Laboratory Test Reference Guide

Laboratory Information

Test Name

MDRO Screen

Synonyms

E.S.B.L
C.P.E
ESBL screen
CPE screen
Extended-spectrum beta-lactamases
Carbapenemase-producing Enterobacteriaceae /
MDRO Multi drug resistant organisms
MRSA
Methicillin resistant Staphylococcus aureus
VRE
V.R.E.
Vancomycin resistant enterococci
Candida auris

Constituent Tests

Specimen Collection

Specimen Collection and Transport Protocols

 SITES FOR TAKING SPECIMENS

 MRSA 

• One nasal swab (same swab used to swab both anterior nares) and one perineal swab and one or two additional sites (if relevant) from any of the following for screening purposes: 

• Clinical specimens such as wounds, catheter urine, respiratory or any other as clinically indicated 

• Neonates - One swab from umbilicus 

Procedures for taking specimens 

• Purple microbiology swabs are used. 

• Moisten the swab in saline or sterile transport medium to increase the uptake of organisms 

• Rub the swab over the indicated area several times 

• Send the specimens to Microbiology with the request form correctly completed (see sample of microbiology form for MRSA on page 18). MRSA results will generally be available in two to three days 

ESBL/VRE 

• Faecal stools or rectal swab 

Procedure for taking rectal swab 

• Moisten swab by inserting into media at bottom of container. 

• Carefully insert the swab into the rectum to a depth of approximately 1.5 - 2 cm 

• Gently rotate the swab, ensuring some faecal matter is collected. 

• Remove the swab and insert it back into the container – label container. 

• Send the specimens to Microbiology with the request form correctly completed. (see sample of microbiology form for ESBL/VRE on page 19 and 20) ESBL results will generally be available in two to three days, VRE will take up to seven days 

Candida auris 

• Axilla swab (same swab used to swab left and right axilla) 

• Groin swab (same swab used to swab left and right groin) and 

• Urine from catheterised patients 

Samples from these sites if clinically indicated: 

• wounds, 

• sputum or endotracheal secretions 

• cannula entry sites 

Procedures for taking specimens 

• Purple microbiology swabs are used for swab specimens. 

• For swab samples - moisten the swab in saline or sterile transport medium to increase the uptake of organisms 

• Rub the swab over the indicated area several times 

• Send specimens to Microbiology with the request form correctly completed (see sample of microbiology form for Candida auris on page 21) -results will generally be available in three to five days. 

Link Waikato Hospital Laboratory - Swab Guide

Link Management of Multidrug Resistant Organism (MDRO)

Test Information

Department

Microbiology

Test Availability

Mon - Sun, 0800 - 2400

Method

Chromogenic culture media

Additional Information

Note : swabs are not shared between test types, separate swabs are required for each site.

For example a routine adult screen without wounds etc would require 2 swabs for MRSA screening (Nasal and Groin), 1 swab for ESBL/VRE (Rectal), and 2 swabs for Candida auris (Axilla and Groin). 5 swabs in total.