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HelpTest ID: KPNRP KPC (blaKPC) and NDM (blaNDM) in Gram-Negative Bacilli, Molecular Detection, PCR, Varies
Infectious
Reporting Name
KPC and NDM PCRUseful For
Assessing pure isolates of gram-negative bacilli for mechanism of carbapenem resistance
Clinical Information
Nonsusceptibility to carbapenems in gram-negative bacilli by means of the enzyme KPC (Klebsiella pneumoniae carbapenemase) or NDM (New Dehli metallo-beta-lactamase) is becoming more common. The genes blaKPC and blaNDM encode KPC and NDM enzyme production, respectively. In addition to KPC and NDM production, there are other mechanisms of resistance to carbapenems in gram-negative bacilli, including production of other carbapenemases, or plasmid-encoded AmpC, or extended beta-lactamase production combined with decreased membrane permeability. Detection of carbapenemases by the modified Hodge test may be subjective and is not rapid. Testing for the minimum inhibitory concentration (MIC) determines the level but not the mechanism of resistance. PCR is a sensitive, specific, and rapid means of detecting of a specific portion of the genes encoding KPC and NDM production.
Interpretation
This PCR detects and differentiates both blaKPC and blaNDM. A positive KPC (Klebsiella pneumoniae carbapenemase) PCR indicates that the isolate carries blaKPC. A positive NDM (New Dehli metallo-beta-lactamase) PCR indicates the isolate carries blaNDM.
A negative result indicates the absence of detectable blaKPC or blaNDM DNA; however, false-negative results may occur due to inhibition of PCR, sequence variability underlying primers and, or loss of a plasmid carrying blaKPC and blaNDM.
Report Available
2 daysDay(s) Performed
Monday through Friday
Clinical Reference
1. Cunningham SA, Noorie T, Meunier D, et al: Rapid and simultaneous detection of genes encoding Klebsiella pneumoniae carbapenemase (blaKPC) and New Delhi metallo-beta-lactamase (blaNDM) in Gram-Negative Bacilli. J Clin Microbiol 2013;51:66-69
2. Multiplex Real-Time PCR Detection of Klebsiella pneumoniae Carbapenemase (KPC) and New Delhi Metallo-beta-lactamase (NDM-1) genes. Centers for Disease Control and Prevention 2011 (unpublished)
3. CLSI Document M100-S23, Vol.33 No.1, 2013. CLSI, Wayne, PA
4. New Carbapenem-Resistant Enterobacteriaceae Warrant Additional Action by Healthcare Providers. Centers for Disease Control and Prevention Health Alert Network, February 14, 2013
Method Name
Real-Time Polymerase Chain Reaction (PCR) Using LightCycler with Amplified Product Detection Using Fluorescent Resonance Energy Transfer (FRET) Hybridization Probes
Specimen Type
VariesShipping Instructions
1. See Infectious Specimen Shipping Guidelines in Special Instructions for shipping information.
Necessary Information
Organism identification and specimen source are required.
Specimen Required
The high sensitivity of amplification by PCR requires the specimen to be processed in an environment in which contamination of the specimen by Klebsiella pneumoniae (KPC) or New Dehli metallo-beta-lactamase (NDM) DNA is unlikely.
Supplies: Infectious Container, Large (T146)
Collection Container/Tube: Slant
Specimen Volume: Isolate
Collection Instructions:
1. Isolate the bacteria.
2. Bacterial organism must be in pure culture, actively growing. Do not submit mixed cultures.
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Varies | Ambient (preferred) | ||
| Refrigerated | |||
Reference Values
Not applicable
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
87150 x2
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| KPNRP | KPC and NDM PCR | 85502-3 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| SRC53 | Specimen source | 31208-2 |
| 35168 | KPC PCR | 49617-4 |
| 35169 | NDM PCR | 73982-1 |
Forms
If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.
Special Instructions
mml-idsurveillance