Isolate Requests

Tests Offered

Enterobacterales:

Escherichia coli, Klebsiella oxytoca, Klebsiella aerogenes, Klebsiella pneumoniae and Enterobacter spp

Providencia, Proteus, Morganella, Citrobacter, and Serratia

Other Enterobacterales

MIC: ≥4 µg/ml doripenem, imipenem or meropenem, ≥2 µg/ml ertapenem

MTPHL will perform testing for Carbapenemase Resistant Enterobacterales (CRE) and forward to our Regional Lab if needed

Please send antimicrobial sensitivities with the submitted isolate

Pseudomonas aeruginosa

MIC: ≥8 µg/ml imipenem, meropenem or doripenem

MTPHL will perform testing for Carbapenemase Resistant Pseudomonas aeruginosa (CRPA) and forward to our Regional Lab if needed

Please send antimicrobial sensitivities with the submitted isolate

Acinetobacter baumannii

MIC: ≥8 µg/ml imipenem, meropenem or doripenem

MTPHL will perform testing for Carbapenemase Resistant Acinetobacter baumannii (CRAB) and forward to our Regional Lab if needed

Please send antimicrobial sensitivities with the submitted isolate

Aspergillus fumigatus

All confirmed azole-resistant A. fumigatus isolates are first priority

Please send antimicrobial sensitivities with the submitted isolate

Second priority are isolates from any specimen source, especially invasive sites

Isolates will be submitted to a Regional Lab for AST testing

Candida spp.

Species identification, especially C. auris

Isolates will be submitted to our Regional Lab for further testing

Enterococcus

MIC: ≥32 µg/ml vancomycin, ≥8 µg/ml daptomycin and ≥8 µg/ml linezolid

Isolates will be confirmed and submitted to our Regional Lab for further testing

Please send antimicrobial sensitivities with the submitted isolate

Haemophilus influenzae

All isolates from sterile sites

MTPHL will confirm, test for serotype with antisera and forward to a Regional Lab for serotyping by PCR if needed

Mycobacterium tuberculosis

All isolates

MTPHL will confirm and forward for sensitivities and DNA sequencing

Neisseria gonorrhoeae

GONOCOCCAL TREATMENT FAILURE

All test requests require preauthorization before specimen submission, please contact our HAI/AR Epidemiologist Erika Baldry at (406)444-0275 or Erika.Baldry@mt.gov

All isolates

Isolates or specimens are sent to MTPHL and forwarded to a Regional Laboratory for testing for susceptibility to azithromycin, cefixime and ceftriaxone by gradient strip diffusion, in a CLIA-compliant manner, results returned to submitters

Neisseria meningitidis

All isolates from sterile sites

MTPHL will confirm, test for serotype B with antisera and forward to a Regional Lab for serotyping by PCR (if isolate is B negative)

PAN-RESISITANT ORGANISMS

    Resistant to all drugs tested

    by the submitting clinical laboratory

PAN-NOT SUSCEPTIBLE ORGANISMS

   Non-susceptible OR intermediate to

   all drugs tested by the submitting

   clinical laboratory

Isolates will be submitted to our Regional Laboratory for Expanded AST testing (ExAST). Has three reportable drugs resulted to submitting laboratory: Aztreonam, Aztreonam-avibactam and Ceftazidime-avibactam

Please send antimicrobial sensitivities with the submitted isolate

Hard to treat Enterobacteriaceae infections for Expanded AST testing

(ExAST)

Has three reportable drugs resulted to submitting laboratory: Aztreonam, Aztreonam-avibactam and Ceftazidime-avibactam

Isolates not susceptible to all β-lactams tested, including either ceftazidime/avibactam or meropenem/vaborbactam 

OR

Possess at least one Metallo Beta-lactamase gene (bla_NDM, bla_VIM or bla_IMP) confirmed by a molecular test

Please submit all testing results with isolate

Staphylococcus aureus

MIC: ≥8 µg/ml vancomycin

MTPHL will confirm and submit isolate to our Regional Lab for further testing

Please send antimicrobial sensitivities with the submitted isolate

Streptococcus pneumoniae

All isolates from a sterile site

MTPHL will confirm and submit isolate to a Regional Lab for serotyping by PCR