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Test ID: KNSRP Klebsiella pneumoniae Carbapenemase (blaKPC) and New Delhi Metallo-beta-Lactamase (blaNDM) Surveillance, PCR, Varies

Reporting Name

KPC and NDM Surveillance PCR

Useful For

Identifying carriers of carbapenem-resistant Gram-negative bacilli harboring Klebsiella pneumoniae carbapenemase or New Delhi metallo-beta-lactamase genes

Clinical Information

The Centers for Disease Control and Prevention recommends active surveillance to detect unrecognized colonized patients who may be a potential source for carbapenem-resistant (drug-resistant) Enterobacteriaceae (CRE) transmission. Such surveillance testing may be focused in certain high-risk settings or patient groups (eg, intensive care units, long-term acute care, patients transferred from areas or facilities with high CRE prevalence) or by infection control to investigate an outbreak. Nonsusceptibility to carbapenems in gram-negative bacilli by means of the enzyme Klebsiella pneumoniae carbapenemase (KPC) or New Delhi metallo-beta-lactamase (NDM) is becoming more common. The genes blaKPC and blaNDM encode KPC and NDM enzyme production, respectively. Polymerase chain reaction testing is a sensitive, specific, and rapid means identifying patients colonized by CRE-harboring blaKPC or blaNDM.

Interpretation

This polymerase chain reaction (PCR) test detects and differentiates blaKPC and blaNDM in surveillance specimens (perirectal/rectal/perianal/anal swabs or feces). A positive Klebsiella pneumoniae carbapenemase (KPC) and/or New Delhi metallo-beta-lactamase (NDM) PCR result indicates that the patient is colonized by a Gram-negative bacillus (or Gram-negative bacilli) harboring a carbapenemase gene, blaKPC and/or blaNDM, respectively.

 

A negative result indicates the absence of detectable DNA.

Report Available

1 to 4 days

Day(s) Performed

Monday through Friday

Clinical Reference

1. Lolans K, Calvert K, Won S, Clark J, Hayden MK: Direct ertapenem disk screening method for identification of KPC-producing Klebsiella pneumoniae and Escherichia coli in surveillance swab specimens J Clin Microbiol. 2010;48:836-841. doi: 10.1128/JCM.01988-09.

2. New carbapenem-resistant Enterobacteriaceae warrant additional action by healthcare providers. Centers for Disease Control and Prevention Health Alert Network, February 14, 2013

3. Vasoo S, Cunningham SA, Kohner PC, et al: Comparison of a direct and broth-enriched PCR, HardyCHROM ESBL and the CDC method for detection of Klebsiella pneumoniae carbapenemase carriage in surveillance rectal swabs. Abstracts of the Ninth International Symposium on Antimicrobial Agents and Resistance, Kuala Lumpur, Malaysia. March 13-15, 2013

Method Name

Real-Time Polymerase Chain Reaction (PCR) using LightCycler and Fluorescent Resonance Energy Transfer (FRET)

Specimen Type

Varies


Ordering Guidance


This assay should be used for surveillance testing on perirectal/rectal/perianal, anal swabs, or fecal specimens only. If testing isolates from culture, order KPNRP / KPC (blaKPC) and NDM (blaNDM) in Gram-Negative Bacilli, Molecular Detection, PCR, Varies.



Necessary Information


Specimen source is 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 or New Delhi metallo-beta-lactamase DNA is not likely.

 

Submit only 1 of the following specimens:

 

 

Preferred:

Specimen Type: Perianal, anal, perirectal, rectal

Supplies: Culturette (BBL Culture Swab) (T092)

Container/Tube: Culture transport swab (Dacron or rayon swab with aluminum or plastic shaft with either Stuart or Amies liquid medium)

Specimen Volume: Swab

Specimen Stability Information: Refrigerated (preferred)/Frozen

 

Acceptable:

Specimen Type: Preserved feces

Supplies: Culture and Sensitivity Stool Transport Vial (T058)

Container/Tube: Commercially available transport system specific for recovery of enteric pathogens from fecal specimens (15 mL of nonnutritive transport medium containing phenol red as a pH indicator, either Cary-Blair or Para-Pak C and S vial)

Specimen Volume: Representative portion of feces

Collection Instructions:

1. Collect fresh feces and submit 1 gram or 5 mL in container with transport medium.

2. Place feces in preservative within 2 hours of collection.

Specimen Stability Information: Ambient (preferred)/Refrigerated


Specimen Minimum Volume

See Specimen Required

Specimen Stability Information

Specimen Type Temperature Time Special Container
Varies Varies

Reference Values

Negative

Test Classification

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

CPT Code Information

87798 x 2

LOINC Code Information

Test ID Test Order Name Order LOINC Value
KNSRP KPC and NDM Surveillance PCR 85502-3

 

Result ID Test Result Name Result LOINC Value
SRCKP Specimen source 31208-2
35165 KPC PCR 49617-4
35166 NDM PCR 73982-1

Forms

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

Mayo Clinic Laboratories | Microbiology and Infectious Disease Catalog Additional Information:

mml-idsurveillance