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 .