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pdfAttachment C: CRE Instrument - Web Version
Form Approved
OMB No. 0920-0879
Expiration Date 01/31/2021
2020 Carbapenem Resistance Veterinary Diagnostic
Laboratory Survey
Page 1
The purpose of this survey is to assess current activities and technologies used to detect carbapenem resistance in
Enterobacteriaceae, Pseudomonas, and Acinetobacter from dogs and cats and to determine how information
regarding carbapenem-resistance is shared with laboratory clients, the veterinary and scientific community, human
and animal health officials, public health, and other interested parties.
This survey is being administered through the American Association of Veterinary Laboratory Diagnosticians (AAVLD)
in collaboration with the Centers for Disease Control and Prevention (CDC). It contains a series of questions regarding
laboratory activities and practices related to detection, carbapenem susceptibility testing, carbapenemase
mechanism testing, data sharing capabilities, and emerging technologies for detecting carbapenem resistance. Use
of trade names and commercial sources is for identification only and does not imply endorsement. Participation is
completely voluntary.
The estimated time to complete this survey is (estimated time from pilot testing to be input here). Your survey
answers will be sent to a link at REDCap where data will be stored in a password protected electronic format. The
information gathered in this survey may be published; data will be published in aggregate form without identifying
any individual laboratory in order to protect the privacy of your laboratory and maintain confidentiality. A summary of
the results from this survey will be provided to your laboratory via email through AAVLD.
We appreciate your participation in this survey. Please complete the survey by (date six weeks from initial email to be
input here). If you have any questions or concerns regarding the survey, please contact Michelle Waltenburg
[[email protected]].
Laboratory Name:
__________________________________
State:
__________________________________
Title of person completing the survey:
__________________________________
((director, administrator, supervisor))
CDC estimates the average public reporting burden for this collection of information as 20 minutes, including the time
for reviewing instructions, searching existing data/information sources, gathering and maintaining the data/
information needed, and completing and reviewing the collection of information. An agency may not conduct or
sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB
control number. Send comments regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE,
MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0879).
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Section 1: The first set of questions ask about laboratory testing scope.
Please check the appropriate response or if needed write answers or comments in the spaces
provided.
1. From which of the following sources does your laboratory receive clinical samples (mark all that apply)?
Academic veterinary practices
Private veterinary practices
Other veterinary diagnostic laboratories
Other (please specify below):
Specify other:
__________________________________
2. What proportion of samples received by your laboratory are from dogs and cats?
Less than 10%
Between 10% and< 25%
Between 25% and < 50%
Between 50% and < 75%
75% or more
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Section 2: The second set of questions ask about bacterial identification and antimicrobial
susceptibility testing (AST).
Please check the appropriate response or if needed write answers or comments in the spaces
provided.
3. Which method(s) does your laboratory currently use for Gram-negative species identification (mark all that apply)?
Conventional biochemical tube tests
Commercially available test strips (e.g., API® strips)
Automated bacterial ID systems (e.g., Vitek®, BD Phoenix (TM), Sensititre (TM), MicroScan)
MALDI-TOF system
Sequencing or other molecular based methods
Other (please specify below):
Specify other:
__________________________________
4. Does your laboratory conduct antimicrobial susceptibility testing (AST) on any Gram-negative isolates?
Yes
No
The following attachment contains information on carbapenem breakpoints by laboratory testing guidelines. Please
consult the information as needed to answer Question 5.
[Attachment: "Laboratory testing guidelines.pdf"]
5. What laboratory testing standards does your laboratory use (select all that apply)?
CLSI M100
CLSI VET08
VetCAST/EUCAST
Other (please specify below):
Specify other:
Any comments you wish to share if you use multiple
standards for identification and AST:
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Section 3: The following set of questions ask about Enterobacteriaceae from dogs and cats
specifically. For the purpose of this survey, Enterobacteriaceae includes, but is not limited to,
the following species: E. coli, Salmonella spp., Klebsiella spp., Enterobacter spp., Citrobacter
spp., Providencia spp., Proteus spp., and Morganella spp.
Please check the appropriate response or if needed write answers or comments in the spaces
provided.
