NPHL has moved to an electronic ordering system, NUlirt, and it is now the preferred method to order all tests. Once ordered, print a "batch list" (see
NUlirt Guide).
Forms Required - NUlirt batch list of NPHL Test Request Form (completed in its entirety) must accompany the specimen to include the following information: symptoms and date of onset, pregnancy status, travel and vaccine history. Testing
will not be performed without all required information.
Please call NPHL Client Services at 402-559-2440 or toll free at 800-334-0459 for further clarification.
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| Test: |
Carbapenemase Confirmation
|
| Synonym: |
Carbapenemase molecular detection, CARBAR, KPC Detection, CRE, CPE, MCIM |
| Method: |
- Modified carbapenem inactivation method
- Cepheid Xpert Carba-R for Acinetobacter baumannii
|
| Availability: |
- Test performed Monday-Friday
- Turnaround time 7 days
|
| Specimen: |
- Fresh isolate
- Submit isolate of Enterobacterales and/or Pseudomonas aeruginosa and/or Acinetobacter baumanii that are non-susceptible (intermediate or resistant) to carbapenems as mentioned below
- Enterobacterales: Ertapenem MIC >/= 1 µg/mL, or meropenem MIC >/= 2 µg/mL, or imipenem MIC >/= 2 µg/mL, or non-susceptible by disk diffusion method (see rare exceptions below)
- Pseudomonas aeruginosa: Meropenem or imipenem MIC >/= 4 µg/mL or non-susceptible by disc diffusion method, and:
- Labs that report susceptiblities for both cefepime and ceftazidime: Submit CRPA isolates that are resistant (MIC >/= 16) to both of these antibiotics
- Labs that report susceptibilites to either cefepime or ceftazidime: Submit CRPA isolates that are resistant (MIC >/= 16) to the antibiotic being reported
- Acinetobacter baumannii: Doripenem >/= 4 µg/mL or imipenem >/= 4 µg/mL or meropenem >/= 4 µg/mL or non-susceptible by disc diffusion method
- Submit all isolates of in-house or reference laboratory confirmed carbapenemase-producing Enterobacterales (CPE) or Pseudomonas aeruginosa (CP-PA) or Acinetobacter baumannii (CP-CRAB)
- Exceptions:
- For identical organisms and suceptibility patterns, repeat testing not performed within 30 days.
- DO NOT submit the following isolates
- Proteus species, Providencia species, Morganella morganii, or Klebsiella aerogenes non-susceptible only to imipenem but susceptible to meropenem and ertapenem
- Pseudomonas aeruginosa that are mucoid or from cystic fibrosis patients
|
| Collection Device: |
- Isolate on media slant or plate
- Test subject to CLIA regulations and requires 2 patient identifiers on container and requisition forms
|
| Volume: |
One agar plate or slant |
| Storage/Transport: |
- See Category B shipping instructions
- Specimen Packaging & Shipping - NPHL
- Seal tubes with Parafilm™ or tape and place in biohazard bag with absorbent material
- NPHL Test Request Form (completed in its entirety) must accompany specimens
|
| Unacceptable: |
Organisms that do not meet the requirements outlined on the supplemental requisition or submitted without the supplemental requisition |
| Specimen Stability: |
Stable at ambient air 15°-25° C |
| Reportable Disease: |
|
| Comments: |
- 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
|
| Revised: |
10/22/2025 |
If you have questions about proper specimen collection, please call
NPHL Client Services at 402-559-2440 or toll free at 800-334-0459.
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