Antimicrobial Resistance

​​​​​​​​​​​Public health laboratories conduct antimicrobial susceptibility testing (AST) to determine emerging resistance, identify and report novel resistance mechanisms, maintain reference testing methods and respond to community outbreaks of resistant organisms. AST is an essential laboratory function shared by public health and clinical laboratories, which perform AST to inform clinical treatment of patients.

APHL supports public health laboratories in combatting antimicrobial resistance by assessing capability and ​capacity, releasing guidance, conducting training and liaising with clinical laboratory partners. The association also sponsors forums for public health and clinical laboratories to foster a seamless exchange of specimens and information.


In 2013, CDC first released Antibiotic Resistance Threats in the United States, a comprehensive assessment of top antimicrobial resistance threats. The report emphasized that collaboration across all sectors of government, public health and healthcare would be critical to meet this challenge. APHL is  working with partner organizations to draw attention to the issue and to advocate for a swift and united response. In 2019, CDC released an updated Antibiotic Resistance Threats in the United States report.

In 2015, Congress provided $160 million to CDC to implement aspects of the 2014 National Strategy for Combating Antibiotic-Resistant Bacteria. The strategy, which aims to fight antimicrobial resistance in the US and globally, calls for a regional laboratory network of public health laboratories to respond to local outbreaks of antimicrobial resistant organisms. CDC established the Antibiotic Resistance (AR) Laboratory Network, including seven regional labs, in September 2016.

Public Health Labs and the AR Laboratory Network 

Using conventional and advanced methods to detect and characterize antimicrobial resistant organisms, the Antibiotic Resistance Laboratory Network (AR Lab Network) detects changes in resistance and helps identify outbreaks of antimicrobial diseases. In addition to enhanced capacity in 50 states, four large cities, and Puerto Rico, state public health laboratories in Maryland, Minnesota, New York, Tennessee, Utah, Washington and Wisconsin were designated as regional laboratories to provide nationwide coverage for complex antimicrobial resistance testing. The AR Lab Network also includes the National Tuberculosis Molecular Surveillance Center (National TB Center), located at the Michigan Department of Health and Human Services. The National TB Center will conduct whole genome sequencing for isolates of Mycobacterium tuberculosis starting March 2018.

APHL supports the AR Lab Network with communications, fellowships and liaison with public health and laboratory partners. The association also develops methods to rapidly message test results from regional labs back to submitters and to CDC and provide technical assistance in implementing electronic laboratory reporting protocols​.

For more information about available testing at the regional laboratories or how to submit specimens for testing, state laboratories can contact their respective regional laboratories.

AR Lab Network Regional Laboratories

Northeast Region

Mid-Atlantic Region

Southeast Region

Midwest Region

Central Region

Mountain Region

West Region

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AR Lab Network Newsletters

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