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Culture, MDR Non-ESBL or CRE screen

Multi-Drug Resistant, Extremely Drug Resistant

Test Codes

EPIC: LAB7568

Department

Microbiology

Instructions

Cultures to detect microorganisms that are Multi-Drug Resistant (MDR).
The suspect agent must be indicated (via comment) for the test.

For more information, please see the Beaumont Isolation Practices Policy.

Physician Office/Draw Specimen Preparation

• Respiratory Tract Specimens (Bronchial Washings, Bronchial Brushes, BAL): Submit in a sterile, non-leaking collection container.
• Sputum: Specimens collected and placed in sterile, non-leaking collection containers. Collect deep cough specimens. At least one of these should be an early morning specimen. Do NOT submit saliva. Specify whether the specimen is induced or expectorated, since induced sputum specimens resemble saliva.
• Sterile Body Fluids: Submit in a sterile, non-leaking collection container.
• Stool: Random stool specimen, about the size of a walnut, placed in a container with Para-Pak transport medium. Specimens not in Para-Pak transport medium must be placed in a sterile collection container, refrigerated, and sent to the Laboratory immediately.
• Tissue: Submit in a sterile, non-leaking collection container.
• Rectal Swab: Rectal swab submitted in Amies transport medium. Fecal material must be visible on the swab.
• Urine: Approximately 15 mL urine specimen in a sterile collection container (clean-catch, catheter, cystoscopic, random or suprapubic needle aspiration).
• Wounds: An aspirate collected using a syringe and needle and delivering contents to a sterile collection container. Do NOT submit the syringe with needle attached. OR an E-swab 

Preparation for Courier Transport

Refer to the Lab Test Directory of the culture type for specimen transport information. 

Rejection Criteria

Refer to the Lab Test Directory entry of the culture type for specimen rejection criteria. 

Inpatient Specimen Preparation

Transport specimens immediately to the Laboratory for testing.

Storage

Specimen Stability for Testing:

Refer to the Lab Test Directory entry of the culture type for specimen stability information. 

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 4 days

Laboratory

Dearborn Microbiology Laboratory
Taylor, Trenton and Wayne sent to Dearborn Microbiology Laboratory for testing.

Royal Oak Microbiology Laboratory
Farmington Hills, Grosse Pointe, and Troy sent to Royal Oak Microbiology Laboratory for testing. 

Performed

Sunday – Saturday, 24 hours a day.
Preliminary results available in 24 hours.

Reference Range

No MDR bacteria recovered.

Test Methodology

Bacterial Culture.

Interpretation

This screening assay can identify MDR organisms. However, a negative result does not preclude the presence of MDR organisms.  

Clinical Utility

This test identifies individuals colonized or infected with MDR organisms for infection control purposes in a healthcare setting. 

Clinical Disease

MDR organisms are a major concern in the healthcare setting. MDR organisms are increasing in prevalence and their ability to transfer this resistance to other bacteria makes them a formidable opponent. Individuals may be colonized or infected with MDR organisms. Infections commonly include urinary tract infections, bacteremia, and pelvic, wound, and tissue infections.

Epidemiology

MDR's are transmitted by the same routes as antimicrobial susceptible infectious agents (1). Patient-to-patient transmission in healthcare settings, usually via hands of HCWs, has been a major factor accounting for the increase in incidence and prevalence in acute care facilities (1). Preventing the emergence and transmission of these pathogens requires a comprehensive approach that includes numerous infection control measures, education and training of medical and other healthcare personnel, judicious antibiotic use, comprehensive surveillance for targeted organisms, environmental measures, and decolonization therapy when appropriate (1).

Transmission

Hands, fomites.

Reference

1. Siegel, J.D. et al. HICPAC, 2007. Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. http://www.cdc.gov/hicpac/pdf/isolation/Isolation2007.pdf.

CPT Codes

87081
LOINC:  73835-1

Contacts

Last Updated

6/30/2021