Lab Matters Spring 2019 - Page 35

PUBLIC HEALTH PREPAREDNESS AND RESPONSE Using MicrobeNet to Enhance Biothreat Agent Detection 2019 Preparedness Summit For the 20th anniversary, APHL and CDC are leading an initiative to highlight the role and success of the LRN, especially as it pertains to partnerships in biological, chemical, radiological and emerging threat detection and response. The 2019 Preparedness Summit in St. Louis, MO, co-sponsored by APHL, provided a forum for public health and emergency preparedness professionals to network, share current information on preparedness collaborations and emerging technologies, share model practices, and discuss solutions to ongoing challenges. At this year’s Summit, APHL hosted three LRN sessions covering everything from laboratory testing capacity and capabilities to partnerships with clinical laboratories, FBI, National Guard Bureau Civil Support Teams and other first responders. n by Robert Nickla, RBP, M(ASCP), LRN coordinator, Oregon State Public Health Laboratory and Samuel Abrams, MPH, PMP, specialist, Public Health Preparedness and Response providing a laboratory network essential for statewide emergency preparedness and response, MLS also plays a key role in detecting emerging infectious disease outbreaks. The Florida Bureau of Public Health Laboratories (BPHL), with LRN member laboratories in Jacksonville, Tampa, and Miami, utilized their network of laboratories to respond to the Zika virus outbreak in 2016. Florida was the first state to report local transmission of Zika virus. However, by this time, the Florida BPHL had already implemented laboratory testing capabilities and worked with the health department on mitigation programs to combat the virus spreading. Within six months Florida was declared Zika free. Communication among the laboratories in Florida contributed to the successful coordination of efforts to eliminate the threat of Zika in the state. Part of LRN’s success over the last 20 years’ in being well equipped to respond to threats, lie in strong partnerships. By maintaining partnerships across multiple sectors, the LRN can continue to meet new, challenging demands, as threats continue to evolve. n The US Centers for Disease Control and Prevention (CDC) curates and provides a free online database containing a variety of identification information for pathogens that are not commonly encountered in laboratory diagnostic testing. Known as MicrobeNet, the database was established by CDC in 2013 to assist public health laboratories (PHLs) and sentinel clinical laboratories with diagnostic capabilities and species identifications, and is updated monthly. MicrobeNet is a robust and powerful online tool that can provide laboratorians the capability option to search for species identification assistance based on genetic sequence (16s ribosomal), phenotype biochemical profiles, or by real time protein classification profiles, the latter of which is generated by matrix-assisted laser desorption/ionization – time of flight mass spectrometry (MALDI-TOF MS) technology. MicrobeNet as a Resource MicrobeNet provides a unique, expansive resource that many laboratorians are now learning about. In addition to having an easily searchable database, individuals are able to submit their MALDI-TOF MS system read files to compare against MicrobeNet. In instances where PHL MALDI-TOF MS software libraries return an inconclusive match, the protein profile can be submitted online to MicrobeNet and compared against the CDC’s libraries. Within a few moments the user will be provided the best matches for their sample, which may help with specific identification of a potential biothreat pathogen. MicrobeNet is intended for use by PHLs, clinical laboratories and research laboratories worldwide. Why Use MicrobeNet? Among the countless number of samples processed monthly, both PHLs and clinical laboratories may encounter rare or emerging pathogens, and routinely encounter potential biothreat agents. MALDI-TOF instruments are becoming common in the microbiology laboratory and although laboratories continue to implement the use of MALDI-TOF MS technology for specimen identification, the software libraries used for identification are often limited in their capability and adding additional libraries can be cost prohibitive or not yet available. Typically, a laboratory only utilizes the MALDI-TOF library that is provided from their instrumentation manufacturer. MicrobeNet consists of the manufacturers’ database, but also offers an increased database that is comprised of a merged library of the manufacturers’ entries plus the entries that CDC has added to their own connected library. The enhanced MicrobeNet library provides a free resource that is fast, expansive and highly accurate, allowing a laboratorian to further speciate their sample and determine whether a biothreat agent or near-neighbor is likely contained within the sample. This enhanced library detection assistance can provide an increase in accuracy identification matching results, and can help decrease the amount of time a clinical laboratory spends handling and testing a potentially significant pathogen, such as a biothreat agent rule-out. The increased identification efficiency leads towards safer laboratories with fewer exposure potentials, and ultimately better patient outcomes with faster and more accurate results. n DIGITAL EXTRA: Read about how the State Hygienic Laboratory at the University of Iowa uses MicrobeNet. PublicHealthLabs @APHL Spring 2019 LAB MATTERS 33