Test Name - Carbapenemase Gene Detection
Pre-Approval Required
āāCarbapenem resistant
Escherichia coli,
Klebsiella oxytoca,
Klebsiella pneumonia,
Klebsiella aerogenes,
Enterobacter species and
Pseudomonas aeruginosa that meet the criteria listed in the FAQ and āAcceptable Specimen type for testing sectionā can be routinely submitted. Please routinely submit Pan Non-susceptible
Pseudomonas aeruginosa,
Acinetobacter spp., and
Enterobacterales isolates, including other than those listed above for surveillance testing. Testing is available for carbapenem resistant
Enterobacterales other than those listed above and
Acinetobacter spp. , but pre-approval is required prior to submission. Contact the HAI program at
HAIprogram@cdph.ca.gov or MDL at
MDL.Submissions@CDPH.ca.gov for pre-approval.
Supplemental Information or Form
Form Lab AST (PDF)
MDL Expanded Carbapenemase Testing Frequently Asked Questions (FAQāā)ā
Performed on Specimens From
Human source
Acceptable Sample/Specimen Type for Testing
Pure culture isolate.
āāIsolate must be identified to at least the genus level by the submitter.
Mixed cultures received in MDL will not be tested.
āIsolates must meet one of the following criteria:
Please Note: If the species is intrinsically resistant to a carbapenem antibiotic (for example Proteus and Morganella morganii and imipenem) they must also be resistant to another relevant carbapenem. Please refer to the FAQ and contact MDL to request a review of the available AST results prior to submission as needed.
āāāCarbapenem resistant Enterobacterales (CRE)
Enterobacterales must be resistant to at least one relevant carbapenem, i.e., imipenem, ertapenem, doripenem, or meropenem.
Carbapenem-resistant Pseudomonas aeruginosa(CRPA)
Submit carbapenem-resistant P. aeruginosa isolates that are resistant to imipenem, meropenem, or doripenem by standard AST methods (i.e., MIC of ā„ 8 Āµg/mL) and Nonsusceptible (i.e., intermediate or resistant MIC ā„ 16Āµg/ml) to cefepime or ceftazidime.
āāCarbapenem resistant Acinetobacter spp. (CRAB)
Pan-NS Acinetobacter can be routinely submitted to CDPH without preapproval. Testing of other carbapenem resistant CRAB is available at MDL and the ALRN regional laboratory but requires pre-approval before submission.
Very rarely isolates can carry a carbapenemase gene and not express it. These isolates may test positive for a carbapenemase gene via a genotypic assay but not demonstrate carbapenem resistance in a phenotypic assay such as AST. Isolates with a positive genotypic result that do not demonstrate carbapenem resistance can be tested at MDL or sent out to other ARLN labs for further testing. Please contact MDL prior to submission of these or other unusual isolates.
āMinimum Volume Required
None
Storage & Preservation of Sample/Specimen Prior to Shipping
Store
at ambient temperature
Transport
Ship
cultures on nonselective nutrient or similar agar in tubes with leak-proof screw
cap closures.
Sample/Specimen Labeling
Testing
subject to CLIA regulations require two patient identifiers on the specimen
container and the test requisition
Shipping Instructions which Include Specimen Handling Requirements
Ship
at ambient temperature.
Test Methodology
Carbapenemase Genotypic Detection: PCR based assay
Expanded AST (ExAST): Test provided through Antibiotic Resistance Laboratory Network (ARLN). Please see MDL Expanded Carbapenemase Testing Frequently Asked Questions (FAQ) for submission instruction.
Turnaround Time
Carbapenemase Genotypic Detection: 7 business days
Expanded AST (ExAST): Defined by ARLN testing laboratory
Interferences & Limitations
None
Additional Information
None
MDL Points of Contact
MDL ā Bacterial Diseases Section (510) 412-3903
Monday-Friday 8 AM to 5 PM PT
Email: MDL.Submissions@CDPH.ca.gov