{"id":9961,"date":"2025-03-01T14:01:40","date_gmt":"2025-03-01T19:01:40","guid":{"rendered":"https:\/\/dhss.delaware.gov\/dph\/mdrotesting\/"},"modified":"2025-03-02T00:41:43","modified_gmt":"2025-03-02T05:41:43","slug":"mdrotesting","status":"publish","type":"page","link":"https:\/\/dhss.delaware.gov\/dph\/lab\/mdrotesting\/","title":{"rendered":"lab\/mdrotesting ~  Multi-Drug Resistance Organism (MDRO) Testing  &#8211; Delaware Health and Social Services &#8211; State of Delaware"},"content":{"rendered":"<div data-swiftype-index=\"true\">\n\n\n\n\n\n  <br>\n\n\n  \n\n\n  <div class=\"container\" id=\"main_header\">\n\n\n    <!-- BEGIN readspeaker div -->\n\n\n    <div class=\"rs_skip rsbtn rs_preserve\" id=\"readspeaker_button1\">\n\n\n      <a accesskey=\"L\" class=\"rsbtn_play\" href=\"https:\/\/app-na.readspeaker.com\/cgi-bin\/rsent?customerid=7262&#038;lang=en_us&#038;readid=main_content&#038;url=https:\/\/dhss.delaware.gov\/dph\/lab\/mdrotesting.html\" title=\"Listen to this page using ReadSpeaker\">\n\n\n        <span class=\"rsbtn_left rsimg rspart\"><span class=\"rsbtn_text\"><span>Listen<\/span><\/span><\/span>\n\n\n        <span class=\"rsbtn_right rsimg rsplay rspart\"><\/span>\n\n\n      <\/a>\n\n\n    <\/div>\n\n\n    <!-- END readspeaker div -->\n\n\n\n\n\n    \n\n\n    <header class=\"pull-left\">\n\n\n      <h1><!--[type=EDIT name=\"Page Title\"]-->Multi-Drug Resistance Organism (MDRO) Testing<!--[END]--><\/h1>\n\n\n    <\/header>\n\n\n  <\/div><br>\n\n\n \n\n\n  <div class=\"container\">\n\n\n    <div class=\"row\">\n\n\n      <div class=\"col-md-3\" id=\"leftCol\">\n\n\n        <div class=\"panel-group\" id=\"accordion\">\n\n\n          <div class=\"panel sectionmenu_panel\">\n\n\n            <div class=\"panel-heading\">\n\n\n              <p class=\"panel-title\"><a class=\"agency_nav\" data-parent=\"#accordion\" data-toggle=\"collapse\" href=\"#collapseOne\"><strong><i class=\"fa fa-align-justify fa-fw\"><\/i> Public Health Menu<\/strong><\/a><\/p>\n\n\n            <\/div>\n\n\n\n\n\n            <div class=\"panel-collapse collapse in\" id=\"collapseOne\">\n\n\n              <div class=\"panel-body\" id=\"clf_nav\">\n\n\n                  <ul class=\"nav nav-stacked nav-pills-clf\" id=\"agency_sidebar\">\n    <li><a href=\"\/dph\/\"><h2>Home <i class=\"fa fa-home fa-fw\"><\/i><\/h2><\/a><\/li>\n    <li class=\"toplevel\"><a data-parent=\"#agency_sidebar\" data-toggle=\"collapse\" href=\"#HomeMenu\"><h2>About <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n      <ul class=\"panel-collapse collapse\" id=\"HomeMenu\">\n        <li><a href=\"\/dph\/about.html\">About DPH<\/a><\/li>\n        <li><a href=\"\/dph\/sections.html\">Sections &#038; Programs<\/a><\/li>\n        <li><a href=\"\/dph\/ofclocations.html\">Office Locations<\/a><\/li>\n        <li><a href=\"\/dph\/contact.html\">Contact Info<\/a><\/li>\n      \n        <li><a href=\"\/calendars.html\" target=\"_blank\">Calendar<\/a><\/li>\n      <\/ul>\n    <\/li>\n    <li class=\"toplevel\"><a data-parent=\"#sidebar\" data-toggle=\"collapse\" href=\"#ServicesMenu\"><h2>Services <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n      <ul class=\"panel-collapse collapse\" id=\"ServicesMenu\">\n        <li><a href=\"\/dph\/servicesaz.html\">A-Z Services<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/environmental.html\">Air &#038; Water Quality<\/a><\/li>\n        <li><a href=\"\/dph\/ss\/vitalstats.html\">Birth, Death, &#038; Marriage Records<\/a><\/li>\n        <li><a href=\"\/dph\/clinics.html\">Clinics<\/a><\/li>\n        <li><a href=\"\/dph\/healthdatastats.html\">Health Data &#038; Statistics<\/a><\/li>\n        <li><a href=\"\/dph\/php\/emsps.html\">Emergency Preparedness<\/a><\/li>\n        <li><a href=\"\/dph\/healthandwellness.html\">Health &#038; Wellness<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/healthyhomes.html\">Healthy Homes<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/healthywp.html\">Healthy Workplaces<\/a><\/li>\n        <li><a