6. Does your laboratory conduct AST on any Enterobacteriaceae isolates?
Yes
No
7. Please indicate which method your laboratory uses for primary susceptibility testing of Enterobacteriaceae from
dogs and cats:
Kirby-Bauer disk diffusion
Automated testing instrument (e.g., Vitek®, BD Phoenix (TM), Sensititre (TM), MicroScan)
Other broth microdilution method (please specify below):
Agar dilution method
Gradient diffusion method (e.g., Etest®)
Other or use several methods (please specify or describe below):
Specify other broth microdilution method:
__________________________________
Specify other or describe several methods used:
__________________________________________
8. Please indicate which method(s) your laboratory uses for secondary, supplemental, or confirmatory testing of
Enterobacteriaceae from dogs and cats (if performed):
Kirby-Bauer disk diffusion
Automated testing instrument (e.g., Vitek®, BD Phoenix (TM), Sensititre (TM), MicroScan)
Other broth microdilution method (please specify below):
Agar dilution method
Gradient diffusion method (e.g., Etest®)
Other method (please specify below):
Not performed
Specify other broth microdilution method:
Specify other:
__________________________________
__________________________________
9. Does your laboratory currently conduct AST on Enterobacteriaceae for clinical management of individual patients?
Yes
No
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9a. Which isolates undergo AST for clinical decision making?
Most Enterobacteriaceae isolates received routinely undergo AST.
Only Enterobacteriaceae isolates from suspected infections undergo AST.
Only Enterobacteriaceae isolates that are requested by submitter/clinician undergo AST.
Other Enterobacteriaceae isolates (please specify below)
Specify other:
__________________________________
10. Does your laboratory currently conduct AST on Enterobacteriaceae for any monitoring/surveillance programs?
Yes
No
10a. Please select the organism(s) included in surveillance AST:
E. coli, commensal
Pathogenic E. coli (e.g., STEC, EHEC, AEEC)
Salmonella
Klebsiella
Enterobacter
Citrobacter
Providencia
Proteus
Morganella
Other (please specify below):
Specify other organism(s):
__________________________________
11. Does your laboratory currently conduct AST on Enterobacteriaceae for any research projects?
Yes
No
11a. Please select the organism(s) included in research project AST:
E. coli, commensal
Pathogenic E. coli (e.g., STEC, EHEC, AEEC)
Salmonella
Klebsiella
Enterobacter
Citrobacter
Providencia
Proteus
Morganella
Other (please specify below):
Specify other organism(s):
__________________________________
12. For Enterobacteriaceae, if preliminary AST suggests multidrug-resistance (e.g., resistance was detected to 2 or
more classes of antibiotics), does your laboratory routinely do any additional AST or mechanism of resistance testing
(e.g., ESBL, carbapenemase-production) to investigate further?
Yes
No
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At request of client
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13. For Enterobacteriaceae, does your laboratory's primary AST panel for dogs and cats include one or more
third-generation cephalosporins (e.g., cefpodoxime, ceftiofur, cefovecin, ceftriaxone)?
Yes
No
14. Are any third-generation cephalosporins (e.g., cefpodoxime, ceftiofur, cefovecin, ceftriaxone) included in any
secondary, supplemental, or confirmatory AST for Enterobacteriaceae?
Yes
No
15. For Enterobacteriaceae, does your laboratory's primary AST panel for dogs and cats include one or more
carbapenems?
Yes
No
15a. Please select the carbapenem(s) included:
Imipenem
Meropenem
Doripenem
Ertapenem
Other carbapenem (please specify below):
Specify other carbapenem:
__________________________________
16. Are any carbapenems included in any secondary, supplemental, or confirmatory AST for Enterobacteriaceae?
Yes
No
16a. Please select the carbapenem(s) included:
Imipenem
Meropenem
Doripenem
Ertapenem
Other carbapenem (please specify below):
Specify other carbapenem:
__________________________________
17. Does your laboratory provide MIC interpretations for carbapenems in Enterobacteriaceae?
Yes
No
Sometimes (please specify below):
Specify:
__________________________________
18. Does your laboratory provide zone diameter interpretations for carbapenems in Enterobacteriaceae?
Yes
No
Specify:
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Sometimes (please specify below):
__________________________________
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Section 4: The following set of questions ask about Pseudomonas aeruginosa from dogs and
cats specifically.
Please check the appropriate response or if needed write answers or comments in the spaces
provided.
19. Does your laboratory conduct AST on any Pseudomonas aeruginosa isolates?
Yes
No
20. Please indicate which method your laboratory uses for primary susceptibility testing of Pseudomonas aeruginosa
from dogs and cats:
Kirby-Bauer disk diffusion
Automated testing instrument (e.g., Vitek®, BD Phoenix (TM), Sensititre (TM), MicroScan)
Other broth microdilution method (please specify below):
Agar dilution method
Gradient diffusion method (e.g., Etest®)
Other or use several methods (please specify or describe below):
Specify other broth microdilution method:
Specify other or describe several methods used:
__________________________________
__________________________________
21. Please indicate which method(s) are used for secondary, supplemental, or confirmatory testing of Pseudomonas
aeruginosa from dogs and cats (if performed):
Kirby-Bauer disk diffusion
Automated testing instrument (e.g., Vitek®, BD Phoenix (TM), Sensititre (TM), MicroScan)
Other broth microdilution method (please specify below):
Agar dilution method
Gradient diffusion method (e.g., Etest®)
Other method (please specify below):
Not performed
Specify other broth microdilution method:
Specify other method:
__________________________________
__________________________________
22. Does your laboratory currently conduct AST on Pseudomonas aeruginosa for clinical management of individual
patients?
