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HelpTest ID: TBIDS Culture Referred for Identification, Mycobacterium and Nocardia with Antimicrobial Susceptibility Testing, Varies
Infectious
Ordering Guidance
This test is intended for Mycobacterium species, Nocardia species, or other aerobic actinomycete genera.
Shipping Instructions
1. See Infectious Specimen Shipping Guidelines for shipping information.
2. Place specimen in a large infectious container (T146) and label as an etiologic agent/infectious substance.
Necessary Information
1. Specimen source is required.
2. Isolate description is required: Gram stain reaction, morphology, tests performed.
Specimen Required
Specimen Type: Organism in pure culture
Supplies: Infectious Container, Large (T146)
Container/Tube: Middlebrook (7H10 or 7H11) or Lowenstein-Jensen medium slant or in broth (eg, Mycobacteria Growth Indicator Tube [7H9] broth)
Specimen Volume: Isolate
Collection Instructions: Organism must be in pure culture, actively growing. Do not submit mixed cultures.
Useful For
Rapid identification to the species level and susceptibility testing for Mycobacterium species, Nocardia species, and other aerobic actinomycete genera and species from pure culture isolates
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| RMALM | Id MALDI-TOF Mass Spec AFB | No, (Bill Only) | No |
| RTBSP | Id, Mtb Speciation, PCR | No, (Bill Only) | No |
| ISMY | ID by 16S Sequencing | No, (Bill Only) | No |
| SRG | Susceptibility Rapid Grower | No, (Bill Only) | No |
| RSLG | Susceptibility Slow Grower | No, (Bill Only) | No |
| SSNS | Susceptibility Nocardia species | No, (Bill Only) | No |
| STV1 | Susceptibility, Mtb Complex, Broth | No, (Bill Only) | No |
| STV2 | Susceptibility, Mtb Cx, 2nd Line | No, (Bill Only) | No |
| STVP | Susceptibility, Mtb Complex, PZA | No, (Bill Only) | No |
| MTBVP | Mtb PZA Confirmation, pnc A Sequence | No, (Bill Only) | No |
| MIC | Susceptibility, MIC | No, (Bill Only) | No |
| LCTB | Id, MTB complex Rapid PCR | No, (Bill Only) | No |
Testing Algorithm
When this test is ordered, reflex antimicrobial susceptibility testing will be performed at an additional charge. All mycobacteria and Nocardia (including aerobic actinomycetes) submitted will be identified and billed as appropriate.
Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI TOF MS) and/or 16S rDNA sequencing is used for identification, when applicable, for slowly and rapidly growing Mycobacterium species and aerobic actinomycetes.
Mycobacterium tuberculosis complex rapid polymerase chain reaction (PCR) is used to rule out M tuberculosis complex from all broth specimens received with sufficient volume. Testing on solid growth is determined based on growth rate, colony morphology, or specific request by clients.
The M tuberculosis complex will be further identified to the species level upon request using rapid PCR testing.
Minimum inhibitory concentration (MIC) determination by either the microtiter broth dilution method or critical concentration testing by broth dilution will be automatically performed as appropriate after species identification.
For more information see Culture Referred for Identification and Susceptibility for Mycobacterium and Nocardia Algorithm.
Special Instructions
Method Name
16S rDNA Sequencing/Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry (MALDI TOF MS)/Rapid Polymerase Chain Reaction (PCR)
Reporting Name
Mycobacteria Culture Refer ID+SuscSpecimen Type
VariesSpecimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Varies | Ambient (preferred) | ||
| Refrigerated | |||
Clinical Information
There are approximately 200 recognized species of mycobacteria and more than 100 Nocardia species. Many of these species are human pathogens and, therefore, identification to the species level is important to help guide patient care. In addition, there are other aerobic actinomycete genera that can be human pathogens including, but not limited to, Tsukamurella, Rhodococcus, and Gordonia species.
Mycobacteria species, Nocardia species, and other aerobic actinomycete genera are identified using matrix-assisted laser desorption ionization time-of-flight mass spectrometry or nucleic acid sequencing of a 500-base pair region of the 16S ribosomal RNA gene. Mycobacterium tuberculosis complex can also be identified via rapid polymerase chain reaction assay which targets a unique sequence within the katG gene, which is present in members of the M tuberculosis complex and can also detect genotypic resistance to isoniazid mediated by mutations in the katG target, when present.
After identification, antimicrobial susceptibility testing is performed following Clinical and Laboratory Standards Institute M24 guidelines using either broth dilution or critical concentration methods as appropriate for the species.
Reference Values
Not applicable
Interpretation
Organisms growing in pure culture are identified to the species level whenever possible.
Clinical Reference
1. Martin I, Pfyffer GE, Parrish N. Mycobacterium: general characteristics, laboratory detection, and staining procedures. In: Carroll KC, Pfaller MA, eds. Manual of Clinical Microbiology. 13th ed. Vol 1. ASM Press; 2023:594-613
2. Clinical and Laboratory Standards Institute. Susceptibility testing of mycobacteria, nocardiae, and other aerobic actinomycetes. 3rd ed. CLSI document M24-ED3:2018. CLSI; 2018
Day(s) Performed
Monday through Sunday
Report Available
60 to 70 daysTest 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
Culture Referred for Identification, Mycobacterium
87118-Identificaiton of mycobacteria
87158-Identification of mycobacteria by other methods (if appropriate)
87118 -Id MALDI-TOF Mass Spec AFB (if appropriate)
87153-Mycobacteria Identification by Sequencing (if appropriate)
87150-Id, Mtb Speciation, PCR (if appropriate)
87186-Susceptibility Rapid Grower (if appropriate)
87186-Susceptibility Slow Grower (if appropriate)
87186-Susceptibility Nocardia species (if appropriate)
87188 x 3-Antimicrobial Susceptibility, Mycobacterium tuberculosis Complex, Broth Method (if appropriate)
87186-Suscetpbility, Mtb Cx, 2nd Line (if appropriate)
87188-Susceptibility, Mycobacterium tuberculosis Complex, Pyrazinamide (if appropriate)
87153-Mtb PZA Confirmation, pncA Sequencing (if appropriate)
87150- Id, MTB complex Rapid PCR (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| TBIDS | Mycobacteria Culture Refer ID+Susc | 543-9 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| TBIDS | Mycobacteria Culture Refer ID+Susc | In Process |
Forms
If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.
mml-mycobacteria