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Testing Results
IMPORTANT! Sites requesting testing must have approval from the appropriate state or local health department before submitting specimens. Approval must be sent to NPHL by email at nphl@unmc.edu or by calling (402) 559-9444.

A Special Microbiology Form must accompany the specimens. Some tests require additional forms and patient history. This will be listed below when applicable. When requested, testing will not be performed without all required information.

Please call NPHL Client Services at (402) 559-2440 or toll free at (866) 290-1406 for further clarification.

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  Test: Molecular Detection of Carbapenemase
Supplemental Forms Required:
Molecular Detection of Carbapenemase Supplemental Form  
  Synonym: CARBAR, KPC Detection, CRE, CPE 
  Method: Cepheid Xpert Carba-R 
  Availability: Test performed Monday-Friday 
  Specimen: Resistance to imipenem, doripenem, ertapenem or meropenem as defined by the CDC.
Carbapenem-resistant Enterobacteriaceae (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 Enterobacteriaceae 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 Enterobacteriaceae 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 Enterobacteriaceae (CPE).  
  Collection Device: 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  
  Volume: One agar plate or slant 
  Storage/Transport: Prior to and during shipment: Ambient air 15-25°C
Shipping instructions, including specimen-handling requirements during transport: Package and ship ambient as Category B, Biological Substance, UN3373 using shipping material provided by NPHL. See instructions and shipping address: http://nphl.org. If courier not available, contact Client Services (866) 290-1406 to arrange pickup.  
  Unacceptable: Organisms that do not meet the requirements outlined on the supplemental requisition or submitted without the supplemental requisition 
  Specimen Stability: Stable at ambient temperatures 
  Reference Interval: Not detected 
  Reportable Disease: All carbapenemase-resistant Enterobacteriaceae will be reported immediately to local or state health department. 
  Comments: Testing results are to be used for epidemiological and infection control purposes only. The confirmation of a carbapenemase-resistant Enterobacteriaceae 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.  
  Revised: 12/18/2018 

 

If you have questions about proper specimen collection, please call NPHL Client Services at (402) 559-2440 or toll free at (866) 290-1406.

 


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