SPECIAL SECTION: THE LABORATORY RESPONSE NETWORK
APHL and CDC Host LRN Bacillus anthracis
E-test Training
®
by Tyler Wolford, MS, manager, Emergency Preparedness and Response
Antimicrobial resistance is the ability
of a microbe to resist the effects of
medication used to treat patients. For
highly pathogenic bacteria such as
Yersinia pestis and Bacillus anthracis, this
resistance can pose a serious threat.
To improve post-exposure treatment,
the Laboratory Response Network for
Biological Threats Preparedness (LRN-B)
utilizes the Epsilometer test (E-test ® ) to
provide important data on antimicrobial
susceptibility (AST) of B. anthracis.
E-test ® is intended for the in vitro
determination of AST of B. anthracis
isolates to ciprofloxacin, levofloxacin and
tetracycline. In a bioterrorism event or
a naturally-occurring infection with B.
anthracis, using an E-test ® result can help
guide appropriate antimicrobial therapy
and prophylaxis.
Few LRN-B laboratories routinely perform
AST to detect drug-resistant B. anthracis
because it requires specialized training
and poses biosafety risks to laboratorians
when manipulating the bacteria. In
addition, the current LRN-B protocol for
AST by E-test ® is limited by the number
of antibiotics and sample types. In 2019,
the US Centers for Disease Control and
Prevention (CDC) modified the E-test ®
protocol to include the antibiotic
doxycycline and clinical isolates as a
sample type, further increasing the data
gathered from the test. The LRN-B plans to
deploy the updated E-test ® protocol to the
network by the end of 2019.
APHL, in partnership with CDC, hosted
a training for E-test ® in August 2019.
Twenty-nine laboratory scientists from
LRN-B laboratories attended the two-day
training course, which provided expert
guidance on the assay, an overview of the
related science, and the opportunity to
perform the assay. CDC will be seeking
US Food and Drug Administration (FDA)
pre-Emergency Use Authorization and
develop mechanisms to facilitate B.
anthracis E-test ® use in emergencies for
non-select agent registered labs. n
PublicHealthLabs
@APHL
Instructors and trainees at the B. anthracis E-test ® training.
In February 2018, APHL and CDC hosted a Botulinum Neurotoxin EndoPep–
Mass Spectrometry assay training in which 14 laboratory scientists received
training. The LRN-B also offers more comprehensive methods courses. The LRN
Rapid Methods Course focuses on molecular detection techniques and sample
processing, while the LRN Conventional Methods Course covers standard
microbiological detection techniques such as culturing, microscopy, gram
staining and biochemical testing.
APHL.org
Fall 2019 LAB MATTERS
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