Testing for Carbapenemase-Producing Organisms

Since June 2023, the County of San Luis Obispo (SLO) Public Health Laboratory has been monitoring bacterial resistance against a class of antibiotics known as carbapenems. Carbapenems have broad antibacterial activity, and resistance to these antibiotics means that fewer treatment options are available to patients. The Carba-R assay tests the 5 most common genetic types of carbapenem resistance. In total, 51 different bacteria have been tested from various sources (see graph), with none showing resistance.

In the event of a detection, the laboratory is prepared to screen exposed patients for colonization with carbapenem-resistant bacteria. This testing is offered through a grant for strengthening antimicrobial resistance (AR) surveillance in California.

CAPSLO Mobile Clinic Launch

On April 13, the Center for Health and Prevention (a program of Community Action Partnership of SLO County) launched a new mobile clinic that will provide sexual wellness and reproductive health care to residents living in the rural and underserved areas of the county. The 25-foot truck will bring medical services directly to people and communities with fewer options for clinic care. Inside the mobile unit, clients can receive testing and treatment for sexually transmitted infections, contraception, vaccines, and counseling among other critical and confidential services. The mobile clinic truck was purchased using American Rescue Plan Act funds awarded by the County of SLO.

Disease Alerts and Outbreaks

• Highly pathogenic avian influenza: In April 2024, an individual tested positive for highly pathogenic avian influenza A(H5N1) virus, following exposure to infected dairy cattle in Texas. While the current risk of avian influenza to the public remains low, it is important that clinicians promptly identify any suspected human cases having contact with potentially infected birds, livestock, or other animals. If HPAI A(H5N1) is suspected, clinicians should send appropriate specimens (e.g., nasopharyngeal swab in viral transport medium) to the Public Health Laboratory, where we can differentiate between influenza A(H5N1) and seasonal influenza A strains.

Chart. H5N1 detections in animals in the U.S. (source: www.cdc.gov/flu/avianflu/avian-flu-summary.htm)

• Measles: The Centers for Disease Control and Prevention (CDC) continues to monitor measles cases across the United States. As of April 18, a total of 125 measles cases have been reported nationwide so far in 2024, with outbreaks in Los Angeles and Sacramento counties. This represents the highest yearly case count since 2019. Notably, 54% of cases have been hospitalized for isolation or management of complications. The SLO Public Health Laboratory performs measles PCR testing to support case and outbreak investigations.

Instrumentation Update

The SLO Public Health Laboratory recently acquired the Microbial Surveillance WGS upgrade to its Clear Dx sequencing platform. This upgraded platform fully automates sequencing of bacterial isolates, providing initial results on the full genetic makeup of a bacteria in as little as 27 hours. We hope to leverage this tool to identify unknown pathogens, link cases together in an outbreak, and monitor antibiotic resistance patterns.

Questions? 

Please contact the Laboratory Director by email or phone. 

Glen M. Miller, PhD, HCLD(ABB)

Director, Public Health Laboratory

San Luis Obispo County Public Health Laboratory

2191 Johnson Avenue, San Luis Obispo, CA 93401

(805) 781-5512

[email protected]