Lab Matters Summer 2016 | Page 10

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Teresa Passaretti of the Wadsworth Center Bacteriology Laboratory performs real-time PCR with an in-house laboratorydeveloped test that detects Legionella, Legionella pneumophila and Legionella pneumophila serogroup 1 and assesses for inhibition

Elizabeth Nazarian, Yan Zhu, MLS, Lisa Mingle, PhD, and Kara Mitchell, PhD, MS, discuss testing data during the Legionella South Bronx investigation

Jill Taylor, PhD, director of the Wadsworth Center, Nellie Dumas and Elizabeth Nazarian from the Bacteriology Laboratory during a typical planning discussion during the Legionella South Bronx investigation

Armstrong said,“ Congress was very clear to us: they don’ t want us to start covering the ongoing cost of operations. Our funding is meant to be catalytic and to promote innovation in the US public health system.”

In practice, that has meant working through other CDC programs to support the adoption of appropriate next-gen technologies, such as whole genome sequencing( WGS), and to support workforce training. Partly because of AMD efforts, at the end of 2015, 37 state PHLs had NGS instrumentation in-house, and another nine reported plans to acquire the technology by the end of 2016.

The next round of funding for CDC’ s Epidemiology and Laboratory Capacity Cooperative Agreements will include about $ 2.5 million from the AMD program to develop a cross-cutting NGS infrastructure. Armstrong said his program intends to fund about three dozen laboratories and“ maybe more than that.”

Already, NGS testing platforms are in use across the country to address a wide range of public health issues, from TB and Zika virus to newborn screening and food safety testing.

At the end of 2015, 37 state PHLs had NGS instrumentation in-house, and another nine reported plans to acquire the technology by the end of 2016

Robert Myers, PhD, director of the Maryland State Department of Health and Mental Hygiene Laboratories Administration, said his lab has been using NGS for specific applications since 2012. One of the biggest advantages of the technology, he said, is its discriminatory power, enabling epidemiologists to identify novel microbes— such as a Bergeyella zoohelcum isolate from a Maryland pig bite victim— and to identify genetically related sub-clusters of pathogens. In one investigation, for example, WGS revealed that an East Coast Salmonella Newport outbreak two summers ago actually comprised multiple sub-clusters, with different tainted food items implicated in New York cases versus those in Maryland, Virginia, Delaware, Pennsylvania and Ohio. The technology has been used to similar effect in other outbreaks.