Test Id : TBIDS
Culture Referred for Identification, Mycobacterium and Nocardia with Antimicrobial Susceptibility Testing, Varies
Useful For
Suggests clinical disorders or settings where the test may be helpful
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
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 |
|---|---|---|---|
| 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
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
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.
Method Name
A short description of the method used to perform the test
16S rDNA Sequencing/Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry (MALDI TOF MS)/Rapid Polymerase Chain Reaction (PCR)
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
Acid-Fast Bacilli (AFB)
Aerobic Actinomycetes
Bacillus, Acid-Fast
Culture Referred for Identification, Nocardia (Aerobic Actinomycetes)
Culture Referred for Identification, TB (Tuberculosis)
Culture, TB (Tuberculosis)
Mycobacteria Culture
Mycobacterium tuberculosis (MTB)
Nocardia Referred for Identification
Organism Referred for Identification, Mycobacterium
Organism Referred for Identification, Nocardia (Aerobic Actinomycetes)
Referral for Identification
Tubercle Bacilli: Mycobacterium tuberculosis
Tuberculosis (TB)
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
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.
Specimen Type
Describes the specimen type validated for testing
Varies
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.
ORDER QUESTIONS AND ANSWERS
| Question ID | Description | Answers |
|---|---|---|
| Q00M0016 | Specimen Source (Required) and Isolate Description-Stain reaction, morphology, tests performed (Required) |
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
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:
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.
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
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
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
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.
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
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
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.
Not applicable
Interpretation
Provides information to assist in interpretation of the test results
Organisms growing in pure culture are identified to the species level whenever possible.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
If the organism is received in mixed culture or contaminated, the report may be delayed, or identification may not be possible.
Clinical Reference
Recommendations for in-depth reading of a clinical nature
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
Method Description
Describes how the test is performed and provides a method-specific reference
DNA sequence analysis utilizes a 500-base pair region of the 16S rRNA gene as the target for identification of mycobacteria and is performed using the MicroSeq kit from Applied Biosystems. Sequence data generated is compared to several different databases of known mycobacterial and aerobic actinomycete sequences to obtain organism identification. These include MicroSeq, NCBI GenBank, and Mayo Clinic Mycobacteria database. A 100% agreement with a database strain is needed for an acceptable identification to the species level.(Hall L, Doerr KA, Wohlfiel SL, Roberts GD: Evaluation of the MicroSeq system for identification of mycobacteria by 16S ribosomal DNA sequencing and its integration into a routine clinical mycobacteriology laboratory. J Clin Microbiol. 2003 Apr;41[4]:1447-1453)
Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI TOF MS) analysis is done using the Bruker BioTyper platform and the Bruker BDAL library, Bruker Mycobacterial Library, and the Mayo Clinic Library. A spectral score of 2.0 or greater is required for identification to the species level.
Rapid polymerase chain reaction (PCR) is performed following specimen digestion and decontamination using N-acetyl cysteine and sodium hydroxide. Genomic DNA is extracted using the MagNA Pure (Roche Applied Sciences) extraction platform. The purified genomic DNA is placed on the LightCycler instrument, which amplifies and monitors, by fluorescence, the development of target nucleotide sequences after each PCR cycle. A specific target sequence from a portion of the katG gene from Mycobacterium tuberculosis complex is amplified and the resulting segment is detected by melt-curve analysis using sequence-specific fluorescence resonance energy transfer hybridization probes. The LightCycler PCR assay is a closed PCR system that greatly reduces the potential for false-positive results due to specimen cross-contamination as compared with traditional open-system PCR or other amplification methods like transcription-mediated amplification.(Buckwalter SP, Connelly BJ, Louison LK, et al. Description, validation, and review of a decade of experience with a laboratory-developed PCR test for detection of M tuberculosis complex in pulmonary and extrapulmonary specimens. J Clin Tuberc Other Mycobact Dis. 2022;29:100340. doi:10.1016/j.jctube.2022.100340)
The method employed in this assay is broth microtiter dilution using a commercially available plate from Trek Diagnostics. Antimicrobials included in the assay are tested according to the Clinical and Laboratory Standards Institute (CLSI) guidelines.(Clinical and Laboratory Standards Institute: Susceptibility testing of mycobacteria, nocardia spp., and other aerobic actinomycetes. 3rd ed. CLSI standard M24. CLSI; 2018)
This test method is based on growth or absence of growth of M tuberculosis complex isolates in broth cultures containing critical concentrations of the antimycobacterial agents isoniazid, rifampin, and ethambutol. One of two US Food and Drug Administration-cleared platforms, the BACTEC MGIT 960 (Becton Dickinson) or the VersaTREK (ThermoFisher) will be used.(Brown-Elliott BA, Cirillo DM, Musser KA, Rowlinson M-C. Susceptibility test methods: Mycobacteria, nocardia, and other actinomycetes. In: Carroll KC, Pfaller MA, eds. Manual of Clinical Microbiology. 13th ed. ASM Press; 2023)
This test utilizes the Sensititre MycoTB broth microtiter dilution plate (Trek/ThermoFisher). Antimicrobials are tested according to CLSI M24 guidelines.(Thermo Scientific Sensititre MIC Susceptibility Plates for Mycobacterium tuberculosis. Product Insert. 011-MYCOTB-CID9502. Revision Date: 09/07/2016; Brown-Elliott BA, Cirillo DM, Musser KA, Rowlinson M-C. Susceptibility test methods: Mycobacteria, nocardia, and other actinomycetes. In: Carroll KC, Pfaller MA, eds. Manual of Clinical Microbiology, 13th ed. ASM Press; 2023)
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 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
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.
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® 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 |
|---|---|---|
| TBIDS | Mycobacteria Culture Refer ID+Susc | 543-9 |
| 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.
|
|---|---|---|
| TBIDS | Mycobacteria Culture Refer ID+Susc | In Process |