Carbapenem Resistant Organisms, Isolate Testing

Carbapenem Resistant Enterobacterales, Carbapenem Resistant Pseudomonas aeruginosa, Carbapenem Resistant Acinetobacter baumanii, CRE, CRPA, CRAB, CRO, ARLN, Carbapenem, Antimicrobial resistance, Antimicrobial Susceptibility Test, PCR, Antimicrobial, MALDI-TOF, mCIM, Broth Micro Dilution

G-2E

Definitive identification of CRO isolates by MALDI-TOF, antimicrobial susceptibility determined by broth micro dilution, and carbapenemase production determination by real-time PCR.

N/A 

• Antimicrobial susceptibility report from submitter

• Copies of any previous Lab tests (carbapenemase production or PCR), if available. 

N/A

Human

• Pure-cultured CRO isolate from any type of clinical specimen.

• Pure-cultured CRE isolates resistant to any imipenem, meropenem or ertapenem.

• Pure-cultured CRPA isolates resistant to at least one imipenem, or meropenem AND non-susceptible (intermediate or resistant) to cefepime or ceftazidime.

• CRAB isolates resistant to imipenem, or meropenem.

• At least one viable pure isolate per plate or slant. 

• Single tube of pure culture isolate.

• Isolates may be shipped to Laboratory at ambient temperatures

• Ensure that growth media used does not expire before specimen collection date  

Isolates should be submitted on a non-inhibitory, non-selective agar plate or/slant or broth.

• At least two patient identifiers required on specimen (e.g., patient full name, date of birth, medical record number).

• Three patient identifiers are preferred. 

• Identifiers on specimen must exactly match identifiers in submission form.

• Additional DSHS Laboratory specimen labeling guidelines available online here.

• Ship according to Dangerous Goods Regulations, IATA, and/or CFR 49

• Category B Biological Substance, UN3373 shipping requirements apply

• Submitters are responsible for packaging and shipping specimens according to regulatory requirements.

• Additional DSHS Laboratory submission guidelines available online here.

• Identification of CRE,CRPA, and CRAB by MALDI-TOF.
• Antimicrobial susceptibility testing by broth micro dilution.
• Carbapenemase production in CRE and CRPA determined by modified Carbapenem Inactivation Method (mCIM). Carbapenemase producing CRE, CRPA and CRAB identified by real-time PCR.

7 working days

• Organisms must be viable for culture studies.

• The results from this test should be used only for epidemiological purposes and not for patient treatment. 

• Mixed culture submitted. 
• Insufficient specimen growth. 
• Antimicrobial susceptibility results not provided by submitter.
• Missing identifiers on specimen and/or submission form.
• Isolate submitted not a target organism.
• Media expired at time of isolate culture.
• Discrepancies between specimen label and submission form.
• Incomplete, missing, or illegible submission form.

N/A