Yes
No
22a. Which isolates undergo AST for clinical decision making?
Most Pseudomonas aeruginosa isolates received routinely undergo AST.
Only Pseudomonas aeruginosa isolates from suspected infections undergo AST.
Only Pseudomonas aeruginosa isolates that are requested by submitter/clinician undergo AST.
Other Pseudomonas aeruginosa isolates (please specify below):
Specify other:
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23. Does your laboratory currently conduct AST on Pseudomonas aeruginosa for any monitoring/surveillance
programs?
Yes
No
24. Does your laboratory currently conduct AST on Pseudomonas aeruginosa for any research projects?
Yes
No
25. For Pseudomonas aeruginosa, if preliminary AST suggested multidrug-resistance (e.g., resistance was detected to
2 or more classes of antibiotics), does your laboratory routinely do any additional AST or mechanism of resistance
testing (e.g., carbapenemase-production, PCR) to investigate further?
Yes
No
At request of client
26. For Pseudomonas aeruginosa, does your laboratory's primary AST panel for dogs and cats include one or more
third-generation cephalosporins (e.g., cefpodoxime, ceftiofur, cefovecin, ceftriaxone)?
Yes
No
27. Are any third-generation cephalosporins (e.g., cefpodoxime, ceftiofur, cefovecin, ceftriaxone) included in any
secondary, supplemental, or confirmatory AST for Pseudomonas aeruginosa?
Yes
No
28. For Pseudomonas aeruginosa, does your laboratory's primary AST panel for dogs and cats include one or more
carbapenems?
Yes
No
28a. Please select which carbapenem(s) are included:
Imipenem
Meropenem
Doripenem
Other carbapenem (please specify below):
Specify other:
__________________________________
29. Are any carbapenems included in any secondary, supplemental, or confirmatory AST for Pseudomonas
aeruginosa?
Yes
No
29a. Please select which carbapenem(s) are included:
Imipenem
Meropenem
Doripenem
Other carbapenem (please specify below):
Specify other:
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30. Does your laboratory provide MIC interpretations for carbapenems in Pseudomonas aeruginosa?
Yes
No
Sometimes (please specify below):
Specify:
__________________________________
31. Does your laboratory provide zone diameter interpretations for carbapenems in Pseudomonas aeruginosa?
Yes
No
Specify:
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Sometimes (please specify below):
__________________________________
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Section 5: The following set of questions ask about Acinetobacter baumannii complex from
dogs and cats specifically.
Please check the appropriate response or if needed write answers or comments in the spaces
provided.
32. Does your laboratory conduct AST on any Acinetobacter baumannii complex isolates?
Yes
No
33. Please indicate which method your laboratory uses for primary susceptibility testing of Acinetobacter baumannii
complex from dogs and cats:
Kirby-Bauer disk diffusion
Automated testing instrument (e.g., Vitek®, BD Phoenix (TM), Sensititre (TM), MicroScan)
Other broth microdilution method (please specify below):
Agar dilution method
Gradient diffusion method (e.g., Etest®)
Other or use several methods (please specify or describe below):
Specify other broth microdilution method:
Specify other or describe several methods used:
__________________________________
__________________________________
34. Please indicate which method(s) are used for secondary, supplemental, or confirmatory testing of Acinetobacter
baumannii complex from dogs and cats (if performed):
Kirby-Bauer disk diffusion
Automated testing instrument (e.g., Vitek®, BD Phoenix (TM), Sensititre (TM), MicroScan)
Other broth microdilution method (please specify below):
Agar dilution method
Gradient diffusion method (e.g., Etest®)
Other (please specify below):
Not performed
Specify other broth microdilution method:
Specify other:
__________________________________
__________________________________
35. Does your laboratory currently conduct AST on Acinetobacter baumannii complex for clinical management of
individual patients?
Yes
No
35a. Which isolates undergo AST for clinical decision making?
Most Acinetobacter baumannii complex isolates received routinely undergo AST.
Only Acinetobacter baumannii complex isolates from suspected infections undergo AST.
