APHL supports public health laboratories in their efforts against antimicrobial resistance (AR) by assessing capability and capacity, releasing guidance, conducting training and liaising with clinical laboratory partners. Public health laboratories conduct antimicrobial susceptibility testing (AST) to determine emerging resistance, identify and report novel resistance mechanisms, maintain reference testing methods and respond to community outbreaks of resistant organisms. AST is an essential laboratory function shared by public health and clinical laboratories who perform AST to inform clinical treatment of ill patients.
Defining the Problem of Antimicrobial Resistance
In 2013 CDC released Antibiotic Resistance Threats in the United States, a comprehensive assessment of top antimicrobial resistance threats. The report emphasized that collaboration across all sectors of government, public health and healthcare would be critical to meet this challenge. APHL is now working with partner organizations to draw attention to the issue and to advocate for a swift and united response.
Federal Government Response
In 2015, Congress provided $161 million to CDC to implement aspects of the 2014 National Strategy for Combatting Antibiotic-Resistant Bacteria. The strategy, which aims to fight antibiotic resistance in the US and globally, calls for the establishment of a regional laboratory network of public health laboratories able to respond to local outbreaks of antimicrobial resistant organisms. Selection of these regional laboratories is happening now. Once selected these highly skilled laboratories will use conventional and advanced methods to detect and characterize antimicrobial resistant organisms, and identify the healthcare facilities where these infections are transmitted. This will allow healthcare and public health professionals to take measures to eliminate the spread of the organisms.
Public Health Laboratory Role
As this evolving effort moves forward, APHL will play a central role in providing training for the AR regional laboratories, ensuring that all public health laboratories have the skills and resources to perform critical baseline AST, and providing forums for public health and clinical laboratories to connect to encourage a seamless flow of specimens and information.