Home
HelpTest ID: MTBPZ Mycobacterium tuberculosis Complex, Pyrazinamide Resistance by pncA DNA Sequencing, Varies
Infectious
Reporting Name
Mtb PZA Resistance, pncA SequencingUseful For
Detection of genotypic resistance to pyrazinamide by Mycobacterium tuberculosis complex isolates
Specimen Type
VariesShipping Instructions
1. See Infectious Specimen Shipping Guidelines.
2. Place specimen in a large infectious container (T146) and label as an etiologic agent/infectious substance.
Necessary Information
Specimen source and suspected organism identification are required.
Specimen Required
Specimen Type: Organism
Supplies: Infectious Container, Large (T146)
Container/Tube: Middlebrook 7H10 agar slant
Specimen Volume: Isolate
Collection Instructions: Organism must be in pure culture, actively growing.
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Varies | Ambient (preferred) | ||
| Refrigerated | |||
Special Instructions
Reference Values
Pyrazinamide resistance not detected
Day(s) Performed
Varies
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
87153-Mtb PZA Confirmation, pncA Sequence
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| MTBPZ | Mtb PZA Resistance, pncA Sequencing | 46245-7 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| MTBPZ | Mtb PZA Resistance, pncA Sequencing | 46245-7 |
Clinical Information
The protein product of the Mycobacterium tuberculosis complex pncA gene is an enzyme that is responsible for activation of the prodrug pyrazinamide (PZA). DNA sequencing of the Mycobacterium tuberculosis complex pncA gene can be used to detect mutations that correlate with in vitro PZA resistance.(1,2) The sequencing result can be available in as little as 1 day after the Mycobacterium tuberculosis complex isolate grows in culture, thereby providing a more rapid susceptibility result than the average 10 to 14 days required by phenotypic broth methods.
Interpretation
Polymorphisms in the pncA gene that have been previously correlated in our laboratory with pyrazinamide (PZA) resistance will be reported as "Mutation was detected in pncA suggesting resistance to pyrazinamide."
Wildtype pncA or a silent pncA gene polymorphism (ie, no change in the amino acid translation) will be reported as "No mutation was detected in pncA."
New polymorphisms in the pncA gene that have not previously been seen in our laboratory will require additional testing using a reference broth method to determine their correlation with PZA resistance.
Clinical Reference
1. Somoskovi A, Dormandy J, Parson LM, et al: Sequencing of the pncA Gene in members of the Mycobacterium tuberculosis complex has important diagnostic applications: identification of a species-specific pncA mutation in "Mycobacterium canettii" and the reliable and rapid predictor of pyrazinamide resistance. J Clin Microbiol. 2007;45(2):595-599
2. Dormandy J, Somoskovi A, Kreiswirth BN, Driscoll JR, Ashkin D, Salfinger M: Discrepant results between pyrazinamide susceptibility testing by the reference BACTEC 460TB method and pncA DNA sequencing in patients infected with multi-drug resistant W-Beijing Mycobacterium tuberculosis strains. Chest. 2007;131(2):497-501
3. Somoskovi A, Parson LM, Salfinger M: The molecular basis of resistance to isoniazid, rifampin, and pyrazinamide in Mycobacterium tuberculosis. Respir Res. 2001;2(3):164-168
4. Bouzouita I, Cabibbe AM, Trovato A, Draoui H, Ghariani A, Midouni B, Essalah L, Mehiri E, Cirillo DM, Slim-Saidi L. Is sequencing better than phenotypic tests for the detection of pyrazinamide resistance? Int J Tuberc Lung Dis. 2018 Jun 1;22(6):661-666. doi:10.5588/ijtld.17.0715
Report Available
7 to 21 daysReflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| MTBVP | Mtb PZA Confirmation, pnc A Sequence | No, (Bill Only) | No |
Testing Algorithm
When this test is ordered, the reflex test may be performed and charged.
Method Name
DNA Sequencing
Forms
If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.
mml-mycobacteria