Antimicrobial Resistance Laboratory Network

Key points

  • CDC's Antimicrobial Resistance Laboratory Network (AR Lab Network) includes seven high-capacity testing and reference testing regional labs, the National Tuberculosis Molecular Surveillance Center, and labs in 50 states, some cities and territories.
  • The AR Lab Network supports lab testing in healthcare, community, and environmental settings.
AR Lab Network logo. A map of the U.S. with gradient colors of teal, blue, purple, dark red, red and orange-red.

Purpose

CDC's AR Lab Network is an effort between U.S. healthcare facility labs and public health department labs, regional labs and the National Tuberculosis Molecular Surveillance Center and CDC.

The AR Lab Network works with laboratories nationwide to identify, track, and respond to emerging and enduring antimicrobial-resistant threats including, but not limited to:

Impact

The AR Lab Network is the first network in the nation providing comprehensive antimicrobial resistance testing of healthcare-associated infections (HAIs) and community-associated infections, fungal diseases, sexually transmitted diseases and drug-resistant Mycobacterium tuberculosis.

Collaboration from the local to national levels results in more rapid response for detecting antimicrobial resistance (AR). The network closes the gap between local capabilities and the data needed to combat AR by providing:

  • Comprehensive lab capacity and infrastructure for antimicrobial-resistant pathogens (disease causing organisms) detection found in health care, the community and the environment.
  • Cutting-edge technology, like next-generation DNA sequencing.
  • Quality data to drive response efforts to prevent AR infections and transmissions.

From 2017-2023 AR Lab Network labs screened and tested the following:

  • 362.009 Total carbapenem-producing and -resistant isolates and samples
    • 120,752 Carbapenem-resistant Enterobacterales isolates
    • 88,384 Carbapenem-resistant Pseudomonas aeruginosa isolates
    • 25,370 Carbapenem-resistant Acinetobacter baumannii isolates
    • 127,503 Carbapenem-producing organism screenings

How labs work together

U.S. healthcare and clinical labs should work with their local or state public health department to submit isolates or specimens for testing. The public health lab should work with their regional lab. Labs will also work with CDC.

AR Lab Network Collaboration image. Shows the healthcare lab, working with the public health lab, who collaborates with the regional lab, who then works with CDC.
AR Lab Network collaboration.
How labs work together
Lab type Roles and how they work with the AR Lab Network
Healthcare Facility and Clinical Labs
  • Perform initial tests on patient samples (called specimens, like blood or urine) that help healthcare providers make earlier, more precise diagnoses and tailor treatment for patients.
  • Establish protocols that immediately notify the health department, healthcare provider and infection control staff when they identify unusual resistance.
  • Work with the public health department to understand when, where, and how to submit specimens or isolates (pure samples of the germ) for additional antimicrobial resistance characterizations.

When a clinical lab suspects an organism of concern for antimicrobial resistance, they send the isolate to their public health lab. Submitting isolates provides opportunity for supplemental characterization, public health awareness of the AR threat (including public health support if local assistance is needed), and surveillance.
Public Health Department Labs
  • Support healthcare and clinical labs by identifying the pathogen (germ) and perform more advanced testing (e.g., molecular or antimicrobial resistance testing).
  • Provide clinical labs with timely lab results and recommendations.
  • Report concerning resistance to state health department epidemiologists and CDC, to inform rapid response.
  • Send specimens or isolates to their state health department, AR Lab Network regional lab and CDC to support response efforts or if they need additional testing.
  • Coordinate with the affected facilities, regional lab, and CDC, to identify individuals who come into contact with resistant germs and inform infection control measures.
The AR Lab Network Regional Labs and National TB Center
  • Support public health labs by confirming results, providing supplemental testing and providing guidance.
  • Detect existing and emerging types of antimicrobial resistance, track changes in resistance and identify outbreaks.
  • Generate data to ensure that important AR threats are identified quickly to inform infection prevention and response actions, therefore protecting people and combating future resistance threats.

All seven regional labs perform core testing. Select regional labs provide additional testing to support nationwide needs, including receiving pathogens from other CDC funded activities like Neisseria gonorrhoeae isolates from the Gonococcal Isolate Surveillance Project (GISP) and Strengthening the United States Response to Resistant Gonorrhea (SURRG) program. The National TB Center is equipped to perform whole genome sequencing for M. tuberculosis isolates identified in the U.S.
CDC
  • Established the AR Lab Network and provides technical expertise and coordination to lead the network.
  • Develop new lab tests, guidance, and tailored solutions so health departments can quickly and efficiently identify new AR threats.
  • Support infection prevention experts, programs and training in every state.
  • Collect, track and monitor AR threats detected by local, state and regional public health labs and identify data gaps and trends in resistance.
  • Report critical findings across federal government agencies, state public health departments and sample submitters.
  • As needed, confirm test results when unusual resistance threats are identified, recommend local prevention efforts and support outbreak responses.
  • Add isolates to the Antimicrobial Resistance Isolate Bank for drug and diagnostic test development.

AR Lab Network Stories

Illustration of gonorrhea.
Pilot to Test for Drug-Resistant Gonorrhea in Emergency Departments
CDC and health departments work to expand drug-resistant gonorrhea surveillance to emergency rooms.
Pilot Program with HP Accelerates Antibiotic Testing
Stop Spread of Unusual Antibiotic Resistance
Stopping C. auris in an Oklahoma Hospital

How it's funded

CDC's Antimicrobial Resistance Solutions Initiative (AR Solutions Initiative) invests in national infrastructure, including the AR Lab Network, to detect, respond, contain, and prevent resistant infections across healthcare settings, communities, the food supply, and the environment (water, soil).

Funding recipients

AR Lab Network Regional Labs Map
CDC's AR Lab Network Regional laboratories map.

Funding through CDC's AR Solutions Initiative supports all 50 state health departments, some cities, and territories. CDC also collaborates with other federal agencies, state and local health departments, patients, public health partners, and the private sector to address this threat.

Contacts

Minnesota Department of Health Public Health | ARLNMN@state.mn.us

Resources

Video

Your Partner for Pathogen Detection YouTube Video - 1:39

Transcript

Closing the Gap YouTube Video - 2:35

Transcript Low Resolution Video

Expanding Your Lab Capabilities YouTube Video 1:47

Transcript

Improve Testing Locally YouTube Video 2:21

Transcript Low Resolution Video

Web

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Content Source:
National Center for Emerging and Zoonotic Infectious Diseases (NCEZID)