4.2 Appearance N/A 4.3 Sample preparation For safety considerations to Section 1.2. 4.4 Microscopy 4.4.1 Standard N/A 4.4.2 Supplementary / preparation of smears N/A 4.5 Culture and investigation Direct culture Inoculate culture media with swab or other sample (refer to ). 4.5.1 Culture media, conditions and organisms Clinical Specimen Standard Incubation Cultures Target organism(s) details/ media read Temp Time conditions °C Screening: Any sample Chromogenic 35-37 Aerobic 18-24hr Carbapenemase ≥18hr with carbapenem Any condition ***/ Chromogenic Enterobacteriaceae medium for CPE + OR detection of 35-37 Aerobic 16-48hr species# Pseudomonas ≥16hr carbapenem If not available, resistance/ Acinetobacter species MacConkey / CLED agar + production 35-37 Aerobic 18-24hr Carbapenemase ≥18hr 10µg MEM disc* producing Enterobacteriaceae In certain Any sample Chromogenic situations agars with 35-37 Aerobic 18-24hr Klebsiella pneumoniae ≥18hr increased carbapenem ***/ sensitivity is Chromogenic Escherichia coli desired medium for CPE OR If not available, MacConkey / CLED agar +
4.2 Appearance N/A 4.3 Sample preparation For safety considerations to Section 1.2. 4.4 Microscopy 4.4.1 Standard N/A 4.4.2 Supplementary / preparation of smears N/A 4.5 Culture and investigation Direct culture Inoculate culture media with swab or other sample (refer to ). 4.5.1 Culture media, conditions and organisms Clinical details/ conditions Specimen Standard media Incubation Cultures read Target organism(s) Temp °C Time Screening: Any condition + detection of carbapenem resistance/ production Any sample Chromogenic with carbapenem ***/ Chromogenic medium for CPE OR If not available, MacConkey / CLED agar + 10µg MEM disc* 35-37 Aerobic 18-24hr ≥18hr Carbapenemase Enterobacteriaceae 35-37 Aerobic 16-48hr ≥16hr Pseudomonas species# Acinetobacter species 35-37 Aerobic 18-24hr ≥18hr Carbapenemase producing Enterobacteriaceae In certain situations increased sensitivity is desired Any sample Chromogenic agars with carbapenem ***/ Chromogenic medium for CPE OR If not available, MacConkey / CLED agar + 35-37 Aerobic 18-24hr ≥18hr Klebsiella pneumoniae Escherichia coli