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.

Background

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

• Wadsworth Center (NY)
• NY AR Lab Network email

Mid-Atlantic Region

• Maryland Public Health Laboratory
  
• MD AR Lab Network email

Southeast Region

• Tennessee State Public Health Laboratory​
• TN AR Lab Network email​

Midwest Region

• Wisconsin State Laboratory of Hygiene
  
• WI AR Lab Network email​

Central Region

• Minnesota Department of Health Public Health Laboratory
  
• MN AR Lab Network email; attn to Central Region Coordinator Paula Snippes Vagnone

Mountain Region

• Utah Public Health Laboratory
  
• Utah AR Lab Network email​

West Region

• Washington State Public Health Laboratories
  
• WA AR Lab Network email​

Read More

AR Lab Network Newsletters

• Fall 2020
  

• July 2020
  

• April 2020
  

• January 2020​
  

• October 2019​

• July 2019

• February 2019​

• October 2018

• May 2018
  

• February 2018​
  

• December 2017
  

• November 2017​
  

• October 2017​
  

• September 2017
  

Educational Resources

• Antimicrobial Resistance Testing Training Resources
  

• Candida auris: An Emerging Multidrug-Resistant Yeast
  

• CRO Breakpoint Implementation Toolkit​
  

APHL Blog​

• Fighting Antimicrobia​l Resistance Requires Clinical and Public H​​​ealth Response
  

• Representing Public Health Labs at the White House Forum on Antibiotic Stewardship
  

Media

• FDA Releases 2018 National Antimicrobial Resistance Monitoring System (NARMS) Integrated Summary and NARMS Now: Integrated Data Featuring Genomic Data and Predicted Resistance, FDA Press Release, December 11, 2020
  

• More People in the United States Dying from Antibiotic-Resistant Infections than Previously Estimated, CDC Press Release, November 13, 2019
  

• United States Gathers 350 Commitments to Combat Antibiotic Resistance, Action Must Continue, CDC Press Release, September 23, 2019
  

• US Challenges World to Intensify Global Fight against Antibiotic Resistance, CDC Press Release, September 25, 2018
  

• Fighting antibiotic resistance: CDC tool maps progress in every state, but still more to be done, CDC Press Release, January 10, 2018
  

• CDC invests more than $200 million to help states respond to infectious diesases threats, CDC Press Release, August 4, 2017
  

• State, Regional Antibiotic Resistance Labs Aim to Boost Tracking, CIDRAP, April 13, 2017
  

CDC

• AR Lab Netw​​ork
  

• Antimicrobial Resistance Investments
  

CLSI AST Subcommittee​ News Updates

• Volume 5, Issue 1
  

• Volume 4, Issue 2​

• Volume 4, Issue 1​
  

• Volume 3, Issue 2​
  

• Volume 3, Issue 1​
  

• Volume 2, Issue 1 
  

• Volume 1, Issue 2 
  

• Volume 1, Issue 1​