href=\"\/dph\/lab\/labs.html\">Laboratory<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/feir.html\">Restaurant Inspections<\/a><\/li>\n        <li><a href=\"\/dph\/screen.html\">Screening and Testing<\/a><\/li>\n        <li><a href=\"\/dph\/chca\/dphwichominf01.html\">WIC<\/a><\/li>\n        <li><a href=\"\/dph\/servicesadd.html\">Additional Services<\/a><\/li><li>\n      <\/li><\/ul>\n    <\/li>\n    <li class=\"toplevel\"><a data-parent=\"#sidebar\" data-toggle=\"collapse\" href=\"#InformationMenu\"><h2>Information <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n        <ul class=\"panel-collapse collapse\" id=\"InformationMenu\">\n        <li><a href=\"\/dph\/factsheetsaz.html\">A-Z Fact Sheets<\/a><\/li>\n        <li><a href=\"\/dph\/pubreportsaz.html\">A-Z Publications &#038; Reports<\/a><\/li>\n        <li><a href=\"\/dph\/diseasesandconditions.html\">Diseases &#038; Conditions<\/a><\/li>\n        <li><a href=\"\/dph\/faq.html\">FAQ&#8217;s<\/a><\/li>\n        <li><a href=\"\/dph\/php\/alerts.html\">Health Alerts<\/a><\/li>\n        <li><a href=\"\/dph\/healthylifestyles.html\">Healthy Lifestyles<\/a><\/li>\n        <li><a href=\"\/dph\/hipaa.html\">HIPAA<\/a><\/li>\n        <li><a href=\"\/dph\/regs.html\">Regulations<\/a><\/li>\n        <li><a href=\"\/dph\/forms.html\">Request Forms<\/a><\/li>\n        <li><a href=\"\/dph\/links.html\">Links &#038; Resources<\/a><\/li>\n        <li><a href=\"http:\/\/delaware.gov\/help\/foia_request.shtml\">FOIA Request Form<\/a><\/li>\n      <\/ul>\n    <\/li>\n    <li><a id=\"SocialMenuHeader\"><h2>Connect <i class=\"fa fa-thumbs-o-up fa-fw\"><\/i><\/h2><\/a>\n      <ul id=\"SocialMenu\">\n        <li class=\"facebook\"><a href=\"https:\/\/www.facebook.com\/DEPublicHealth\" target=\"_blank\" title=\"Division of Public Health Facebook Page\"><i class=\"fa fa-facebook-square fa-lg\"><\/i> Facebook<\/a><\/li>\n        <li class=\"twitter\"><a href=\"https:\/\/twitter.com\/Delaware_DHSS\" target=\"_blank\" title=\"Delaware Health and Social Services Twitter Account\"><i class=\"fa fa-twitter-square fa-lg\"><\/i> Twitter<\/a><\/li>\n        <!-- <li class=\"googleplus\"><a href=\"#\"><i class=\"fa fa-google-plus-square fa-lg\"><\/i> Google +<\/a><\/li>\n        <li class=\"flickr\"><a href=\"#\"><i class=\"fa fa-flickr fa-lg\"><\/i> Flickr<\/a><\/li>\n        <li class=\"youtube\"><a href=\"#\"><i class=\"fa fa-youtube-square fa-lg\"><\/i> Youtube<\/a><\/li>\n        <li class=\"instagram\"><a href=\"#\"><i class=\"fa fa-instagram fa-lg\"><\/i> Instagram<\/a><\/li>\n        <li class=\"linkedin\"><a href=\"#\"><i class=\"fa fa-linkedin-square fa-lg\"><\/i> Linkedin<\/a><\/li>\n        <li class=\"pinterest\"><a href=\"#\"><i class=\"fa fa-pinterest-square fa-lg\"><\/i> Pinterest<\/a><\/li> -->\n      <\/ul>\n    <\/li>\n  <\/ul>\n\n\n              <\/div>\n\n\n            <\/div>\n\n\n          <\/div>\n\n\n        <\/div><br>\n\n\n      <\/div>\n\n\n\n\n\n      <div class=\"col-md-9\" id=\"main_content\"> \n\n\n  <!--[type=HTMLEDIT name=\"Content\"]-->\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<!-- Google Translate Element BEGIN -->\n\n\n\n            <div id=\"google_translate_element\"><\/div>\n\n\n\n                <script type=\"text\/javascript\">\n\n\n\n                    function googleTranslateElementInit() {\n\n\n\n                    new google.translate.TranslateElement({pageLanguage: 'en'}, 'google_translate_element');\n\n\n\n}\n\n\n\n                <\/script>\n\n\n\n                <script src=\"\/\/translate.google.com\/translate_a\/element.js?cb=googleTranslateElementInit\" type=\"text\/javascript\">\/**\/<\/script><br>\n\n\n\n            <!