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Carbapenemase Molecular Detection  

 
IMPORTANT! Pre-approval needed from state or local health department. Local or State Health Department. Send approval to NPHL@unmc.edu or call (402) 559-9444.

NPHL has moved to an electronic ordering system, NUlirt, and it is now the preferred method to order all tests. Once ordered, print a "batch list" (see NUlirt Guide).

Forms Required - Nulirt batch list or NPHL Test Request Form (completed in entirety) must accompany the specimen to include the following information: symptoms and date of onset, pregnancy status, travel and vaccine history. Testing will not be performed without all required information.

Please call NPHL Client Services at (402) 559-2440 or toll free at (800) 334-0459 for further clarification.

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Test: Molecular Detection of Carbapenemase  
Synonym: CARBAR, KPC Detection, CRE 
Method: PCR; Cepheid Xpert Carba-R  
Availability: NPHL Special Microbiology Requisition and Special Microbiology Supplemental Form Required. Test performed Monday-Friday.  
Specimen: Carbapenem Resistant Organism Guidelines:
  • Submission of all isolates of Enterobacteriaceae that are non-susceptible (intermediate or resistant) to any of the carbapenems
  • Exceptions are Enterobacter cloacae and E.aerogenes: only submit isolates that are non-susceptible to Carbapenems other than ertapenem
  • Submission of all non-mucoid isolates of Pseudomonas aeruginosa that are non-susceptible to carbapenems other than ertapenem from non-cystic fibrosis patients
 
Collection Device: Isolate area on media slant or plate, sealed with parafilm or tape.

Specimen Labeling: Test subject to CLIA regulations and required 2 patient identifiers on specimen container and requisition forms  
Volume: One agar or slant  
Storage/Transport: Prior to shipment: Ambient air

Shipping instructions, including specimen handling requirements during transport: Package and ship ambient as Category B, Biological Substance, UN3373 using shipping material provided by NPHL. See instructions and shipping address: http://nphl.org . If courier not available, contact Client Services (866) 290-1406 to arrange pickup.  
Unacceptable: Organisms that do not meet the requirements outlined on the supplemental requisition or submitted without the supplemental requisition  
Specimen Stability: Stable at ambient temperatures  
Reference Interval: N/A  
Reportable Disease: All carbapenemase-resistant Enterobacteriaceae will be reported immediately to local or state health department. 
Comments: Testing results are to be used for epidemiological and infection control purposes only. The confirmation of a carbapenemase-resistant Enterobacteriaceae need to be reported immediately to the in-house infection control official. 
Revised: 1/24/2017 
If you have questions about proper specimen collection, please call NPHL Client Services at (402) 559-2440 or toll free at (800) 334-0459.

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