Summary
·
Effective June 1, 2026, carbapenem-resistant Acinetobacter
baumannii (CRAB) isolates submitted to the New Jersey Public Health and
Environmental Laboratory (NJPHEL) Antimicrobial Resistance Laboratory Network
(ARLN) will no longer routinely undergo oxacillinase (OXA) polymerase chain
reaction (PCR) testing.
o
Over 90% of CRAB isolates carry an OXA gene
(e.g., OXA-23) and should generally be considered OXA-positive.
·
CRAB submission and reporting criteria remain
unchanged (see “Resources”).
·
CRAB isolates submitted to NJPHEL ARLN will
continue to undergo species identification via MALDI-TOF, antimicrobial
susceptibility testing, and real-time PCR (RT-PCR) for the “Big Five”
carbapenemases (i.e., NDM, KPC, VIM, IMP and OXA-48) via Cepheid and/or Streck
panels.
Background
Carbapenem-resistant
Acinetobacter baumannii (CRAB) is a highly prevalent
healthcare-associated pathogen in New Jersey. More than 90% of CRAB isolates
carry an oxacillinase (OXA) gene that produces enzymes that break down the
antibiotic oxacillin. In New Jersey, CRAB isolates most frequently carry
blaOXA-23, blaOXA-51, and blaOXA-24/40. Therefore, consider all CRAB isolates
collected in New Jersey as OXA-positive, regardless of testing.
Update
Effective
June 1, 2026, NJPHEL will discontinue routine use of the OXA polymerase chain
reaction (PCR) panel on CRAB isolates submitted for further testing. Use of the
OXA PCR panel will be restricted to CRAB isolates collected from pediatric
patients ages 21 years and younger.
At this time, there are no changes to the current
criteria for reporting cases and submitting CRAB isolates to NJDOH (see
“Resources”). NJPHEL will continue to conduct the following test methods on
CRAB isolates submitted for further testing:
·
Species identification via MALDI-TOF and/or
Vitek-2
·
Antimicrobial susceptibility testing, including
sulbactam-durlobactam via Sensititre™ and cefiderocol via disk diffusion
·
RT-PCR for the “Big Five” carbapenemases (i.e.,
NDM, KPC, VIM, IMP and OXA-48) via Cepheid and/or Streck panels
Recommendations
for Clinical and Reference Laboratories:
·
Continue submitting CRAB isolates to
NJPHEL as outlined in the current submission and reporting process document
(see “Resources”).
Recommendations
for Healthcare Providers
·
Patients identified to have CRAB should be
considered OXA-positive.
o
In acute care settings, these patients should be
placed and maintained on Contact Precautions.
o
In skilled nursing facilities, these patients
should be placed and maintained on Enhanced Barrier Precautions, unless Contact
Precautions are otherwise indicated (see “Resources”).
·
Continue to report single cases of CRAB to NJDOH Communicable Disease Service (CDS) as
outlined in the current submission and reporting process document (see
“Resources”).
·
Report suspected or confirmed
outbreaks of CRAB to your local health department and NJDOH CDS.
Contact Information:
NJDOH Communicable Disease
Service:
·
CDS HAI/AR Unit
Email: DOH.CDS.HAIAR.EPI@doh.nj.gov
·
NJDOH
Communicable Disease Service, (609) 826-5964 during business hours
NJDOH Public Health and
Environmental Laboratory:
·
NJPHEL ARLN Lab Email: phel.arlnlab@doh.nj.gov
Resources
·
NJDOH Acinetobacter
Submission Criteria and Reporting Instructions: https://www.nj.gov/health/phel/documents/Microbiology/ARLN/Acinetobacter%20Isolate%20Submission%20and%20Reporting%20to%20NJDOH.pdf
·
NJDOH
Carbapenemase-Producing Organism Result Reporting Instructions: https://www.nj.gov/health/cd/documents/topics/ar/njdoh_cpo_reporting_process.pdf
·
PHEL Specimen
Submission Instructions: https://www.nj.gov/health/phel/documents/Client%20Services/Shipping%20Specimens%20to%20PHEL.pdf
· NJDOH Antimicrobial Resistance Webpage: https://www.nj.gov/health/cd/topics/ar.shtml
This information has been broadcast to: Local & County Health; Mercer ACO; Mercer Emergency Relief Organizations; Mercer Health Educator; Mercer Health Officer Backup; Mercer Health Officers; Mercer LHD Emergency Response; Mercer Local Health; Mercer PHN; Mercer REHS; Health Care Sector; Animal Health Professionals; Mercer Animal Facilities; Mercer Animal Other; Mercer Vets; Community Health Centers(FQHCs); Mercer Health Centers; Emergency Medical Services / First Responders; Mercer County OEM; Mercer EMS; Mercer EMS/FS Other; Mercer Fire; Mercer HAZMAT; Mercer Local OEM; Mercer Police; Health Care Facilities/Other; Mercer Ambulatory Care; Mercer Assisted Living; Mercer Hospice; Mercer Nursing Homes; Mercer Other Health Care Facilities; Mercer Substance Abuse Treatment; Mercer Urgent Care Centers; Health Care Providers; Mercer Dentists; Mercer Dermatologists; Mercer Infectious Disease; Mercer Medical Society; Mercer Neurologists; Mercer Nurses; Mercer OB GYN; Mercer Occupational Med; Mercer Ophthalmologist; Mercer Other Health Care Providers; Mercer Pediatrics; Mercer Primary Care; Mercer Surgeons; Hospitals/Acute Care; Mercer Critical Care/Trauma Centers; Mercer Hospital Administration; Mercer Hospital Community Ed; Mercer Hospital Emergency; Mercer Hospital Emergency Coordinators; Mercer Hospital Facility Management; Mercer Hospital Food Services; Mercer Hospital Human Resources; Mercer Hospital Public Relations; Mercer Hospital Quality Assurance; Mercer Hospital Security; Mercer Hospitals Other; Mercer Infection Control Practitioners; Mercer Medical Affairs; Mercer Nursing Patient Care Services; Mercer Outpatient; Mercer Respiratory Therapy; Hospitals/Other; Hospitals/Veterans; Labs/Non-Sentinel; Mercer Clinical Labs; Labs/Sentinel; Pharmaceutical Suppliers; Mercer Hospital Pharmacies; Mercer Internist Critical Care; Mercer Pharmaceutical Suppliers;