges, we describe the processes and impact of the program.
authors.affiliation: Multidrug-Resistant Organism Repository and Surveillance Network, Walter Reed Army Institute of Research F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
authors.forename: Emil P
authors.initials: EP
authors.lastname: Lesho
authors.affiliation: Multidrug-Resistant Organism Repository and Surveillance Network, Walter Reed Army Institute of Research Armed Forces Health Surveillance Center, Global Emerging Infections Surveillance and Response System, Silver Spring F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
authors.forename: Paige E
authors.initials: PE
authors.lastname: Waterman
authors.affiliation: Navy and Marine Corps Public Health, EpiData Center Department, Portsmouth, Virginia.
authors.forename: Uzo
authors.initials: U
authors.lastname: Chukwuma
authors.affiliation: Navy and Marine Corps Public Health, EpiData Center Department, Portsmouth, Virginia.
authors.forename: Kathryn
authors.initials: K
authors.lastname: McAuliffe
authors.affiliation: Navy and Marine Corps Public Health, EpiData Center Department, Portsmouth, Virginia.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Neumann
authors.affiliation: Multidrug-Resistant Organism Repository and Surveillance Network, Walter Reed Army Institute of Research.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Julius
authors.affiliation: Brooke Army Medical Center, San Antonio, Texas.
authors.forename: Helen
authors.initials: H
authors.lastname: Crouch
authors.affiliation: Armed Forces Health Surveillance Center, Global Emerging Infections Surveillance and Response System, Silver Spring.
authors.forename: Ruvani
authors.initials: R
authors.lastname: Chandrasekera
authors.affiliation: Navy Bureau of Medicine and Surgery, Falls Church, Virginia.
authors.forename: Judith F
authors.initials: JF
authors.lastname: English
authors.affiliation: Multidrug-Resistant Organism Repository and Surveillance Network, Walter Reed Army Institute of Research.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Clifford
authors.affiliation: F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
authors.forename: Kent E
authors.initials: KE
authors.lastname: Kester
mesh_terms: D000890:Anti-Infective Agents / Q000494:pharmacology*; D001419:Bacteria / Q000187:drug effects*; D001424:Bacterial Infections / Q000517:prevention & control*; D003428:Cross Infection / Q000517:prevention & control*; D024881:Drug Resistance, Bacterial; D062665:Epidemiological Monitoring; D012106:Research; D014481:United States; D059030:United States Department of Defense
chemical_list: D000890:Anti-Infective Agents
keywords: Department of Defense; antimicrobial resistance; infection prevention; surveillance