AR Lab Network

Mountain Region

About us

The Antimicrobial Resistance Laboratory Network (AR Lab Network) at the Utah Public Health Laboratory (UPHL) was established by the Centers for Disease Control (CDC) in 2016. We serve as the Mountain States Regional Laboratory within the national AR Lab Network and receive specimens from Arizona, Colorado, Idaho, Montana , New Mexico, Utah, Texas, and Wyoming. 

We screen, identify, and test bacterial and fungal samples from healthcare facilities and clinical laboratories to classify the kind of carbapenemase or antifungal resistance and prevent the spread of multidrug resistant organisms.

What we do

Identification

We confirm the identity of antimicrobial resistant isolates with the following methods: 

  • Bacterial identification using MALDI-TOF mass spectrometry
  • Yeast (Candida spp) identification MALDI-TOF mass spectrometry
  • Whole Genome Sequencing of isolates with suspected novel or emerging carbapenemase and to understand transmission.

Screening

We screen the following samples using culture and PCR methods for the presence of specific carbapenemases:

  • CPOs such as CRE, CRPA, CRAB
  • Candida auris
  • Group A Streptococcus(Utah providers only)

We offer this service for free in collaboration with public health officials, such as state healthcare-associated Infections (HAI) coordinator, infection preventionists, and epidemiologists.

Antimicrobial Susceptibility (AST)

We perform antimicrobial susceptibility testing (AST) to confirm each sample’s phenotype and determine if it’s a multidrug-resistant organism.

Expanded AST (ExAST)

With pre-authorization, we perform expanded AST (ExAST) on highly resistant CRE, CRPA, and CRAB isolates that are Multidrug-Resistant Organism (MDROs). 

Aztreonam-avibactam
Submit CRE Isolates that Test 

  • Not-susceptible to one carbapenem such as: Ertapenem, Meropenem, Doripenem, Imipenem, Ceftazidime-avibactam, Meropenem-vaborbactam, Imipenem- relebactam
  • Or, test positive for NDM, VIM,  or IMP genes

Meropenem-vaborbactam
Submit CRE Isolates that Test 

  • Not-susceptible to Meropenem

Imipenem-relebactam
Submit CRE (except for P. mirabilis) and CRPA that Test

  • Not-susceptible to Imipenem

Sulbactam-durlobactam
Submit CRAB Isolates that Test

  • Resistant to Imipenem, Meropenem or Doripenem

How to submit isolate or clinical (colonization screening) samples for testing

All  samples, clinical and isolate,  must be submitted to us with a completed test request form. Clinical samples must be collected with an ARLN-specific testing kit.

Follow these steps before submitting a sample to us:

  1. Contact us in advance to schedule testing and order testing kits. 
    • Email [email protected] if you are a laboratory or healthcare facility in Utah.
    • Email [email protected] if you are a laboratory or healthcare facility in another Mountain Region state. 
  2. Register with the Utah Lab Web Portal, please contact [email protected]
  3. Alternatively, fill out the ARLN Test Request Form
  4. Collect the samples and follow the instructions in the packaging and shipping guidance document when shipping clinical samples. 

For clinical samples, you can also use the Lab Web Portal to fill out the test request form. If you would like to use Lab Web Portal, please contact [email protected]

Watch this video for more information on how to use the Lab Web Portal or review the Lab Web Portal Quick guide.

Submission, collection, and testing guidance

Colonization Collection guidance

Isolate CRE, CRPA, and CRAB guidance

  • Isolate:  slant or plate 
    • CRE resistant to one or more carbapenem (ertapenem, doripenem, meropenem, or imipenem)
    • CRPA resistant to a carbapenem (imipenem, meropenem) and non-susceptable to cefepime, ceftazidime, or ceftolozane-tazobactam
    • CRAB resistant to any carbapenem (doripenem, imipenem, meropenem)

AST testing

Testing guidance:

    Other resources:

    ExAST testing

    Testing guidelines

    • Pre-authorization is required before submitting a sample for testing. 
    • We do not test multiple samples from the same patient, source, and organism in a 6-month period.

    Pre-authorization

    Candida spp. Isolate Submission and Updates, not albicans

    Neisseria gonorrhoeae

    Testing guidelines

    • Pre-authorization is required before submitting a sample for testing. 
    • We use E-test gradient strips (azithromycin, cefixime, ceftriaxone, and ciprofloxacin). 
    • Testing is for patients with suspected treatment failure or disseminated gonorrhea infections. 
    • We only accept bacterial isolates for testing.

      Submission guidelines

        Pre-authorization

        Resources

        Data and reports

        Figure 1: Utah's antimicrobial resistant isolates submitted by year.

        Figure 2: Mechanisms of Carbapenem-resistant Pseudomonas aeruginosa from isolates submitted in Utah, 2021-2025

        Figure 3: Mechanisms of Carbapenem-resistant Acinetobacter baumannii from isolates submitted in Utah, 2021-2025.

        Figure 4: Mechanisms of Carbapenem-resistant Enterobacterales from isolates submitted in Utah, 2021-2025.

         

        Contact us

        For AR Lab Network questions

        For Utah epidemiology questions