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Culture, MDR ESBL Screen

Extended Spectrum B-Lactamase, ESBL, Multi-Drug Resistant

Test Codes

EPIC: LAB7570

Department

Microbiology

Instructions

These are cultures to detect microorganisms that are Extended Spectrum B-Lactamase (ESBL) producers.

Specimen Collection Criteria

Collect: 

• Rectal swab in Amies transport medium (E-swab). Fecal material must be visible on the swab.
• Stool specimen in a sterile collection container (NOT in Para-Pak media).

Physician Office/Draw Specimen Preparation

Rectal swabs in Amies transport medium should be refrigerated (2-8°C or 36-46°F) prior to transport, but can be maintained at room temperature (20-26°C or 68-78.8°F).

Stool specimens must be refrigerated (2-8°C or 36-46°F) and transported to the Laboratory immediately.

Preparation for Courier Transport

Transport:
Stool specimen or rectal swab in the appropriate container, at room temperature (20-26°C or 68-78.8°F) or refrigerated (2-8°C or 36-46°F), as described above.

Rejection Criteria

• Stools in 10% formalin, SAF or PVA fixatives are NOT suitable for testing.
• Fresh stools received more than 2 hours after collection will not be tested.
• Rectal swabs with no visible fecal material will not be tested.
• Rectal swabs more than 24 hours old will not be tested.

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 previously positive entry for specimen stability information.

Rectal Swabs:
Room Temperature: (20-26°C or 68-78.8°F): 24 hours
Refrigerated (2-8°C or 36-46°F): 24 hours

Stool Specimens:
Room Temperature (20-26°C or 68-78.8°F): 2 hours (Unpreserved)
Refrigerated (2-8°C or 36-46°F): 2 hours (Unpreserved)
Frozen (-20°C/-4°F or below): Unacceptable (Unpreserved)

Specimen Storage in Department Prior to Disposal:

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

Laboratory

Royal Oak Microbiology Laboratory

Performed

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

Reference Range

Negative for ESBL-producing E. coli, K. pneumoniae, K. oxytoca or P. mirabils.

Test Methodology

Bacterial Culture.

Interpretation

This screening test can identify ESBL-producing E. coli, K. pneumoniae, K. oxytoca or P. mirabils organisms. However, a negative result does not preclude the presence of ESBL producing organisms.

Clinical Utility

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

Clinical Disease

MDR and ESBL organisms are a major concern in the healthcare setting. Resistant Enterobacterales 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 ESBL organisms. Infections commonly include urinary tract infections, bacteremia, and pelvic, wound, and tissue infections.

Epidemiology

MDRs and ESBLs 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

Contacts

Last Updated

4/4/2024