All laboratories shall submit the following directly to the State Public Health Laboratory for further examination. Bacillus anthracis isolates and suspect isolates Brucella sp. isolates and suspect isolates Burkholderia mallei isolates and suspect isolates Burkholderia pseudomallei isolates and suspect isolates Carbapenem-resistant and carbapenemase producing Enterobacteriacea isolates Campylobacter sp. isolates Clostridium botulinum isolates and suspect isolates Specimens obtained from human sources with indication or suspicion of eastern equine

encephalitis (EEE) virus infection Francisella tularensis isolates and suspect isolates Haemophilus influenzae isolates from a usually sterile site Influenza viruses diagnostic specimens or isolates known or suspected to contain antiviral resistant virus Legionella sp., isolates and suspect isolates Listeria monocytogenes isolates Specimens with indication or suspicion of measles virus infection Specimens with indication or suspicion of mumps virus infection Mycobacterium tuberculosis Neisseria gonorrhoeae isolates Neisseria meningitidis isolates from a usually sterile site Salmonella sp. isolates SARS-CoV-2 isolates Shiga toxin producing organism isolates including E. coli O157, and any broths which test positive for shiga toxin producing organisms where the organism has not been isolated Shigella sp. isolates Staphylococcus aureus, vancomycin-intermediate and vancomycin-resistant isolates only Streptococcus pneumoniae isolates from a usually sterile site and only from individuals younger than 18 years old Vibrio sp. isolates Specimens obtained from human sources with indication or suspicion of West Nile virus infection Yersinia pestis isolates and suspect isolates Yersinia sp. (non pestis) isolates Organisms with antimicrobial resistance of a novel nature Where necessary for the investigation, monitoring, control and prevention of diseases

dangerous to the public health, the Department may require added specimens or isolates from organisms listed in 105 CMR 300.170 be submitted to the State Public Health Laboratory for further examination.