CRE Laboratory Testing and Protocols
Laboratory testing protocols for CRE, and information about subimitting isolates for the case study on Carbapenem-resistant Klebsiella pneumoniae.
Applying the surveillance definition in clinical laboratories/hospitals
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All laboratories should aim to implement the 2011 Clinical and Laboratory Standards Institute (CLSI) breakpoints for carbapenems and cephalosporins.
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MDH strongly encourages hospitals to use the CRE surveillance definition for hospital surveillance; however, we recognize there are limitations to its use such as:
- Laboratories may not test all carbapenems/cephalosporins stated in the definition (e.g., card/panel only has one carbapenem), and/or
- Laboratories may not have breakpoints that go low enough to detect CRE based on the January 2011 CLSI breakpoints.
- Given these limitations, some laboratories may need to modify the surveillance definition to align with their current laboratory practices. Laboratories that implement modifications to the CRE surveillance definition should communicate this to appropriate hospital personnel.
Laboratory testing and protocols
MDH PHL Special Microbiology Laboratory is available during regular business hours for consultation for CRE testing and result interpretation (651-201-5581).
- Laboratory Testing and Practices for CRE (K. pneumoniae)
CDC: Laboratory Protocol for Detection of Carbapenem-Resistant or Carbapenamase-Producing, Klebsiella spp. and E. coli from Rectal Swabs; Modified Hodge Test for Carpenamase Detection in Enterobacteriaceace; and Multiplex Real-Time PCR Detection of Klebsiella pneumoniae Carbapenemase (KPC) and New Delhi metallo-β-lactamase (NDM-1) genes.
- Minnesota Laboratory System: Disease Specific Information: Carbapenem Resistant Enterobacteriacea (CRE)
Minnesota Laboratory System (MLS) updates on CRE/KPC for Minnesota laboratories.
Case study on Carbapenem-resistant Klebsiella pneumoniae
- MASTER Case Study: November 2008: Carbapenem-resistant Klebsiella pneumoniae
Multi-level Antimicrobial Susceptibility Testing Resources case study teaching how to describe a strategy for testing and reporting carbapenemase-producing isolates of Enterobacteriaceae.
Spotlight
Hand Hygiene
Information about washing/cleaning your hands.
Antimicrobial Susceptibilities of Selected Pathogens (MDH Antibiogram)
If you have questions or comments about this page, use our IDEPC Comment Form or call 651-201-5414 (TTY: 651-201-5797) for the MDH Infectious Disease Epidemiology, Prevention and Control Division.
