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 molecular detection of resistance genes
Order Approval Required? No
Specimen Type:
- Pure bacterial isolate
- Carbapenem Resistant Enterobacterales (CRE)
- Carbapenem Resistant Pseudomonas aeruginosa (CRPA)
- 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
Additional Information:
- Submission must include a copy of laboratory susceptibility testing results
- Limit isolate subcultures prior to submission
Causes for Rejection:
- Isolate is not carbapenem resistant
- Evidence of exposure to temperature extremes during transport
- Mucoid P. aeruginosa isolate
- Isolate does not confirm as Enterobacterales, P. aeruginosa, or A. baumannii complex
- 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.
Reference Value
Organism Identification
Bacterial genus, complex/group, or species
AST
Minimum inhibitory concentration (MIC) and applicable interpretation
mCIM
Detected, Not Detected, or Inconclusive
PCR for resistance genes
Detected or Not Detected