Test Id : MMLSA
Antimicrobial Susceptibility, Anaerobic Bacteria, Minimal Inhibitory Concentration, Varies
Useful For
Suggests clinical disorders or settings where the test may be helpful
Determining the in vitro susceptibility on isolates of anaerobic bacteria involved in human infections
Directing antimicrobial therapy for anaerobic bacterial infections
Reflex Tests
Lists tests that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial tests.
| Test Id | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| COMM | Identification Commercial Kit | No, (Bill Only) | No |
| RMALD | Ident by MALDI-TOF mass spec | No, (Bill Only) | No |
| GID | Bacteria Identification | No, (Bill Only) | No |
| ISAE | Aerobe Ident by Sequencing | No, (Bill Only) | No |
| REFID | Additional Identification Procedure | No, (Bill Only) | No |
| SALS | Serologic Agglut Method 1 Ident | No, (Bill Only) | No |
| EC | Serologic Agglut Method 2 Ident | No, (Bill Only) | No |
| SHIG | Serologic Agglut Method 3 Ident | No, (Bill Only) | No |
| STAP | Identification Staphylococcus | No, (Bill Only) | No |
| STRP | Identification Streptococcus | No, (Bill Only) | No |
| SIDC | Ident Serologic Agglut Method 4 | No, (Bill Only) | No |
| ANAID | Anaerobe Ident | No, (Bill Only) | No |
| RMALA | Id MALDI-TOF Mass Spec Anaerobe | No, (Bill Only) | No |
| ISAN | Anaerobe Ident by Sequencing | No, (Bill Only) | No |
| PCRID | Identification by PCR | No, (Bill Only) | No |
| BLA | Beta Lactamase | No, (Bill Only) | No |
| SANA | Anaerobe Suscep per agent | No, (Bill Only) | No |
| ANIDE | Organism Ref for ID, Anaerobic Bact | Yes | No |
| MECAB | mecA PCR Test, Bill Only | No, (Bill Only) | No |
Additional Tests
Lists tests that are always performed, at an additional charge, with the initial tests.
| Test Id | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| BATTA | Anaerobe Suscep Battery | No | Yes |
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
When this test is ordered, the reflex tests may be performed at an additional charge. All anaerobic bacterial organisms recovered will automatically have susceptibility testing performed and billed as appropriate. Antimicrobial agents appropriate to the organism and specimen source will be tested according to Mayo Clinic's practice and the laboratory's standard operating procedures.
For a listing of the antimicrobials routinely tested in this laboratory as well as antimicrobials that may be tested upon request, see Anaerobic Bacteria Antimicrobials. If the organism or antimicrobial agent of interest is not listed in this table, call 800-533-1710 and ask to speak to the Bacteriology Anaerobe Laboratory.
If organism identification is not provided within 72 hours of specimen receipt, referred anaerobic bacteria identification will be performed at an additional charge.
Method Name
A short description of the method used to perform the test
Minimal Inhibitory Concentration (MIC) by Agar Dilution
NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
Aliases
Lists additional common names for a test, as an aid in searching
Antibiotic Susceptibility
Bacterial Susceptibility Testing (1 test)
MIC Test, Anaerobic Bacteria
Susceptibility Testing
Minimum Inhibitory Concentration (MIC)
Clindamycin
Ertapenem
Metronidazole
Minocycline
Moxifloxacin
Penicillin
Piperacillin-tazobactam
Amoxicillin-clavulanate
Cefotaxime
Ceftriaxone
Ciprofloxacin
Meropenem
Vancomycin
Actinobaculum
Actinomyces
Anaerococcus
Bacteroides
Bifidobacterium
Campylobacter
Clostridium
Clostridioides
Cutibacterium
Eggerthella
Finegoldia
Fusobacterium
Peptoniphilus
Porphyromonas
Prevotella
Propionibacterium
Staphylococcus saccharolyticus
Veillonella
Helcococcus
Lactobacillus
Ampicillin-sulbactam
Imipenem
Minimal Inhibitory Concentration (MIC)
Rifampin
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
When this test is ordered, the reflex tests may be performed at an additional charge. All anaerobic bacterial organisms recovered will automatically have susceptibility testing performed and billed as appropriate. Antimicrobial agents appropriate to the organism and specimen source will be tested according to Mayo Clinic's practice and the laboratory's standard operating procedures.
