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 who 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 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 2015, Congress provided $161 million to CDC to implement aspects of the 2014 National Strategy for Combatting 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. This network was established in September 2016 and is now in development.
PHLs and the Antimicrobial Resistance Laboratory Network
Using conventional and advanced methods to detect and characterize antimicrobial resistant organisms, the Antimicrobial Resistance Laboratory Network (ARLN) detects changes in resistance and helps identify outbreaks of antimicrobial diseases. State public health laboratories in Maryland, Minnesota, New York, Tennessee, Texas, Washington and Wisconsin designated as regional laboratories provide nationwide coverage for antimicrobial resistance testing. In additional to the seven regional laboratories the ARLN includes the National Tuberculosis Molecular Surveillance Center (National TB Center), located at the Michigan Department of Health and Human Services. The National TB Center conducts whole genome sequencing for all isolates of Mycobacterium tuberculosis in the United States.
APHL supports the ARLN 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.
ARLN Regional Laboratories
- Minnesota Department of Health Public Health Laboratory
- MN ARLN email; attn to ARLN Central Region Coordinator Paul Snippes Vagnone
From the APHL Blog
Fighting Antimicrobial Resistance Requires Clinical and Public Health Response
Representing Public Health Labs at the White House Forum on Antibiotic Stewardship
From the Media
State, Regional Antibiotic Resistance Labs Aim to Boost Tracking, CIDRAP, April 13, 2017
Antibiotic Resistance Lab Network
Antimicrobial Resistance Investments
From CLSI AST Subcommittee
Newsletter of the CLSI AST Outreach Working Group