| Carbapenemase Molecular Detection
Order in NUlirt or complete NPHL Test Order Form with
Supplemental Form: Molecular Detection of Carbapenemase Supplemental Form
|CARBAR, KPC Detection, CRE, CPE
|Cepheid Xpert Carba-R
|Test performed Monday-Friday
| Resistance to imipenem, doripenem, ertapenem or meropenem as defined by the CDC. Carbapenem-resistant Enterobacterales (CRE) (excluding Proteus species, Providencia species, or Morganella morganii) are reportable to the Nebraska Department of Health and Human Services via electronic lab report, phone or fax within 24 hours.
Additionally, laboratories unable to perform phenotypic or molecular testing to confirm carbapenemase production in these organisms should send suspected CRE isolates that meet the criteria below to NPHL. Labs that are able to do such testing should only send isolates positive for carbapenemases to NPHL. Ship as Category B, Biological Substance UN3373. Guidelines for submission are below:
1. Submit all isolates of Enterobacterales that are resistant to any of the carbapenems. Exceptions are Enterobacter cloacae and E. aerogenes: only submit isolates that are resistant to carbapenems other than ertapenem. Do not submit Enterobacterales with known intrinsic resistance to carbapenems; i.e. Proteus species, Providencia species, and Morganella morganii.
2. Submit all isolates of in-house or reference laboratory confirmed carbapenemase-producing Enterobacterales (CPE).
| Isolate area on media slant or plate, sealed with Parafilm™ or tape.
Specimen Labeling: Test subject to CLIA regulations and required 2 patient identifiers on specimen container and requisition forms
|One agar plate or slant
Prior to shipment: Ambient air 15-25°C
|Organisms that do not meet the requirements outlined on the supplemental requisition or submitted without the supplemental requisition
|Stable at ambient temperatures
|All carbapenemase-resistant Enterobacterales will be reported immediately to local or state health department.
|Testing results are to be used for epidemiological and infection control purposes only. The confirmation of a carbapenemase-resistant Enterobacterales needs to be reported immediately to the in-house infection control official. Additional CPE colonization testing will need to be considered in consultation with epidemiologists.