Determining Barriers to Submitting Antimicrobial-Resistant Isolates to the Texas Department of State Health Services (DSHS) Antimicrobial Resistance Laboratory Network (AR Lab Network): A Cross-Sectional Study

Background: The Antimicrobial Resistance Laboratory Network (AR Lab Network) was developed by the Centers for Disease Control and Prevention (CDC) to detect and prevent antimicrobial-resistant threats. However, low submission rates of antimicrobial-resistant isolates limit the AR Lab Network’s ability to address antimicrobial resistance (AMR). This study expands on a study conducted in Texas Public Health Region 8 (PHR8). Aim: The aim of this study was to investigate submission barriers for antimicrobial-resistant isolates in Texas acute care hospitals (ACH) and critical access hospitals (CAH). Methods: A survey was designed and emailed to laboratory professionals to identify barriers to antimicrobial-resistant isolate submission. Responses were analyzed using two-sided Fisher’s exact tests to identify associations between responses and respondent characteristics. Results: Of the Texas laboratory personnel invited to participate, 123 responses from 211 hospitals were received, for a response rate of 58.29%. Lack of awareness of the AR Lab Network was the most frequently cited submission barrier (50.48% of respondents). Other submission barriers included submission to another laboratory (49.53%), lack of staff time (42.86%), lack of training or certified personnel (41.9%), and a submission process that was too time-consuming (40%). Discussion: As in the Texas PHR8 study, it was found that, regardless of the respondent’s role, time in that role, or the type of hospital in which they worked, the most common barrier to antimicrobial-resistant isolate submission was lack of awareness of the AR Lab Network. In the future, the identified barriers will be addressed by implementing educational outreach programs about the AR Lab Network for Texas hospitals and healthcare facilities.