APHL supports public health laboratories in their efforts against antimicrobial resistance (AR) by assessing capability and capacity, releasing guidance, conducting training and liaising with clinical laboratory partners. 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 ill patients.
Defining the Problem of Antimicrobial Resistance
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 now working with partner organizations to draw attention to the issue and to advocate for a swift and united response.
AR Lab Network
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 antibiotic resistance in the US and globally, calls for a regional laboratory network of public health laboratories, established in September 2016, to respond to local outbreaks of antimicrobial resistant organisms.
Using conventional and advanced methods to detect and characterize antimicrobial resistant organisms, the Antibiotic Resistance Laboratory Network will detect changes in resistance and help identify outbreaks of antimicrobial diseases. The network offers national coverage via seven state public health laboratories located in Maryland, Minnesota, New York, Tennessee, Texas, Washington and Wisconsin and is set to begin offering testing in 2017.
CLSI AST Subcommittee
The Clinical Laboratory Standards Institute (CLSI) provides laboratory testing standards and guidelines for health care professionals based on input from and consensus among industry, government and healthcare professionals. CLSI has a subcommittee on Antimicrobial Susceptibility Testing. The CLSI AST Outreach Working Group (ORWG) publishes a newsletter which provides readers information concerning the activities of the AST Subcommittee as well as highlights relevant AST-related issues.
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
Antibiotic Resistance Lab Network
Public Health Laboratory Role
As this evolving effort moves forward, APHL will play a central role in providing training for the AR regional laboratories, ensuring that all public health laboratories have the skills and resources to perform critical baseline AST, and providing forums for public health and clinical laboratories to connect to encourage a seamless flow of specimens and information.