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HelpTest Code CARBI Carbapenem Resistance Genes, Molecular Detection, PCR, Varies
Infectious
Ordering Guidance
This assay should be used for testing of isolates of Enterobacterales, Pseudomonas aeruginosa and Acinetobacter baumannii. If testing directly from rectal swabs is desired, order CRPCR / Carbapenem Resistance Genes, Molecular Detection, PCR, Rectal Swab.
Other mechanisms of carbapenem resistance, including other carbapenemase not targeted by this assay, porin mutations, and hyperexpression of drug efflux pumps, may result in carbapenem resistance. These mechanisms are not detected by this assay.
Additional Testing Requirements
1. Organism identification must be provided. If organism identification is unknown, concomitantly order IDENT / Organism Referred for Identification, Aerobic Bacteria.
2. If susceptibility testing is needed, also order ZMMLS / Antimicrobial Susceptibility, Aerobic Bacteria, Varies.
Shipping Instructions
1. For shipping information, see Infectious Specimen Shipping Guidelines.
2. Place specimen in a large infectious container and label as an etiologic agent/infectious substance if appropriate.
Necessary Information
Organism identification and specimen source are required.
Specimen Required
The high sensitivity of amplification by polymerase chain reaction requires the specimen to be processed in an environment in which contamination of the specimen by Klebsiella pneumoniae carbapenemase (KPC), New Delhi metallo-beta-lactamase (NDM), Verona integron-encoded metallo-beta-lactamase (VIM), oxacillin-hydrolyzing beta-lactamase (OXA-48), and imipenemase-type metallo-beta-lactamase (IMP) DNA is not likely.
Supplies: Infectious Container, Large (T146)
Container/Tube: Slant
Specimen Volume: Isolate
Collection Instructions:
1. Perform isolation of infecting bacteria.
2. Bacterial organism must be submitted in pure culture, actively growing. Do not submit mixed cultures.
Useful For
Detecting and differentiating blaKPC, blaNDM, blaVIM, blaOXA-48, and blaIMP gene sequences associated with carbapenem intermediate or resistant results
Aiding in infection control in the detection of gastrointestinal colonization of patients in healthcare settings with bacteria not susceptible to carbapenems using bacterial isolates from rectal or perirectal swabs
Method Name
Real-Time Polymerase Chain Reaction (PCR)/Reverse Transcription (RT-PCR)
Reporting Name
Carbapenem Resistance Genes, VariesSpecimen Type
VariesSpecimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Varies | Ambient (preferred) | ||
| Refrigerated | |||
Reject Due To
| Agar plate Mixed culture |
Reject |
Clinical Information
The global spread of carbapenemase-producing Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter baumannii (organisms not-susceptible to carbapenem antimicrobials) is a critical public health issue. These bacteria are often resistant to all beta-lactam agents and frequently also resistant to multiple classes of other antimicrobial agents, leaving very few treatment options. Tracing the spread of organisms not-susceptible to carbapenems is complicated by the diversity of carbapenem-hydrolyzing enzymes that have emerged and the ability of the genes to spread among multiple bacterial species.
Reference Values
Not Detected
Day(s) Performed
Monday through Friday
Report Available
2 to 4 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
87150
Forms
If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.