For a listing of the antimicrobials routinely tested in this laboratory as well as antimicrobials that may be tested upon request, see Anaerobic Bacteria Antimicrobials. If the organism or antimicrobial agent of interest is not listed in this table, call 800-533-1710 and ask to speak to the Bacteriology Anaerobe Laboratory.
If organism identification is not provided within 72 hours of specimen receipt, referred anaerobic bacteria identification will be performed at an additional charge.
Specimen Type
Describes the specimen type validated for testing
Varies
Shipping Instructions
For shipping information, see Infectious Specimen Shipping Guidelines.
Place specimen in a large infectious container and label as an etiologic agent/infectious substance, if appropriate.
Necessary Information
Organism identification and specimen source are required.
ORDER QUESTIONS AND ANSWERS
| Question ID | Description | Answers |
|---|---|---|
| Q00M0039 | Specimen Source (Required) and Organism Identification (Required unless concurrent identification test is ordered) |
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
Organism identification and specimen source are required.
Specimen Required
Specimen Type: Organism in pure culture
Supplies:
Anaerobic Transport Tube (T588)
Infectious Container, Large (T146)
Container/Tube:
Preferred: Anaerobic transport tube
Acceptable: Thioglycollate broth or any other suitable anaerobic transport system
Collection Instructions:
1. Perform isolation of infection bacteria.
2. Organism must be in pure culture and actively growing. Do not submit mixed cultures.
3. Place specimen in a large infectious container and label as an etiologic agent/infectious substance if appropriate.
Special Instructions
Library of PDFs including pertinent information and forms related to the test
Forms
If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.
Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
See Specimen Required
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
| Agar plate | Reject |
Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Varies | Ambient (preferred) | ||
| Refrigerated | |||
Useful For
Suggests clinical disorders or settings where the test may be helpful
Determining the in vitro susceptibility on isolates of anaerobic bacteria involved in human infections
Directing antimicrobial therapy for anaerobic bacterial infections
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
When this test is ordered, the reflex tests may be performed at an additional charge. All anaerobic bacterial organisms recovered will automatically have susceptibility testing performed and billed as appropriate. Antimicrobial agents appropriate to the organism and specimen source will be tested according to Mayo Clinic's practice and the laboratory's standard operating procedures.
For a listing of the antimicrobials routinely tested in this laboratory as well as antimicrobials that may be tested upon request, see Anaerobic Bacteria Antimicrobials. If the organism or antimicrobial agent of interest is not listed in this table, call 800-533-1710 and ask to speak to the Bacteriology Anaerobe Laboratory.
If organism identification is not provided within 72 hours of specimen receipt, referred anaerobic bacteria identification will be performed at an additional charge.
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Anaerobic bacteria are the greatest component of the human body's normal bacterial flora. Anaerobic bacteria colonize the skin, oral cavity, and genitourinary and lower gastrointestinal tracts and generally do not cause infection. Their presence is important for vitamin and other nutrient absorption and in preventing infection with disease-causing bacteria.
When usual skin and mucosal barriers are compromised, in an anaerobic environment, these bacteria can behave as pathogens. Typical anaerobic infections include periodontitis, abdominal or pelvic abscesses, endometritis, pelvic inflammatory disease, aspiration pneumonia, empyema and lung abscesses, sinusitis, brain abscesses, gas gangrene, and other soft tissue infections.
Anaerobic bacteria grow aggressively in the body under anaerobic conditions and may possess a variety of virulence factors, including capsules and extracellular enzymes. They also can develop resistance to antimicrobials by producing beta-lactamase and other modifying enzymes, and by alterations in membrane permeability and structure of penicillin-binding proteins. Susceptibility testing results are useful to clinicians because anaerobic bacteria are a significant cause of human infection, and they are often resistant to commonly used antimicrobials. Bacteroides and Parabacteroides species produce beta-lactamases. Ertapenem, metronidazole, and clindamycin are generally effective agents, although resistance to clindamycin, and occasionally ertapenem, is increasing.