-- Google Translate Element END -->\n\n\n\n<p class=\"text-left\"><img loading=\"lazy\" decoding=\"async\" alt=\"Photos of BT Lab\" height=\"200\" src=\"\/wp-content\/uploads\/sites\/10\/dph\/img\/mdrobanner.jpg\" width=\"600\"\"><\/p>\n\n\n\n\n\n\n\n<p> The Microbiology section of the Delaware Public Health Laboratory (DPHL) provides routine antimicrobial susceptibility testing (AST) for pathogenic organisms. As part of the Antimicrobial Resistance Laboratory Network (ARLN) the section also provides surveillance of drug resistance exhibited in multi-drug resistant organisms (MDRO). Examples of MDRO include Vancomycin resistant <i>Enterococcus<\/i> (VRE) or <i>Staphylococcus aureus<\/i> (VRSA), carbapenem resistant organisms (CRO), drug resistance Tuberculosis, and drug resistant <i>Neisseria gonorrhoeae<\/i> to name a few. Please contact the DPHL with questions or concerns regarding atypical drug resistance.<\/p> \n\n\n\n\n\n\n\n<p> In 2016, the Centers for Disease Control and Prevention (CDC) established the ARLN to connect laboratories nationwide, with the goal of rapidly detecting resistant organisms and coordinating with local agencies to reduce spread for the protection of the people. DPHL&#8217;s role within this network includes working closely with the Office of Infectious Disease Epidemiology (OIDE) and infection control specialists at acute and long-term care facilities throughout the state, to provide timely results and alerts, when appropriate. As atypical resistance profiles are detected, DPHL works with our ARLN regional lab, the CDC, and impacted facilities to develop and implement response plans.<\/p> \n\n\n\n\n\n\n\n<p>DPHL receives grant funding to test carbapenem resistant Enterobacteriaceae (CRE), <i>Pseudomonas aeruginosa<\/i> (CRPA), and <i>Acinetobacter baumannii<\/i> (CRAB), as they are considered urgent threats by CDC reports. The Microbiology section performs bacterial identification and AST on isolates submitted by state partners. Testing is followed by screening for resistance genes using the modified Carbapenemase Inactivation Method (mCIM). A positive mCIM reflexes to molecular detection for the following plasmid-mediated resistance genes by real time PCR and whole genome sequencing (WGS):<\/p>\n\n\n\n<ul>\n\n\n\n<li> Klebsiella pneumoniae Carbapenemase (KPC)<\/li>\n\n\n\n<li> New Delhi Metallo-beta-lactamase (NDM)<\/li>\n\n\n\n<li> Verona integron-encoded Metallo-beta-lactamase (VIM)<\/li>\n\n\n\n<li> Oxacillinase (OXA)-48 like<\/li>\n\n\n\n<li>Imipenemase (IMP)<\/li>\n\n\n\n<\/ul>\n\n\n\n<p>CDC funding through the ARLN also supports DPHL in providing yeast surveillance testing. New and emerging antifungal resistance has become of increasing concern for <i>Candida<\/i> species, particularly with <i>Candida auris<\/i>. Other <i>Candida<\/i> spp., such as <i>C. glabrata<\/i> and <i>C. parapsilosis<\/i>, are also considered a public health threat due to concerning resistance patterns. <i>Candida auris<\/i> primarily affects individuals with underlying medical conditions that often require complex medical care. Individuals that are colonized with <i>C. auris<\/i> may not exhibit symptoms of active infection. However, those colonized may transmit the organism onto surrounding surfaces, where they can survive for weeks to months, or they may transmit the organism to other individuals. The CDC recommends testing high-risk individuals, to determine colonization status and allow infection control preventionists to make informed decisions to prevent further spread. <i>Candida auris<\/i> colonization testing is currently performed by the ARLN regional lab, Maryland Public Health Laboratory (MPHL). An in-house <i>Candida auris<\/i> colonization test is currently planned for completion in 2024.<\/p> \n\n\n\n\n\n\n\n<p> DPHL receives isolates from laboratory facilities within the state for yeast identification and confirmation. As part of the Mid-Atlantic Region of the ARLN, the DPHL sends these isolates, in compliance with the Department of Transportation&#8217;s requirements for packaging and shipping infectious organisms, to MPHL for further work-up, including antifungal susceptibility testing. Furthermore, the collaboration with our regional partners at MPHL allows for additional services that include, but are not limited to:<\/p>\n\n\n\n<ul>\n\n\n\n<li><i>Neisseria gonorrhoeae<\/i> antibiotic susceptibility testing<\/li>\n\n\n\n<li>Carbapenem Resistant Organism colonization screening<\/li>\n\n\n\n<li>Carbapenem Resistant <i>Acinetobacter baumannii<\/i> surveillance<\/li>\n\n\n\n<li>Carbapenem Resistant Organism mechanism surveillance<\/li>\n\n\n\n<li><i>Candida auris<\/i> colonization screening<\/li>\n\n\n\n<li>Non-<i>Candida albicans<\/i> antimicrobial susceptibility testing<\/li>\n\n\n\n<li><i>Aspergillus fumigatus<\/i> azole susceptibility testing<\/li>\n\n\n\n<\/ul>\n\n\n\n<p>\n\n\n\nAdditional information about CDC&#8217;s ARLN can be found <a href=\"https:\/\/www.cdc.gov\/drugresistance\/laboratories\/AR-lab-network-testing-details.html\"><b>here<\/b><\/a>.