Test Id : MMLNS
Antimicrobial Susceptibility, Nocardia species and other Aerobic Actinomycetes, Varies
Useful For
Suggests clinical disorders or settings where the test may be helpful
Determining the resistance of species of Nocardia and other aerobic actinomycetes to antimicrobial agents.
This test is not useful for determining resistance of aerobic actinomycetes species of the following genera: Actinoallomurus, Actinocatenispora, Actinoplanes, Aeromicrobium, Croceifilum, Hazenella, Intrasporangium, Kineosphaera, Kitasatospora, Kribella, Kutzneria, Laceyella, Marinactinospora, Microbispora, Micromonospora, Nocardioides (not Nocardia), Phycicoccus, Piscicoccus, Prauserella, Risungbinella, Saccharothrix, Sphaerimonospora, Spirillospora, Streptosporangium, Terracoccus, or Thermoactinomyces.
Highlights
Antimicrobials tested for Nocardia species and other aerobic actinomycete susceptibility include: amikacin, amoxicillin/clavulanic acid, ceftriaxone, ciprofloxacin, clarithromycin, doxycycline, imipenem, linezolid, minocycline, moxifloxacin, trimethoprim/sulfamethoxazole, and tobramycin.
For Rhodococcus equi, rifampin and vancomycin will also be tested.
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 |
|---|---|---|---|
| MIC | Susceptibility, MIC | 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 |
|---|---|---|---|
| SSNS | Susceptibility Nocardia species | No, (Bill Only) | Yes |
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
When this test is ordered, susceptibility for Nocardia species will be performed at an additional charge.
When the organism identification is Rhodococcus equi the additional reflex test will be performed at an additional charge for the additional antimicrobials vancomycin and rifampin.
Method Name
A short description of the method used to perform the test
Minimum Inhibitory Concentration (MIC)
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
Amikacin
Amikacin Sulfate (Amikin)
Amikin (Amikacin Sulfate)
Amoxicillin and Clavulanate Potassium (Augmentin)
Augmentin (Amoxicillin and Clavulanate Potassium)
Ciprofloxacin
Clarithromycin
Linezolid (Zyvox)
MIC (Minimum Inhibitory Concentration)
Minimum Inhibitory Concentration (MIC)
Minocycline
Moxifloxacin
Nocardia Susceptibilities
Sulfamethoxazole
Susceptibility Testing
Tobramycin
Zyvox (Linezolid)
Ceftriaxone
Trimethoprim/sulfamethoxazole
Doxycycline
Imipenem
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
When this test is ordered, susceptibility for Nocardia species will be performed at an additional charge.
When the organism identification is Rhodococcus equi the additional reflex test will be performed at an additional charge for the additional antimicrobials vancomycin and rifampin.
Specimen Type
Describes the specimen type validated for testing
Varies
Ordering Guidance
This test is intended for assessing antimicrobial susceptibility of Nocardia species and other pathogenic aerobic actinomycetes which include the more commonly isolated genera of Rhodococcus, Streptomyces, Gordonia, Dietzia, Tsukamurella, and Williamsia species, as well as the lesser isolated genera which include Actinomadura, Amycolatopsis, Dermatophilus, Kroppenstedtia, Nocardiopsis, Nonomuraea, Pseudonocardia, Saccharomonospora, and Saccharopolyspora species.
Certain genera of aerobic actinomycetes will not be accepted for susceptibility testing. Aerobic actinomycetes genera that will not be tested include the following: Actinoallomurus, Actinocatenispora, Actinoplanes, Aeromicrobium, Croceifilum, Hazenella, Intrasporangium, Kineosphaera, Kitasatospora, Kribella, Kutzneria, Laceyella, Marinactinospora, Microbispora, Micromonospora, Nocardioides (not Nocardia), Phycicoccus, Piscicoccus, Prauserella, Risungbinella, Saccharothrix, Sphaerimonospora, Spirillospora, Streptosporangium, Terracoccus, and Thermoactinomyces.
