Lab Matters Winter 2017 | Page 29

infectious diseases

Introducing the Antibiotic Resistance Laboratory Network

by Nikki Marchan , MPH , specialist , Antimicrobial Resistance

Antimicrobial Resistance ( AR ) is a growing concern in the US and globally . In addition to the thousands of related deaths each year , AR threatens modern medicine through the inability to manage infectious complications from patients undergoing routine medical procedures . In 2016 , the Centers for Disease Control and Prevention ( CDC ) established the Antibiotic Resistance Laboratory Network ( ARLN ). The ARLN , part of the CDC ’ s Antibiotic Resistance Solutions Initiative , will expand testing activities for antimicrobial resistant pathogens providing improved surveillance at the state and national level .

The ARLN comprises seven regional laboratories with the infrastructure and specialized capabilities to allow for faster detection and response , improved tracking of resistance and better data to prevent and combat future AR threats .
The role of the regional labs [ in the ARLN ] is vital to ensuring improved and more consistent coordination and tracking of resistance threats at all levels .
Honor , Responsibility and Roadblocks in Washington State
“ It ’ s a prestigious honor ; we distinguished ourselves as having the expertise and resources to perform the work ,” says medical epidemiologist Marisa D ’ Angeli , MD , MPH of the Washington State Public Health Laboratory ( WA PHL ), which will be serving as the Western regional lab . “ It ’ s also a great responsibility to prove that we are up to the task , investing the hours and identifying the necessary resources to be successful at this huge undertaking .”
To qualify as a regional laboratory , multiple prerequisites had to be met in order to provide the capabilities the ARLN required . However WA PHL was up to the task and has been working hard to get ready for the launch of the ARLN . Preparations have included building out new lab space , verifying and validating new testing methods , hiring additional staff and organizing trainings for PHLs in the Western region . They credit their success in this enterprise to the extensive planning efforts by all staff . Moreover , effective communications between WA PHL and ARLN contacts at CDC , as well as feedback from other jurisdictions , have proven instrumental in providing the support needed .
As in all major ventures , there were roadblocks that presented significant challenges . One obstacle was the implementation of required electronic reporting elements , which is a big undertaking within an individual lab , let alone over a region . This was compounded by the fact that WA PHL had previously been behind other states in electronic technology . APHL ’ s Informatics team collaborated with Washington PHL ’ s IT team to successfully increase electronic reporting capacity .
The ARLN will provide nationwide surveillance , filling existing data gaps and informing prevention and response efforts . The role of the regional labs is vital to ensuring improved and more consistent coordination and tracking of resistance threats at all levels .
" We are being counted on to develop new lab capabilities and roll out support to a number of states in the region ,” says Brian Hiatt , WA PHL ’ s office director for microbiology . “ We hope that our lab ’ s selection will lead to increased awareness , improved prevention capabilities and a better overall understanding of drug resistant organisms throughout the region .”
ARLN Regional Laboratories :
Northeast Region
• Wadsworth Center ( NY )
Mid-Atlantic Region
• Maryland Public Health Laboratory
Southeast Region
• Tennessee State Public Health Laboratory
Midwest Region
• Wisconsin State Laboratory of Hygiene
Central Region
• Minnesota Department of Health Public Health Laboratory
Mountain Region
• Texas Department of State Health Services Laboratory
Western Region
• Washington State Public Health Laboratory
Lead Microbiologist Mike Tran of the Washington State Public Health Laboratory uses MALDI-TOF mass spectrometry to confirm microbial identification
APHL . org
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