Only Acinetobacter baumannii complex isolates that are requested by submitter/clinician undergo AST.
Other Acinetobacter baumannii complex isolates (please specify below):
Specify other:
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__________________________________
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36. Does your laboratory currently conduct AST on Acinetobacter baumannii complex for any monitoring/surveillance
programs?
Yes
No
37. Does your laboratory currently conduct AST on Acinetobacter baumannii complex for any research projects?
Yes
No
38. For Acinetobacter baumannii complex, if preliminary AST suggested multidrug-resistance (e.g., resistance was
detected to 2 or more classes of antibiotics), does your laboratory routinely do any additional AST or mechanism of
resistance testing (e.g., carbapenemase-production, PCR) to investigate further?
Yes
No
At request of client
39. For Acinetobacter baumannii complex, does your laboratory's primary AST panel for dogs and cats include one or
more third-generation cephalosporins (e.g., cefpodoxime, ceftiofur, cefovecin, ceftriaxone)?
Yes
No
40. Are any third-generation cephalosporins (e.g., cefpodoxime, ceftiofur, cefovecin, ceftriaxone) included in any
secondary, supplemental, or confirmatory AST for Acinetobacter baumannii complex?
Yes
No
41. For Acinetobacter baumannii complex, does your laboratory's primary AST panel for dogs and cats include one or
more carbapenems?
Yes
No
41a. Please select the carbapenem(s) included:
Imipenem
Meropenem
Doripenem
Other carbapenem (please specify below):
Specify other:
__________________________________
42. Are any carbapenems included in any secondary, supplemental, or confirmatory AST for Acinetobacter baumannii
complex?
Yes
No
42a. Please select which carbapenem(s) are included:
Imipenem
Meropenem
Doripenem
Other carbapenem (please specify below):
Specify other:
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__________________________________
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43. Does your laboratory provide MIC interpretations for carbapenems in Acinetobacter baumannii complex?
Yes
No
Sometimes (please specify below):
Specify:
__________________________________
44. Does your laboratory provide zone diameter interpretations for carbapenems in Acinetobacter baumannii
complex?
Yes
No
Sometimes (please specify below):
Specify:
__________________________________
You answered that your laboratory does not perform AST on any Enterobacteriaceae, Pseudomonas aeruginosa, or
Acinetobacter baumannii complex isolates. Is this true?
Yes
No
Please revisit question(s) 6, 19, and/or 32 to identify which Enterobacteriaceae, Pseudomonas, or Acinetobacter
baumannii complex isolates your laboratory performs AST on.
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Section 6: The following questions ask about what is done when carbapenem resistance from
dogs and cats is detected in any Gram-negative organism.
Please check the appropriate response or if needed write answers or comments in the spaces
provided.
45. If carbapenem resistance was detected in any isolate from a dog or cat, which of the following action(s) would
your laboratory initiate (mark all that apply)?
Notify clinician at submitting facility
Notify biosecurity officer or infection prevention staff at submitting facility
Notify the state agriculture department
Notify the state veterinarian
Notify other public health official/department
Perform additional laboratory testing (e.g., mCIM, CarbaNP, Modified Hodge Test [MHT], whole genome
sequencing)
Other action (please specify below):
None of the above
Specify other action:
__________________________________
46. If your laboratory identified a carbapenem-resistant isolate from a dog or cat, would your laboratory perform any
tests to identify carbapenemase production or carbapenemase genes?
Yes
No
46a. For which organism(s) (mark all that apply)?
Carbapenem-resistant Enterobacteriaceae
Carbapenem-resistant Pseudomonas aeruginosa
Carbapenem-resistant Acinetobacter baumannii complex
Other (please specify below):
Specify other:
__________________________________
46b. What mechanism testing would your laboratory perform (mark all that apply)?
Phenotypic testing
Commercial molecular test (e.g., Cepheid Xpert® Carba-R, BioFire® FilmArray®, VERIGENE®)
PCR for carbapenemase genes
Whole genome sequencing
46c. What phenotypic testing would your laboratory perform for carbapenem-resistant Enterobacteriaceae?
Modified carbapenem-inactivation method (mCIM) or carbapenem-inactivation method (CIM)
Rapid commercial test (e.g., RAPIDEX® CarbaNP)
Modified Hodge Test (MHT)
Other (please specify below):
What other phenotypic testing is performed for
carbapenem-resistant Enterobacteriaceae?
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46d. What phenotypic testing would your laboratory perform for carbapenem-resistant Pseudomonas aeruginosa?
