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Test ID: KPNRP KPC (blaKPC) and NDM (blaNDM) in Gram-Negative Bacilli, Molecular Detection, PCR, Varies

Infectious

Reporting Name

KPC and NDM PCR

Useful 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 days

Day(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 Centers for Disease Control and Prevention 2011 (unpublished)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

Varies


Shipping Instructions


1. See Infectious Specimen Shipping Guidelines in Special Instructions for shipping information.

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



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.

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

mml-idsurveillance