In an irony of evolution, the antimicrobial agents we enlisted to control disease now threaten our health. Decades of overuse in humans and animals have led these protective agents to evolve into drug-resistant foes. Highly mutable and sophisticated, they are outpacing our efforts to develop new antimicrobial drugs to replace those no longer effective.
While sobering, our predicament is not hopeless. The CDC, which leads the national response to antimicrobial resistance (AR), has joined with APHL, public health laboratories and others to fight AR in a new way—with data and surveillance.
To be effective, AR data must be monitored and quickly exchanged among public health and clinical labs, state epidemiologists and CDC in a standardized but flexible manner. The new Antimicrobial Resistance Laboratory Network (ARLN) Reporting Portal offers a solution.
Designed to transport, validate, translate and route public health data electronically, the portal allows laboratories to send data for multiple pathogens using harmonized terminology, instead of sending pathogen-specific reports. CDC epidemiologists receive this data in a single format rather than separate data feeds from different laboratories. The portal also confirms that the data is received by all specified parties, and helps to catch issues and ensure complete data using validation mechanisms. Fifty-five public health laboratories, including seven from the ARLN, now report AR testing data to CDC using the portal.
The ARLN Reporting Portal is hosted on AIMS, APHL's secure, cloud-based platform. AIMS also hosts the Lab Web Portal, which allows ARLN Regional Laboratories to exchange electronic test orders and results with submitters. Significantly, the portal's automated, bi-directional communications meet the two-day reporting requirement for carbapenem resistant Enterobacteriaceae (CRE) colonization testing, now conducted at five of the seven regional labs.
With both portals on AIMS, their data can be integrated. Results data from regional labs are automatically sent to submitters through the Lab Web Portal and to CDC epidemiologists through the Reporting Portal.
Despite progress toward full deployment of the ARLN Reporting Portal, more work remains. APHL and other collaborators must develop a complex technical infrastructure, coordinate exchange of resources, define vocabulary and testing standards and merge the technical capabilities of laboratories nationwide into one common solution. This is no small feat. Still the goal is worthy: a seamless, straightforward surveillance system to expedite patient treatment and prevent illness nationwide.
For more information about APHL's role in developing the ARLN Reporting Portal, contact APHL's Director of Informatics, Patina Zarcone, MPH.