Lab Matters Fall 2022 - Page 22

INFECTIOUS DISEASES

SHARPening Efforts Against Antibiotic Resistance by Nikki Marchan , senior specialist , Antimicrobial Resistance

In 2021 , the US Centers for Disease Control and Prevention ( CDC ) received funding under the American Rescue Plan for the Strengthening Healthcare Associated Infections / Antimicrobial Resistance ( HAI / AR ) Program Capacity ( SHARP ) supplement . Originally funded at the beginning of the COVID-19 pandemic through the Epidemiology and Laboratory Capacity for Infectious Diseases Cooperative Agreement ( ELC ), the SHARP supplement provides dedicated funding to leverage the existing structure of the Antibiotic Resistance Laboratory Network ( AR Lab Network ) to expand laboratory capacity for early detection of AR pathogens and public health infrastructure for rapid response to stop transmission .
“ These funds support critical infrastructure vital to the success of expansion , including support for testing coordination , clinical laboratory engagement and data infrastructure ,” said Stephanie Gumbis of CDC ’ s Antibiotic Resistance Coordination & Strategy Unit . “ SHARP aims to reinforce public health capacity and is a vital component to ensure rapid detection and reporting to support prevention and response efforts to address AR threats .”
Increasing Capability and Capacity
SHARP will not only increase the local , state and federal responses to threats , but it also highlights the appreciation for the collaborative effort needed to effectively respond to growing threats . SHARP will allow the 56 jurisdictions of the AR Lab Network to increase their laboratory capacity to perform CLIA-compliant testing and characterization of pathogens deemed urgent and serious threats by the most recent AR Threats Report . Funding also provides the opportunity for non-regional laboratories to expand capacity even further through optional , specialized testing that previously resided within the seven regional laboratories . Non-regional laboratories who elected to
expand capacity further will now receive funds to :
• Support state-led epidemiologic investigations and HAI / AR prevention efforts focused on screening targeted AR threats .
• Perform whole genome sequencing to support containment priorities .
• Support surveillance activities and outbreak investigations .
• Monitor suspected treatment failures for Neisseria gonorrhoeae cases .
And with dozens of laboratories electing to bring on more advanced testing , the expansion provides for a stronger laboratory network .
Putting the Proper People in Place
In addition to funds provided for increased laboratory testing , SHARP also provides funds to all jurisdictions for dedicated staff to work on complementary AR activities to ensure a robust network . One funded position is the AR Coordinator , who works with laboratory staff , epidemiologists , healthcare facilities and regional laboratories to coordinate the many intricacies involved with AR activities , such as communication , collaboration and outreach between the different groups .
“ All of the testing that happens through the AR Lab Network requires so much more than the actual laboratory work ,” said Emily Schneider , regional epidemiologist for the AR Lab Network West , who also coordinates epidemiological and testing activities within the West region . “ With the high volume of testing , many submitters and the desire to get results out as quickly as possible , it is vital to have a dedicated point of contact , a clear and organized approach for coordination , and a strong laboratory-epidemiology relationship . The opportunity to bring on a dedicated AR Coordinator will be fundamental to building up laboratory capacity to effectively and efficiently serve local , state , regional and federal partners .”
In addition to supporting an AR Coordinator , AR Lab Network jurisdictions also received funding to support a dedicated AR informatics expert . This position will work to ensure information technology infrastructure for timely reporting to all relevant parties , work towards transitioning to HL7 messaging to CDC for all testing , and work directly with APHL to implement reporting via the AIMS Platform and a web-based electronic test order and result portal .
“ As the AR Lab Network program grows , the need for informatics to work closely with [ epidemiologists ] and [ laboratorians ] has become much more apparent ,” said Liore Klein , the Laboratory-Epidemiology Coordinator of the AR Lab Network Program at the Maryland Department of Health Laboratories Administration . “ By carving out space within SHARP for an informatics expert ( or experts ), you can really have someone take ownership of AR informatics and make sure future development efforts not only make sense with the technologies we have but are best suited to the needs of laboratorians , epidemiologists and programmatic partners .” g
20 LAB MATTERS Fall 2022
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