Mid stream urine: >100x 106 cfu/L Escherichia coli (Carbapenemase producer) – Shipped August 2014
The challenge was a simulated midstream urine sample obtained from a 45 year old ICU patient who returned from having surgery in India.
Laboratories were expected to isolate, identify, and report carbapenem-resistant Escherichia coli. Participants were asked to report susceptibility results for the following antimicrobial agents: 3rd generation cephalosporins, carbapenems, aminoglycosides, trimethoprim-sulfamethoxazole (SXT), piperacillin-tazobactam, nitrofurantoin, and ciprofloxacin. Laboratories were also expected to report the isolate to Infection Control because it is a carbapenem-resistant enterobacteria (CRE).
MAIN EDUCATIONAL POINTS from M142-5
- Carbapenemase-producing Enterobacteriaceae (CPE) are frequently multi-drug resistant and require expanded antimicrobial susceptibility testing.
- Clinical laboratories need to be able to identify carbapenem-resistant Enterobacteriaceae (CRE) and have an established procedure to determine if these isolates are CPE. Potential isolates of CPE (i.e., CRE) should be reported to Infection Control.