Montana Public Health Laboratory/CDC AR Laboratory Network

Isolate Requests/Tests Offered 11-15-21

(406)444-5251

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 or ≥4 µg/ml imipenem or ≥4 µg/ml meropenem ≥2 µg/ml ertapenem

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

Pseudomonas aeruginosa

• MIC: ≥8 µg/ml imipenem or ≥8 µg/ml meropenem or ≥8 µg/ml 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 or ≥8 µg/ml meropenem or ≥8 µg/ml 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 and ≥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

• All isolates.

  • MTPHL will confirm and perform yearly AST testing which is forwarded to CDC for surveillance purposes.

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.

  • 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-RESISTANT and PAN-NOT SUSCEPTIBLE Organisms

• Pan-Resistant

  • Resistant to all drugs tested by the submitting clinical laboratory.

• Pan-Not Susceptible

  • 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.