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HelpTest ID: KPNDP Klebsiella pneumoniae Carbapenemase (blaKPC) and New Delhi Metallo-beta-Lactamase (blaNDM) Surveillance, PCR, 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
Useful For
Identifying carriers of carbapenem-resistant gram-negative bacilli harboring Klebsiella pneumoniae carbapenemase or New Delhi metallo-beta-lactamase genes
Method Name
Real-Time Polymerase Chain Reaction (PCR) using LightCycler and Fluorescent Resonance Energy Transfer (FRET)
Reporting Name
KPC and NDM Surveillance, PCRSpecimen Type
VariesSpecimen Minimum Volume
See Specimen Required
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Varies | Varies | ||
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 on 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.
Reference Values
Negative
Reference values apply to all ages.
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.
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 Mar;48(3):836-841. doi: 10.1128/JCM.01988-09.
2. Centers for Disease Control and Prevention (CDC). New carbapenem-resistant Enterobacteriaceae warrant additional action by healthcare providers. Centers for Disease Control and Prevention Health Alert Network; February 14, 2013. Accessed October 10, 2022. Available at https://stacks.cdc.gov/view/cdc/25250
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
Day(s) Performed
Monday through Friday
Report Available
1 to 4 daysTest 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
87999 (if appropriate for government payers
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| KPNDP | KPC and NDM Surveillance, PCR | 85502-3 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| KNSS | Specimen Source | 31208-2 |
| 618315 | KPC PCR | 49617-4 |
| 618316 | NDM PCR | 73982-1 |
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