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Test Code OXVRP OXA-48-like (blaOXA-48-like) and VIM (blaVIM) in Gram-Negative Bacilli, Molecular Detection, PCR

Biohazard Infectious

Secondary ID

65043

Useful For

Assessing pure isolates of Gram-negative bacilli for mechanism of carbapenem resistance

Method Name

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

Reporting Name

OXA-48 and VIM PCR

Specimen Type

Varies


Advisory Information


This assay should be used for testing of isolates of Gram-negative bacilli. If testing directly from rectal swabs, perirectal swabs, anal swabs, perianal swabs, or stool is desired, request OVSRP / OXA-48-like (blaOXA-48-like) and VIM (blaVIM) Surveillance, PCR.

 

Other mechanisms of carbapenem resistance, including other carbapenemase-types, porin mutations, or hyperexpression 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 KPNRP / KPC (blaKPC) and NDM (blaNDM) in Gram-Negative Bacilli, Molecular Detection, PCR.



Additional Testing Requirements


1. Organism identification must be provided. If organism identification is unknown, concomitantly order IDENT / Organism Referred for Identification, Aerobic Bacteria.

2. If susceptibility testing is needed; also order ZMMLS / Antimicrobial Susceptibility, Aerobic Bacteria, MIC.

3. If testing for Klebsiella pneumoniae carbapenemase (KPC) or New Delhi metallo-beta-lactamase (NDM) is also needed; also order KPNRP / KPC (blaKPC) and NDM (blaNDM) in Gram-Negative Bacilli, Molecular Detection, PCR.



Shipping Instructions


See Infectious Specimen Shipping Guidelines in Special Instructions for shipping information.



Necessary Information


Organism identification and specimen source are 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.

 

Supplies: Infectious Container, Large (T146)

Collection Container/Tube: Slant

Specimen Volume: Isolate

Collection Instructions:

1. Perform isolation of infecting bacteria.

2. Bacterial organism must be submitted in pure culture, actively growing. Do not submit mixed cultures.

3. Place specimen in a large infectious container (T146) and label as an etiologic agent/infectious substance, if appropriate.


Specimen Stability Information

Specimen Type Temperature Time
Varies Ambient (preferred)
  Refrigerated 

Reject Due To

Hemolysis

NA

Lipemia

NA

Icterus

NA

Other

Agar plate, mixed culture

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 bacterial isolates.

Reference Values

Not applicable

Interpretation

This PCR detects and differentiates blaOXA-48-like and blaVIM. A positive blaOXA-48-like (oxacillin-hydrolyzing beta-lactamase) PCR indicates that the isolate carries blaOXA-48-like. A positive VIM (Verona integron-encoded metallo-beta-lactamase) PCR indicates the isolate carries blaVIM. 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

2 days

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
OXVRP OXA-48 and VIM PCR In Process

 

Result ID Test Result Name Result LOINC Value
OXORG Organism Identified by Client In Process
OXSRC Specimen Source 31208-2
41743 OXA-48-like PCR In Process
41744 VIM PCR In Process