Modified carbapenem-inactivation method (mCIM) or carbapenem-inactivation method (CIM)
Rapid commercial test (e.g., RAPIDEX® CarbaNP)
Modified Hodge Test (MHT)
Other (please specify below):
What other phenotypic testing is performed for
carbapenem-resistant Pseudomonas aeruginosa?
__________________________________________
46e. What phenotypic testing would your laboratory perform for carbapenem-resistant Acinetobacter baumannii
complex?
Modified carbapenem-inactivation method (mCIM) or carbapenem-inactivation method (CIM)
Rapid commercial test (e.g., RAPIDEX® CarbaNP)
Modified Hodge Test (MHT)
Other (please specify below):
What other phenotypic testing is performed for
carbapenem-resistant Acinetobacter baumannii complex?
__________________________________________
46f. Please indicate PCRs performed to detect which carbapenemase gene(s):
blaKPC
blaNDM
blaOXA-48-like
blaVIM
blaIMP
Other (please specify below):
Specify other carbapenemase gene(s):
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Section 7: The following set of questions ask about laboratory test results from dogs and cats.
Please reference the standards your laboratory uses (e.g., CLSI M100, CLSI VET08,
VetCAST/EUCAST ) to define carbapenem resistance when answering the following questions.
Please check the appropriate response or if needed write answers or comments in the spaces
provided.
The following attachment contains information on carbapenem breakpoints for various laboratory testing guidelines.
Please consult this information as needed to answer questions in Section 7.
[Attachment: "Laboratory testing guidelines.pdf"]
47. Did your laboratory identify any carbapenem-resistant isolate(s) from a dog or cat in 2019 (Jan-Dec)?
Yes
No
Unknown
48a. Approximately how many Enterobacteriaceae isolates from dogs and cats were tested for antibiotic
susceptibility in 2019 (Jan-Dec)?
0-10
11-50
51-100
>201
101-200
Prefer not to answer
48b. Among the Enterobacteriaceae isolates from dogs and cats that your laboratory performed antibiotic
susceptibility, how many were resistant to a carbapenem?
Zero
1-5
6-10
11-15
>16
Prefer not to answer
48c. Among the Enterobacteriaceae isolates from dogs and cats that your laboratory performed antibiotic
susceptibility, how many were resistant to a third-generation cephalosporin?
0-5
6-25
26-50
51-100
>100
Prefer not to answer
49a. Approximately how many Pseudomonas aeruginosa isolates from dogs and cats were tested for antibiotic
susceptibility in 2019 (Jan-Dec)?
0-10
11-50
51-100
101-200
>201
Prefer not to answer
49b. Among the Pseudomonas aeruginosa isolates from dogs and cats that your laboratory performed antibiotic
susceptibility, how many were resistant to a carbapenem?
Zero
1-5
6-10
11-15
>16
Prefer not to answer
49c. Among the Pseudomonas aeruginosa isolates from dogs and cats that your laboratory performed antibiotic
susceptibility, how many were resistant to a third-generation cephalosporin?
Zero
1-5
6-10
11-15
>16
Prefer not to answer
50a. Approximately how many Acinetobacter baumannii complex isolates from dogs and cats were tested for
antibiotic susceptibility in 2019 (Jan-Dec)?
Zero
1-5
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6-10
11-15
>16
Prefer not to answer
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50b. Among the Acinetobacter baumannii complex isolates from dogs and cats that your laboratory performed
antibiotic susceptibility, how many were resistant to a carbapenem?
Zero
1-5
6-10
11-15
>16
Prefer not to answer
50c. Among the Acinetobacter baumannii complex isolates from dogs and cats that your laboratory performed
antibiotic susceptibility, how many were resistant to a third-generation cephalosporin?
Zero
1-5
6-10
11-15
>16
Prefer not to answer
51. Does your laboratory save a viable culture of carbapenem-resistant isolates?
Yes
No
51a. Which isolates are routinely saved (select all that apply)?
Clinical sterile site
Clinical non-sterile site
Surveillance or research specimens
Other (please specify below):
Specify other:
51b. How long are carbapenem-resistant isolates
saved?
__________________________________
__________________________________
52. To your knowledge, are there any public health reporting mandates that require your laboratory to report the
identification of any carbapenem-resistant organisms to public health?
Yes (please specify below):
No
52a. Please describe the public health reporting
mandates:
__________________________________________
((e.g., what organisms and/or resistance
mechanisms, specimen sources, animals, and/or
situations are covered by the mandate?))
53. May we contact your laboratory via AAVLD with questions about your survey responses?
Yes
No
54. Any additional comments you wish to share:
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| File Type | application/pdf |
| File Modified | 2020-09-28 |
| File Created | 2020-09-15 |