The minimal inhibitory concentration (MIC) obtained during antimicrobial susceptibility testing is helpful in indicating the concentration of antimicrobial agent required at the site of infection necessary to inhibit the infecting organism. For each organism-antimicrobial agent combination, the Clinical and Laboratory Standards Institute and/or the European Committee on Antimicrobial Susceptibility Testing provides interpretive criteria for determining whether the MIC should be interpreted as susceptible, susceptible dose dependent, intermediate, nonsusceptible, resistant, or epidemiological cutoff value.
Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Susceptibility results are reported as minimal inhibitory concentration (MIC) in mcg/mL. Breakpoints (also known as clinical breakpoints) are used to categorize an organism as susceptible, susceptible-dose dependent, intermediate, resistant, or nonsusceptible according to breakpoint setting organizations, either the Clinical and Laboratory Standards Institute (CLSI) or the European Committee on Antimicrobial Susceptibility Testing (EUCAST), as applicable.
In some instances, an interpretive category cannot be provided based on available data; therefore, the following comment will be included on the report: There are no established interpretive guidelines for agents reported without interpretations.
For information regarding CLSI and EUCAST susceptibility interpretations, see Susceptibility Interpretative Category Definitions.
Interpretation
Provides information to assist in interpretation of the test results
In vitro susceptibility does not guarantee clinical response. Therefore, the decision to treat with a particular agent should not be based solely on the antimicrobial susceptibility testing result.
Refrigeration may result in decreased viability of anaerobic organisms.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
In vitro susceptibility does not guarantee clinical response. Therefore, the decision to treat with a particular agent should not be based solely on the antimicrobial susceptibility testing result.
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. Rosenblatt JE, Brook I. Clinical relevance of susceptibility testing of anaerobic bacteria. Clin Infect Dis. 1993;16(Suppl 4):S446-S448
2. Jenkins SG, Schuetz AN. Current concepts in laboratory testing to guide antimicrobial therapy. Mayo Clin Proc. 2012;87(3):290-308
3. Schuetz AN, Carpenter DE. Susceptibility test methods: anaerobic bacteria. In: Carroll KC, Pfaller MA, eds. Manual of Clinical Microbiology. 12th ed. ASM Press; 2019:1377-1397
4. Jenkins SG, Schuetz AN. Current concepts in laboratory testing to guide antimicrobial therapy. Mayo Clin Proc. 2012;87(3):290-308
Method Description
Describes how the test is performed and provides a method-specific reference
An agar dilution method is used for routine testing. The antimicrobial is added to agar in various concentrations depending upon levels attainable in serum. A standardized suspension of the organism is applied to the agar plates, which are incubated anaerobically for 42 to 48 hours at 35 to 37 degrees C. The end point is that in which a marked reduction occurs in the appearance of growth on the test plate as compared to that of growth on the control plate. Examples of marked change include a change from confluent growth to a haze, less than 10 tiny colonies, or 1 to 3 normal-sized colonies.(Clinical and Laboratory Standards Institute [CLSI]: Methods for Antimicrobial Susceptibility Testing of Anaerobic Bacteria. 9th ed. CLSI standard M11. CLSI; 2018)
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
Monday through Sunday
Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
Fees :
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
- Authorized users can sign in to Test Prices for detailed fee information.
- Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
- Prospective clients should contact their account representative. For assistance, contact Customer Service.
Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.
CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
CPT codes are provided by the performing laboratory.
87186-Antimicrobial Susceptibility, Anaerobic Bacteria, MIC
87076-Organism Ref for ID, Anaerobic Bact (if appropriate)
87076-Anaerobe Ident (if appropriate)
87076-Id MALDI-TOF Mass Spec Anaerobe (if appropriate)
87153-Anaerobe ident by sequencing (if appropriate)
87150-Identification by PCR (if appropriate)
87185-Beta Lactamase (if appropriate)
87181-Anaerobe Susceptibility per Agent (if appropriate)
87150-mecA PCR (if appropriate)
LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
| Test Id | Test Order Name | Order LOINC Value |
|---|---|---|
| MMLSA | Susceptibility, Anaerobic, MIC | 50545-3 |
| Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
|---|---|---|
| MMLSA | Susceptibility, Anaerobic, MIC | 50545-3 |