Ordering Recommendation

Detect the presence of predominant carbapenemase genes (blaKPC, blaNDM, blaVIM, blaOXA-48, blaIMP) responsible for resistance to carbapenem and other beta-lactam antibiotics. Test is performed on rectal swab specimen.

Mnemonic
CARBA SWAB
Methodology

Qualitative Polymerase Chain Reaction

Performed

Sun-Sat

Reported

2 days

New York DOH Approval Status
Specimens from New York clients will be sent out to a New York DOH approved laboratory, if possible.
Specimen Required
Patient Preparation
Collect

Rectal eSwab. Refer to collection instructions at https://www.aruplab.com/Specimen-Handling/resources/pdf/rectal-eswab.pdf

Specimen Preparation

Transport rectal swab in eSwab transport media (ARUP Supply #45877) available online through eSupply using ARUP ConnectTM or contact ARUP Client Services at (800) 522-2787. Place each specimen in an individually sealed bag.

Storage/Transport Temperature

Refrigerated. Also acceptable: Frozen.

Unacceptable Conditions
Remarks

Specimen source required.

Stability

Ambient: 48 hours; Refrigerated: 6 days; Frozen: 6 days

Reference Interval

Not Detected

Interpretive Data

This assay detects five carbapenemase gene families (blaKPC, blaNDM, blaOXA-48, blaVIM, blaIMP) encoding enzymes that may confer resistance to carbapenem and other beta-lactam antibiotics. This assay is intended for use as an aid to infection control in the detection of carbapenem-resistant bacteria and is not intended to guide or monitor treatment of infection. A negative result does not exclude the presence of other resistance mechanisms or assay-specific nucleic acid in concentrations below the level of detection.

Compliance Category

Modified FDA

Note

This assay will generate a negative IMP result when testing samples containing IMP-7, IMP-13 or IMP-14 gene sequences, and may detect IMP-4 at reduced sensitivity. False-negative results may be encountered in rectal specimens with Pseudomonas aeruginosa containing the blaVIM gene and with Acinetobacter baumanii containing blaIMP gene.

Hotline History
N/A
CPT Codes

87798

Components
Component Test Code* Component Chart Name LOINC
2014278 KPC gene by PCR 49617-4
2014279 NDM gene by PCR 73982-1
2014280 OXA-48 gene by PCR 63368-5
2014281 VIM gene by PCR 63368-5
2014282 IMP gene by PCR 63368-5
2014283 CarbaR Interpretation 48767-8
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.
Aliases
  • carbapenem-resistance
  • carbapenemase
  • CRE
  • Enterobacteriaceae
  • IMP
  • Klebsiella pneumoniae carbapenemase
  • KPC
  • MDR
  • multi-drug resistance
  • NDM
  • NewDelhi metallo-B-lactamase
  • OXA-48
  • resistance mechanism
  • VIM
Antimicrobial Susceptibility - Surveillance Carbapenemase Gene Detection by PCR