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Test Code OVSRP OXA-48-like (blaOXA-48-like) and VIM (blaVIM) Surveillance, PCR

Secondary ID

65042

Useful For

Identifying carriers of Gram-negative bacilli harboring OXA-48-like (oxacillin-hydrolyzing beta-lactamase) or VIM (Verona integron-encoded metallo-beta-lactamase) genes

Method Name

Real-Time Polymerase Chain Reaction (PCR) Using LightCycler and Fluorescent Resonance Energy Transfer (FRET)

Reporting Name

OXA-48 and VIM Surveillance PCR

Specimen Type

Varies


Advisory Information


This assay is for surveillance testing on perirectal/rectal/perianal/anal swabs or stool specimens only. If testing isolates from culture, request OXVRP / OXA-48-like (blaOXA-48-like) and VIM (blaVIM) in Gram-Negative Bacilli, Molecular Detection, PCR.

 

Other mechanisms of carbapenem resistance, including other carbapenemase-types, porin mutations, or hyper-expression of drug efflux pumps may result in carbapenem resistance. These are not detected by this assay. If testing for Klebsiella pneumoniae carbapenemase (KPC) or New Delhi metallo-beta-lactamase (NDM) is desired, order KNSRP / KPC (blaKPC) and NDM (blaNDM) Surveillance, PCR.



Additional Testing Requirements


If testing for Klebsiella pneumoniae carbapenemase (KPC) or New Delhi metallo-beta-lactamase (NDM) is also needed; also order KNSRP / KPC (blaKPC) and NDM (blaNDM) Surveillance, PCR.



Necessary Information


Specimen source is required.



Specimen Required


The high sensitivity of amplification by PCR requires the specimen to be processed in an environment in which contamination of the specimen by oxacillin-hydrolyzing beta-lactamase (OXA-48-like) or Verona integron-encoded metallo-beta-lactamase (VIM) DNA is unlikely.

 

Submit only 1 of the following specimens:

 

Preferred:

Specimen Type: Perianal, perirectal, rectal, anal

Collection Container/Tube: Culture transport swab

 

Acceptable:

Supplies: Cary-Blair or Para-Pak C and S Vial (T058)

Specimen Type: Preserved stool

Container/Tube: Commercially available transport system specific for recovery of enteric pathogens from fecal specimens (15 mL of non-nutritive transport medium containing phenol red as a pH indicator, either Cary-Blair or Para-Pak C and S)

Specimen Volume: Representative portion of stool

Collection Instructions: Collect fresh stool and submit 1 gram or 5 mL in container with transport medium.


Specimen Stability Information

Specimen Type Temperature Time
Varies Refrigerated (preferred) 7 days
  Frozen  7 days

Reject Due To

Hemolysis

NA

Lipemia

NA

Icterus

NA

Other

E-swab (pink cap), calcium alginate swab, cotton-tipped swab, swab sent in gel transport medium, swab sent in viral or universal transport medium

Clinical Information

In the United States, Klebsiella pneumoniae carbapenemase (KPC) is the most common carbapenemase, followed by New Delhi metallo-beta-lactamase (NDM). OXA-48-like and VIM carbapenemases predominate in other parts of the globe, but do occur in the United States. The genes blaOXA-48-like and blaVIM encode OXA-48-like and VIM enzyme production, respectively. PCR is a sensitive, specific, and rapid means of identifying these genes.

 

This test detects the genes encoding OXA-48-like (oxacillin-hydrolyzing beta-lactamase) and VIM (Verona integron-encoded metallo-beta-lactamase) types of beta-lactamases in stool and perirectal/rectal/perianal/anal swabs. It can be used as a tool to find colonized patients. The Centers for Disease Control and Prevention recommends surveillance to detect unrecognized colonized patients who may be a potential source for transmission of carbapenemase-producing Gram-negative bacilli under certain circumstances. Such surveillance may be focused in certain high-risk settings or patient groups (eg, ICUs, long-term care facilities, patients transferred from areas or facilities with a high prevalence of the relevant type of resistance) or may be directed by infection prevention and control to investigate an outbreak.

Reference Values

Not applicable

Interpretation

This PCR assay detects and differentiates blaOXA-48-like and blaVIM in surveillance specimens (perirectal/rectal/perianal/anal swabs or stool). A positive OXA-48-like (oxacillin-hydrolyzing beta-lactamase) and/or VIM (Verona integron-encoded metallo-beta-lactamase) PCR indicates that the patient is colonized by a Gram-negative bacillus harboring blaOXA-48-like and/or blaVIM, respectively. A negative result indicates the absence of detectable DNA.

Clinical Reference

1. Fernandez J, Cunningham SA, Fernandez-Verdugo A, et al: Evaluation of a real-time PCR assay for rectal screening of OXA-48-producing Enterobacteriaceae in a general intensive care unit of an endemic hospital. Diagnostic Microbiology and Infectious Disease 2017 July;88(3):252-258 doi.org/10.1016/j.diagmicrobio.2017.04.001

2. Bush K, Fisher JF: Epidemiological expansion, structural studies, and clinical challenges of new beta-lactamases from gram-negative bacteria. Annual Review of Microbiology 2011;65:455-478

3. Poirel L, Potron A, Nordmann P: OXA-48-like carbapenemases: the phantom menace. Journal of Antimicrobial Chemotherapy 2012;67:1597-1606

4. Nordmann P, Naas T, Poirel L: Global spread of carbapenemase-producing Enterobacteriaceae. Emerging Infectious Diseases 2011;17:1791-1798

Day(s) and Time(s) Performed

Monday through Friday

Analytic Time

1 day

Performing Laboratory

Mayo Medical Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

87798 x 2

LOINC Code Information

Test ID Test Order Name Order LOINC Value
OVSRP OXA-48 and VIM Surveillance PCR In Process

 

Result ID Test Result Name Result LOINC Value
OVSRC Specimen Source 31208-2
41746 OXA-48-like PCR In Process
41747 VIM PCR In Process