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Cipro Resistant Enteric Screen

Prostate, Pre-prostate, ESBL, Extended Spectrum B-Lactamase

Test Codes

EPIC: LAB3381

Department

Microbiology

Instructions

The culture is a comprehensive screening culture to identify ciprofloxacin resistant organisms. The test is intended for screening prior to prostate procedures to determine appropriate prophylaxis treatment, when applicable. 

Specimen Collection Criteria

Collect: Rectal swabs submitted in Amies transport medium (E-swab). Fecal material must be visible on the swab.

Physician Office/Draw Specimen Preparation

Refer to collection guide for appropriate rectal swab collection and specimen preparation information.

Preparation for Courier Transport

Transport specimens immediately to the Laboratory for testing.

Rejection Criteria

Rectal swabs with no visible fecal material or more than 48 hours old will not be tested. Stool in any form is NOT suitable for testing. o 10% formalin, SAF, PVA fixative, or in sterile containers will not be tested.

Inpatient Specimen Preparation

Transport specimens immediately to the Laboratory for testing.

Storage

Specimen Stability for Testing:

Room Temperature: (20-26°C or 68-78.8°F): 48 hours
Refrigerated (2-8°C or 36-46°F): 48 hours

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 48 hours.

Reference Range

No Ciprofloxacin resistant enteric organisms recovered. 

Test Methodology

Bacterial Culture.

Interpretation

This assay identifies ciprofloxacin-resistant organisms. However, a negative result does not preclude fluoroquinolone non-susceptible, gram-negative colonization.

Clinical Utility

This assay can identify individuals colonized or infected with ciprofloxacin resistant organisms. For preoperative screening of patients that are to undergo a prostate biopsy, a rectal swab is appropriate to rule out the presence of ciprofloxacin resistant bacteria. The presence of these organisms with resistance indicates the need for prophylactic treatment with a different antibiotic. 

Clinical Disease

Antibiotic resistance has increased significantly among gram-negative bacilli. Colonization of the gastrointestinal tract by resistant microorganisms serves as a reservoir for person-to-person transmission, as well as a likely source of potential clinical infection. The latter is of particular importance for patients undergoing trans-rectal prostate biopsy in the diagnosis of prostate carcinoma. Complications from this procedure include urinary tract infections, prostatitis, and sepsis. 

Epidemiology

Colonization of the gastrointestinal tract by resistant microorganisms serves as a reservoir for person-to-person transmission, as well as a likely source of potential clinical infection. The latter is of particular importance for patients undergoing trans-rectal prostate biopsy in the diagnosis of prostate carcinoma. (2,3) 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.
2. Hardy Diagnostics, Santa Maria, CA 93455, BHI Broth with Ciprofloxacin, 10µg/ml Product Insert Ref IFU-10562 Cat. no. K258
3. Hardy Diagnostics, Santa Maria, CA 93455 MacConkey Agar with Ciprofloxacin, 10ug/ml Product Insert Ref IFU-10562 Cat. no. G258

CPT Codes

87081

Contacts

Last Updated

9/30/2024