CARBAPENEM RESISTANT ORGANISM TESTING

Laboratory: Microbial Reference and Molecular Detection and Characterization

Test Description: Advanced characterization of carbapenem resistant organisms (CRO) including organism identification, antimicrobial susceptibility testing (AST), phenotypic carbapenemase enzyme detection, and detection of carbapenemase mechanisms

Order Approval Required? No

Specimen Type:

• Pure bacterial isolate
• Carbapenem Resistant Enterobacterales (CRE)
• Carbapenem Resistant Pseudomonas aeruginosa (CRPA)
• VDH Request Only: Carbapenem Resistant Acinetobacter baumannii complex (CRAB)

Collection Container: Slant (i.e. TSA slant) or plate media (i.e. blood agar plate)

Storage Instructions: Store isolates at 2-30°C

Transportation Instructions: Transport: 2-30°C

Test Methodology:

• MALDI-TOF organism identification
• Sensititre GN7F AST
• Modified carbapenem inactivation method (mCIM)
• Streck ARM-D PCR
• Carba-5 lateral flow assay

Additional Information:

• Submission must include a copy of laboratory susceptibility testing results
• Limit isolate subcultures prior to submission
• Limited testing will be performed on isolates from known positive patients collected within 6 months of the date of collection of the last fully characterized isolate
• Isolates may be forwarded to the Centers for Disease Control and Prevention (CDC) or another laboratory for further testing if necessary
• CRO Testing Instructions

Causes for Rejection:

• Submission does not include clinical laboratory susceptibility testing results
• Isolate is not carbapenem resistant
• Mucoid P. aeruginosa isolate
• Isolate does not confirm as Enterobacterales, or P. aeruginosa
• CRAB isolates unless requested by VDH
• Sample lacks two patient identifiers
• Sample submitted with no test request form or mismatched sample and test request form
• Media that has expired prior to inoculation
• Incorrect or broken transport media
• True duplicate specimens (same collection date, source, and patient identifiers) may be rejected
• Specimen received out of the appropriate temperature range.