National Reference Center (NRC) for Antibiotic resistant Gram-negative bacteria
General guidelines
Instructions for sample collection, storage and transport (valid for all tests)
Instructions for samples
See detailed criteria for isolate selection in General Guidelines
Please use appropriate request forms for specific requests (general, typing, virulence).
Enterobacterales
- Suspicion of CPE: reduced susceptibility to carbapenems screening breakpoints for ertapenem or meropenem (see criteria in General Guidelines).
- Suspicion of ESBL: resistance to cefotaxime/ceftriaxone, and/or ceftazidime.
Pseudomonas and Acinetobacter spp.
- Suspicion of carbapenemase production: Strains with reduced susceptibility (R/I) to imipenem and meropenem AND multidrug resistance profile.
- Suspicion of ESBL: Resistance to ceftazidime and/or cefepime AND multidrug resistance profile
Instructions for transport
- Fresh culture (< 24 h) on a non-selective medium and without antibiotics (a blood agar plate preferred to tubes).
- Strain(s) should be packed in triple layers along with the fully completed request form and the susceptibility test results as from the requesting laboratory.
Unacceptable requests
- Absence of appropriate request form for specific requests (general, typing, virulence)
- Incomplete application form.
- Absence of susceptibility test results from requesting laboratory.
- Contaminated or misidentified strain or transported in unsuitable conditions (tubes/agar broken, open).
- “Duplicate” isolates/requests (same bacterial species with the same susceptibility profile from the same patient).
- Strains susceptible to all carbapenems for suspicion of carbapenemase.
- Strains belonging to a group other than Enterobacteriales, Pseudomonas spp. or Acinetobacter spp.
Turnaround time and frequency of testing
- Carbapenemase screening tests are performed every working day after subculture of the isolate (J+1).
- Other confirmatory tests and susceptibility testing by MIC determination (on request) are performed once a week.
Reporting of test results
- The results of the rapid test for CPE screening (partial report) are communicated electronically within 3 working days of receipt of the strain.
- The final report is sent by post mail and/or email within 8 working days of receipt of the strain.
Useful links and reports
Relevant epidemiological information: Health topics A-Z | Sciensano.be