Additional Testing Requirements
If organism identification is not provided, CTB / Mycobacteria and Nocardia Culture, Varies or CTBID / Culture Referred for Identification, Mycobacterium and Nocardia, Varies must also be ordered and will be charged separately.
Shipping Instructions
1. For shipping information see Infectious Specimen Shipping Guidelines.
2. Place specimen in a large infectious container and label as an etiologic agent/infectious substance.
Necessary Information
1. Specimen source is required.
2. Organism identification is required unless either CTB / Mycobacteria and Nocardia Culture, Varies or CTBID / Culture Referred for Identification, Mycobacterium and Nocardia, Varies is also ordered.
ORDER QUESTIONS AND ANSWERS
| Question ID | Description | Answers |
|---|---|---|
| Q00M0037 | 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
Specimen Type: Organism
Supplies: Infectious Container, Large (T146)
Container/Tube:
Preferred: Middlebrook 7H10 agar slant without antimicrobials
Acceptable: Sabouraud's dextrose agar slant or similar media without antimicrobials (eg, 7H11 agar slant, LJ, MGIT [7H9] broth media)
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.
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 resistance of species of Nocardia and other aerobic actinomycetes to antimicrobial agents.
This test is not useful for determining resistance of aerobic actinomycetes species of the following genera: Actinoallomurus, Actinocatenispora, Actinoplanes, Aeromicrobium, Croceifilum, Hazenella, Intrasporangium, Kineosphaera, Kitasatospora, Kribella, Kutzneria, Laceyella, Marinactinospora, Microbispora, Micromonospora, Nocardioides (not Nocardia), Phycicoccus, Piscicoccus, Prauserella, Risungbinella, Saccharothrix, Sphaerimonospora, Spirillospora, Streptosporangium, Terracoccus, or Thermoactinomyces.
Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.
When this test is ordered, susceptibility for Nocardia species will be performed at an additional charge.
When the organism identification is Rhodococcus equi the additional reflex test will be performed at an additional charge for the additional antimicrobials vancomycin and rifampin.
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Nocardia species and other aerobic actinomycetes can cause significant disease, often in immunocompromised patients. Clinical presentation can include, but is not limited to, pneumonia, skin abscess, bacteremia, brain abscess, eye infection, and joint infection.
Antimicrobial susceptibility testing may aid with selection of appropriate antimicrobial agents for patient care.
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.
Interpretive criteria and reporting guidelines are followed using the Clinical Laboratory Standards Institute (CLSI) M24S document.
Interpretation
Provides information to assist in interpretation of the test results
Interpretive values for susceptibility testing of Nocardia species using a broth microdilution method are included in the report, as appropriate.
For Rhodococcus equi, the interpretive values for vancomycin and rifampin will also be included.
See Reference Values for additional information.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
No significant cautionary statements
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. Duggal SD, Chugh TD. Nocardiosis: A neglected disease. Med Princ Pract. 2020;29(6):514-523. doi:10.1159/000508717
2. Conville PS, Brown-Elliott BA, Smith T, Zelazny AM. The complexities of Nocardia taxonomy and identification. J Clin Microbiol. 2017;56(1):e01419-17
Method Description
Describes how the test is performed and provides a method-specific reference
A standardized inoculum made from a pure culture of aerobic actinomycete is prepared and inoculated into wells of a microtiter plate containing different concentrations of antimicrobial agents.
Growth at specified breakpoints is indicative of resistance.(Clinical and Laboratory Standards Institute (CLSI). Susceptibility Testing of Mycobacteria, Nocardia spp., and Other Aerobic Actinomycetes. CLSI standard M24. Clinical and Laboratory Standards Institute (CLSI). Performance Standards for Susceptibility Testing of Mycobacteria, Nocardia spp., and Other Aerobic Actinomycetes. CLSI supplement M24S)
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.
87186
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 |
|---|---|---|
| MMLNS | Susc, Aerobic Actinomycetes | 29577-4 |
| 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.
|
|---|---|---|
| MMLNS | Susc, Aerobic Actinomycetes | 29577-4 |