Sign in →

Test Code CARNP Carbapenemase Detection-Carba NP Test, Varies

Infectious

Useful For

Confirming carbapenemase production from pure isolates of Enterobacterales or Pseudomonas aeruginosa

Additional Tests

Test ID Reporting Name Available Separately Always Performed
CARNB Carbapenemase-Carba NP Test No Yes

Reporting Name

Carbapenemase-Carba NP Test

Specimen Type

Varies


Shipping Instructions


1. For shipping information see Infectious Specimen Shipping Guidelines.

2. Place specimen in a large infectious container (T146) and label as an etiologic agent/infectious substance.



Necessary Information


Specimen source and organism identification are required.



Specimen Required


Preferred:

Specimen Type: Pure culture of Enterobacterales or Pseudomonas aeruginosa from source cultured

Supplies: Infectious Container, Large (T146)

Container/Tube: Agar slant or other appropriate media

Collection Instructions:

1. Perform isolation of bacterial isolate.

2. Submit Enterobacterales or Pseudomonas aeruginosa isolate in pure culture actively growing. Do not submit mixed cultures.

3. Place the slant into the secondary infectious container for shipment.

4. Each isolate must be submitted under a separate order.

 

Acceptable:

Specimen Type: Enterobacterales or Pseudomonas aeruginosa isolate swab

Supplies:

-E-Swab (T853)

-Infectious Container, Large (T146)

Container/Tube: E-Swab collection and transport system

Collection Instructions:

1. Perform isolation of bacterial isolate.

2. Utilize the E-swab to obtain an adequate sample of Enterobacterales or Pseudomonas aeruginosa isolate in pure culture. Do not submit mixed cultures.

3. Place swab into the transport system containing 1-mL liquid Amies transport medium.

4. If needed, break off end of swab and close the transport tube.

5. Place the transport system into the secondary infectious container for shipment.

6. Each isolate must be submitted under a separate order.


Specimen Stability Information

Specimen Type Temperature Time
Varies Ambient (preferred)
  Refrigerated 

Reject Due To

Agar plate Reject

Clinical Information

Gram-negative bacilli (GNB) with acquired carbapenemases have disseminated worldwide, rendering them a global threat. The therapeutic armamentarium for infections caused by carbapenem-resistant Enterobacterales (CRE) is limited, and CRE infections have been associated with significant mortality. Enterobacterales harboring Klebsiella pneumoniae carbapenemase (KPC) are endemic in some regions of the United States, and although still sporadic, GNB harboring New Delhi metallo-beta-lactamase (NDM) have been reported from several states. Timely detection of these carbapenemases (along with emerging carbapenemases such as OXA-48 and VIM) is important. Detection is challenging since isolates may have only borderline reductions in susceptibility to carbapenems, and carbapenem resistance may be mediated by mechanisms other than carbapenemases (eg, AmpC or extended-spectrum beta-lactamase with decreased membrane permeability). While molecular methods are confirmatory, testing may not be immediately available and may be limited by the number of targets assayed. The Carba NP test is preferred over the mCIM (modified carbapenem inactivation method) test due to faster turnaround time.

 

If an isolate is suspected to possess KPC or NDM carbapenemase (eg, due to local epidemiology), CARBI / Carbapenem Resistance Genes, Molecular Detection, PCR, Varies may be preferred over this Carba NP test.

Reference Values

Negative

Day(s) Performed

Monday through Friday

Report Available

2 to 4 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

LOINC Code Information

Test ID Test Order Name Order LOINC Value
CARNP Carbapenemase-Carba NP Test 74676-8

 

Result ID Test Result Name Result LOINC Value
CARNP Carbapenemase-Carba NP Test 74676-8

Method Name

Colorimetric Detection of Carbapenem Hydrolysis

Forms

If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.

Specimen Minimum Volume

See Specimen Required

CPT Code Information

87182