Lab Matters Fall 2019 | Page 21

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 19