\n\n\n\n<\/p>\n\n\n\n<br>\n\n\n\n<p><\/p><h2>Partners:<\/h2>\n\n\n\n\n\n\n\n<ul>\n\n\n\n<li><a href=\"\/dph\/epi\/epi.html\">Office of Infectious Disease Epidemiology (OIDE)<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.aphl.org\/programs\/infectious_disease\/Pages\/Antimicrobial-Resistance.aspx\">Association of Public Health Laboratories (APHL)<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.cdc.gov\/drugresistance\/solutions-initiative\/ar-lab-networks.html\">Centers for Disease Control and Prevention (CDC)<\/a><\/li>\n\n\n\n<li><a href=\"http:\/\/regulations.delaware.gov\/AdminCode\/title16\/Department%20of%20Health%20and%20Social%20Services\/Division%20of%20Public%20Health\/Health%20Promotion%20and%20Disease%20Prevention\/4202.shtml\">List of reportable diseases<\/a><\/li>\n\n\n\n<\/ul>\n\n\n\n<p> The Centers for Disease Control and Prevention (CDC) has published an extensive amount of information highlighting AMR threats over the last 10 years. They can be found here: <a href=\"https:\/\/www.cdc.gov\/drugresistance\/media.html\"><b>Press Release: Antibiotic Resistance | CDC<\/b><\/a><\/p> \n\n\n\n<br>\n\n\n\n<p>Return to the <a href=\"\/dph\/lab\/micromainpg.html\"><b>Microbiology main page<\/b><\/a><\/p>\n\n\n\n<p>Return to the <a href=\"labs.html\"><b>Delaware Public Health Laboratory home page<\/b><\/a>.<\/p>\n\n\n\n<p>This page was last updated 4\/24\n\n\n\n<br>\n\n\n\n<br>\n\n\n\n<\/p><p class=\"smalltext\"><a href=\"http:\/\/www.adobe.com\/products\/acrobat\/readstep2.html\"><img loading=\"lazy\" decoding=\"async\" alt=\"Download Adobe Acrobat Reader\" height=\"21\" src=\"\/wp-content\/uploads\/dhss\/img\/getacro60.gif\" width=\"60\"><\/a> Please note: Some of the files available on this page are in Adobe PDF format which requires Adobe Acrobat Reader.  A free copy of Adobe Acrobat Reader can be downloaded directly from <a href=\"http:\/\/www.adobe.com\/products\/acrobat\/readstep2.html\">Adobe <\/a>. If you are using an assistive technology unable to read Adobe PDF, please either view the corresponding text only version (if available) or visit Adobe&#8217;s <a href=\"http:\/\/access.adobe.com\">Accessibility Tools page<\/a>.<\/p><p>\n  <!--[END]-->\n\n\n  \n\n\n      <\/p><\/div>\n\n\n    <\/div>\n\n\n  <\/div><!-- \/container -->\n\n\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Listen Multi-Drug Resistance Organism (MDRO) Testing Public Health Menu Home About About DPH Sections &#038; Programs Office Locations Contact Info Calendar Services A-Z Services Air &#038; Water Quality Birth, Death, &#038; Marriage Records Clinics Health Data &#038; Statistics Emergency Preparedness Health &#038; Wellness Healthy Homes Healthy Workplaces Laboratory Restaurant Inspections Screening and Testing WIC Additional [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":0,"parent":9943,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-9961","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/9961","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/comments?post=9961"}],"version-history":[{"count":1,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/9961\/revisions"}],"predecessor-version":[{"id":11154,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/9961\/revisions\/11154"}],"up":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/9943"}],"wp:attachment":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/media?parent=9961"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}