AMRHAI reference unit: reference and diagnostic services

Antimicrobial resistance and healthcare associated infections (AMRHAI) reference unit is the national reference laboratory for investigating antibiotic resistance in healthcare associated bacterial pathogens.

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 and pseudomallei)
  • acinetobacter spp
  • aerobic actinomycetes
  • atypical, unknown, emerging bacteria
  • neisseria gonorroheae
  • mycoplasma genitalium

It also offers serodiagnostic testing for:

  • Pseudomonas aeruginosa (P. aeruginosa)

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 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 includes 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.

AMRHAI guidance and forms

Bacteriology refererence department: user manual

AMRHAI serodiagnosis referral form: H3

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 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.



Public Health England
61 Colindale Avenue

Published 1 July 2014
Last updated 29 September 2016 + show all updates
  1. Added details of new sections, services and forms.
  2. First published.