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Introduction
Since 2018, the MDH Laboratories Administration has served as a regional laboratory for
CDC's AR Lab Network. Beyond our core mission of serving Marylanders and Maryland facilities, we serve the Mid-Atlantic Region of the AR Lab Network, providing advanced testing support for the AR Lab Network's core testing areas of carbapenem-resistant organisms and drug-resistant Candida spp. MDPHL provides specialized testing for drug-resistant Neisseria gonorrhoeae and azole-resistant Aspergillus fumigatus for broader portions of the United States. Our full testing menu follows below. Unless specified as “SURVEILLANCE ONLY", all tests are available under the Clinical Laboratory Improvement Act of 1988 (CLIA) for diagnostic/clinical reporting.
Tests Requiring Prior Authorization
Prior Authorization Required | No Authorization Required |
ALL Colonization Screening
Expanded AST for Hard-to-Treat CROs Infections, including aztreonam-avibactam, sulbactam-durlobactam, and meropenem-vaborbactam
AST by gradient diffusion for suspected
Neisseria gonorrhoeae treatment failures
| CRO isolate submissions for surveillance or compliance with
COMAR
Candida spp. isolate submissions for surveillance or compliance with COMAR
|
To preserve testing capacity across the AR Lab Network, some tests require prior authorization before specimen submission.
Maryland facilities and clinical laboratories may request approval for restricted tests by emailing:
Out-of-state submitters may submit requests for Expanded AST for CROs and AST by gradient diffusion for suspected
Neisseria gonorrhoeae treatment failures directly to the MDH Lab (see submission criteria in the full test menu). We will loop in appropriate public health departments as needed.
For all colonization screening, submitters MUST work with their jurisdictional HAI epidemiology group to request colonization screening. Mid-Atlantic Region points of contact are as follows:
MDH Laboratories Administration Test Ordering and Reporting
Maryland AR Lab Network Lab-Web Portal
MDPHL offers an electronic test ordering and reporting portal that submitters can use to order tests and view reports in near-real time. The entire AR Lab Network test menu at MDPHL is available for ordering in the lab-web portal (LWP), and submitters are strongly encouraged to utilize it for all tests ordered.
LWP requisitions are mandatory for all colonization screening, regardless of the organism/mechanism of interest.
To register, visit:
https://lwp-web.aimsplatform.com/md2/#/auth/registration. Your account will appear “locked" until it has been approved by the LWP Admin Team:
MDH Form 4676: Infectious Agents Culture/Detection Form
MDPHL's
Infectious Agents/Culture Detection Form remains a valid requisition for submitting specimens to the lab. Below are some key terms to assist in preparing a requisition form. For the time being, clinical reports will continue to be faxed. However, MDH Lab anticipates transitioning all clinical reporting to the LWP by late 2025. Specimens submitted for regulatory compliance will not receive reports.
Health Care Provider/Facility à this is the health care facility or health department submitting the specimen
Test Request Authorized By à this is the ordering provider. For diagnostic/clinical tests, this must be a medical provider with an NPI number who is legally licensed to order laboratory testing. Qualifications include MD, DO, CRNP, PA-C, CNM.
Laboratory Testing Supplies Available from MDH Laboratories Administration
To facilitate specimen collection and transport, MDH Laboratories Administration can supply specimen collection materials upon request. All materials requests are subject to approval and may be limited due to supply or budget constraints. The following may be requested through the
Outfits Request Form.
CRO Colonization Screening Kits: includes Fisherbrand collection device for the collection of rectal swabs, absorbent paper, and biohazard bags.
C. auris or CRAB Colonization Screening Kits: includes either a BD or Copan Eswab, absorbent paper, and biohazard bags.
Small, medium, and large shipping boxes (LIMITED Quantities Available)
FedEx Return Labels
GC InTrays for the collection and transport of clinical samples of Neisseria gonorrhoeae
Surveillance Testing vs. Clinical/Diagnostic Testing
In accordance with CLIA regulations, the MDH Laboratories Administration differentiates between assays available for clinical/diagnostic testing and those that are available for surveillance only. Each test in the below menu includes its Surveillance/Clinical designation in the “Purpose" section.
Clinical/Diagnostic Testing: testing performed for patient treatment or management purposes. Reports generated from this testing are shared with submitting facilities and placed in patient medical records. Specimens submitted for clinical testing may be subject to more stringent rejection criteria including:
Specimen receipt temperature out of range
Lack of an ordering provider
Specimen collection date outside of specimen testing window
Expired transport media
Inappropriate media/collection swab for the requested test
Incorrect specimen type for requested test
Surveillance/Regulatory Compliance: testing that is performed as part of an infectious disease surveillance program or in compliance with COMAR disease reporting requirements. These results are not returned to submitting facilities and reports cannot be placed in patient medical records. Results are reported in aggregate via other methods to state and local infectious disease surveillance systems.
Specimen Rejection Criteria
In addition to the clinical-specific rejection criteria specified below and in
the MDH Guide to Public Health Laboratory Services, all specimens are subject to the below universal rejection criteria regardless of the test ordered:
Unlabeled or improperly labeled specimen
Non-sterile or leaking container
Inappropriate specimen transport conditions
Illegible, or no submitter information on the request form
Mismatched form and specimen
Broken specimen/sample container
Illegible or no patient information on the specimen
