Guidance

AMRHAI reference unit: reference and diagnostic services

AMRHAI (antimicrobial resistance and healthcare associated infections) is the national reference unit for investigating AMR in healthcare-associated bacteria.

Antimicrobial resistance and healthcare associated infections (AMRHAI) is part of Public Health England’s bacteria reference department (BRD).

AMRHAI has 7 sections:

  • staphylococcus reference
  • opportunist pathogens
  • antibiotic susceptibility testing
  • resistance mechanisms section
  • infection prevention and control
  • bacterial identification services (BIDS)
  • antimicrobial resistance in sexually transmitted infections

AMRHAI services

AMRHAI provides national reference facilities for many healthcare associated bacteria, including:

  • Staphylococcus spp
  • Enterococcus spp
  • klebsiella spp
  • enterobacter spp
  • Serratia spp
  • Pseudomonas spp
  • Stenotrophomonas maltophilia
  • Burkholderia spp (including cepacia complex and pseudomallei)
  • acinetobacter spp
  • aerobic actinomycetes
  • atypical, unknown, emerging bacteria
  • Neisseria gonorroheae
  • Mycoplasma genitalium

AMRHAI seeks to define outbreaks and identify transmission pathways using established and developmental phenotypic and genotypic methods to type isolates, to identify biomarkers associated with virulence, fitness host adaption and to determine their susceptibility to relevant antibiotics. Likely mechanisms of antimicrobial resistance are inferred by interpretive reading, and we offer molecular detection and confirmation of the genetic determinants of key resistances and monitor their dissemination.

AMRHAI also undertakes laboratory-based surveillance, advises on outbreak investigations, antimicrobial agents that may be appropriate for therapy, and on any public health risk. The unit also provides identification services for difficult to identify bacteria and information and advice on infection prevention and control issues.

BIDS (formerly MISU) provides specialist identification services for unknowns which include atypical, difficult to isolate or emerging bacterial pathogens detected in culture negative clinical samples and from isolates with no national reference facility

AMRHAI undertakes commercially-sponsored evaluations of new antibiotics (in-vitro activity studies) and diagnostics and has an active research programme supported through competitively awarded grants. For more information on AMRHAI services and contact details refer to the BRD user manual.

For sexually transmitted infections AMRHAI offers confirmation of resistance, identification, Mycoplasma genitalium diagnostics and antimicrobial resistance testing and medical advice for Chlamydia trachomatis, LGV and Neisseria gonorrhoeae.

AMRHAI guidance and forms

Bacteriology refererence department: user manual

Healthcare pathogens request form: single solate - H2

Healthcare pathogens request form: multiple isolates - H1

AMRHAI bacterial identification request form: single isolate or single clinical - M1

Molecular confirmation tests request form: B7

Neisseria gonorrhoeae isolate referral form: B2

From May 2015: send all requests for confirmation of possible acquired carbapenemase-producing organisms via the Electronic Reporting System (ERS).

This system improves the epidemiological data capture for subsequently confirmed isolates so we can improve our understanding of the epidemiology and risk factors associated with colonisation or infection.

This information will inform public health interventions to prevent further spread of these organisms.

As of July 2017, all bacterial isolates requiring molecular screening for carbapenemase genes should be referred to the Scottish Satellite AMR Reference Laboratory. Isolates requiring MIC determination should still be sent to AMRHAI, with the referral form clearly marked ‘Sent to Glasgow for carbapenemase PCR testing: for MIC determination only’

Contact

AMRHAI

Public Health England
61 Colindale Avenue
London
NW9 5EQ

Published 1 July 2014
Last updated 17 April 2018 + show all updates
  1. Added note for bacterial isolates requiring molecular screening for carbapenemase genes.
  2. Added details of new sections, services and forms.
  3. First published.