Infectious diseases and resistance to antibiotics are global public health threats. Resilient health systems depend on the ability to detect emerging diseases accurately in time to stop outbreaks and avert major international crises such as the recent Ebola epidemic (Albiger, 2018). Public health preparedness requires adequate capacity of microbiology laboratories to: 1) ensure rapid infection diagnostics to guide treatment, detect and control epidemics; 2) characterise infectious agents for designing effective vaccines and control measures; and 3) monitor the impact of prevention of infections and containment of antimicrobial resistance (AMR).
The ECDC is operating the EULabCap (European Laboratory Capability Monitoring System) to assess whether laboratory systems in EU/EEA countries have the critical capabilities and capacities for reliable communicable disease and antimicrobial resistance surveillance and control at Member State and EU levels (ECDC, 2018). In 2016, the EULabCap Index average for EU countries was 7.5 on a maximum scale of 10 ( 8.5). Country scores ranged from a low of 5.6 in Cyprus to a high of 9.6 in France. These results indicate that the EU has strong public health microbiology services that largely meet communicable disease surveillance and response requirements. However, only 18 EU countries (and Norway) showed sufficient laboratory capacity levels (defined as intermediate to high score) for at least 10 of the 12 EULabCap targets (ECDC, 2018).
National improvements in the areas of vulnerability have taken place in 24 EU countries since 2015. Steady increases in the EULabCap Index, and a narrowing score range between countries, indicate convergence towards more balanced laboratory capacities across countries.
Capabilities to diagnose EU notifiable diseases and antimicrobial resistance as well as laboratory contribution to surveillance networks are well in line with EU legislation and case definitions across the EU. Capacities for detection and surveillance of antimicrobial resistance improved steadily between 2013 and 2016 with wider use of standardised methods ( 8.6). EU capabilities of national reference laboratories for rapid detection of (re-) emerging diseases and drug resistance and participation in outbreak investigations also progressed over the years ( 8.7).
Some remaining gaps and inefficiencies still need to be addressed, including the development of clinical guidance for and adequate utilisation of diagnostic tests, upgrading surveillance programme to integrate microbial genomic sequencing methods and digital connectivity of laboratory information with public health monitoring systems at national and EU levels (ECDC, 2018; Revez, 2018).
