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How AR Lab Network Works

Laboratories nationwide work together to rapidly identify antibiotic resistance genes and germs that could cause hard-to-treat or potentially untreatable infections. Collaboration from the local to national levels results in more rapid response for detecting resistance.

Details of How AR Lab Network Works

Icon of a hospital

Healthcare Labs

  • Establishes protocols that immediately notify the health department, healthcare provider, and infection control staff of unusual resistance
  • Works with public health department to understand when and where to submit isolates or specimens
  • Benefits of submitting isolates include:
    • Obtaining resistance mechanism data for resistant germs
    • Better outbreak detection for the hospital’s patient population
  • Examples of isolates or specimens to send include:
    • Carbapenem-resistant Enterobacteriaceae (CRE)
    • Candida species most likely to develop resistance (e.g., C. glabrata and C. auris)
    • Germs with unusual resistance
    • CRE colonization during state outbreak investigations
Icon of a public health department.

Public Health Department Labs

  • Performs bacterial identification, susceptibility testing, molecular testing to characterize CRE and carbapenem-resistant Pseudomonas aeruginosa (CRPA)
  • Reports unusual resistance identified to regional labs and CDC
  • Develops a plan to respond rapidly to unusual genes and germs when they first appear
  • Coordinates with affected healthcare facilities, regional lab, and CDC for every case of unusual resistance, including:
    • Testing CRE to help track and stop spread
    • Performing whole genome sequencing (WGS) of all Salmonella for faster identification and response to outbreaks
  • Provides timely lab results and recommendations to affected health care facilities and providers, and alerts facilities if a patient with resistance came from or was transferred to another facility
Map of U.S. showing AR Lab Network regions in different colors

Regional Labs and National Tuberculosis Molecular Surveillance Center (National TB Center)

  • Detects existing and emerging types of antibiotic resistance, tracks emerging resistance more effectively, and generates stronger data to protect people and combat future resistance threats
  • “Core Testing” is performed at every regional lab, and “Additional Testing” is performed at select labs to support nationwide needs, which complements other lab capacity supported by CDC in every state, five cities, and Puerto Rico

Core Testing

  • Molecular testing to detect colonization of CRE
  • Fungal susceptibility of Candida species to identify emerging resistance
  • Identification and colonization screening to detect and help prevent spread of C. auris
  • Detection and characterization of emerging threats and concerning threats, like mcr-1 and carbapenem-resistant Acinetobacter, and ability to detect changes to known threats, like Methicillin-resistant Staphylococcus aureus

Additional Testing

  • C. difficile special projects
  • Enhanced detection of drug-resistant N. gonorrhoeae using antimicrobial susceptibility testing and WGS
  • Antibiotic susceptibility and serotyping of multidrug-resistant S. pneumonia
  • Perform WGS for all isolates of M. tuberculosis
  • Perform reference susceptibility testing of pan-resistant bacteria to new antibiotic agents

cdc logo icon

CDC

  • CDC coordinates the AR Regional Lab Network and provides technical expertise
  • Confirms testing of unusual isolates and does additional testing
  • Develops and provides new lab tests and guidance so health departments can quickly identify new threats
  • Supports prevention experts, programs, and training in every state, and provides recommendations for local prevention and response
  • Collects, tracks, and monitors threats found from state and regional labs, and reports critical findings to international partners
  • Identifies data gaps and trends in resistance
  • Adds new panels to the Antibiotic Resistance Isolate Bank for drug and diagnostic test development

Regional Labs and Contact Information

Visit CDC’s Healthcare-associated Infections website and click on a state to find state public health contact information, or email ARLN@cdc.gov for more information about the AR Lab Network.

Map of U.S. showing AR Lab Network regions shaded in different colors and core testing for each lab.

 

Tests included in Core Testing are outlined in the table above.

Tests included in Core Testing are outlined in the table above.
Region Location and Contact Information What is Tested
 Central

 

Minnesota Department of Health Public Health Health.ARLNMN@state.mn.us Core Testing
+ C. difficile
+ S. pneumoniae
Mid-Atlantic

 

Maryland Public Health Laboratory

MDPHL.ARLN@maryland.gov

 Core Testing
+ N. gonorrhoeae
Midwest

 

Wisconsin State Laboratory of Hygiene

wiARLN@slh.wisc.edu

Wisconsin website

 Core Testing
+ S. pneumoniae 
Mountain

 

Texas Department of State Health Services Laboratory

TexasARLN@dshs.texas.gov

Core Testing
+ N. gonorrhoeae
Northeast

 

Wadsworth Center Laboratories

Elizabeth.nazarian@health.ny.gov (Bacteria)

mycology@health.ny.gov (Candida)

Wadsworth website

Core Testing

 

Southeast

 

Tennessee State Public Health Laboratory

ARLN.health@tn.gov

Tennessee website

Core Testing
+ N. gonorrhoeae
West

 

Washington State Public Health Laboratories

ARLN@doh.wa.gov

Core Testing
+ N. gonorrhoeae
National Tuberculosis Molecular Surveillance Center Michigan Department of Health and Human Services + M. tuberculosis

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