Test Id : MTBRP
Mycobacterium tuberculosis Complex, Molecular Detection, PCR, Varies
Useful For
Suggests clinical disorders or settings where the test may be helpful
Rapid detection of Mycobacterium tuberculosis complex DNA (preferred method)
Detection of M tuberculosis, when used in conjunction with mycobacterial culture
This test does not assess M tuberculosis rifampin resistance.
This test should not be used to determine bacteriologic cure or to monitor response to therapy.
This test is not intended for the detection of latent tuberculosis and must not be used as a substitute for tests intended for detection of latent tuberculosis such as the tuberculin skin test or an interferon gamma release assay.
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 |
|---|---|---|---|
| TBT | Concentration, Mycobacteria | 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, the reflex test may be performed at an additional charge.
For more information see Meningitis/Encephalitis Panel Algorithm.
Method Name
A short description of the method used to perform the test
Real-Time 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)
AFB (Acid-Fast Bacilli)
Bacillus, Acid-Fast
MTB (Mycobacterium tuberculosis)
Mycobacterium tuberculosis (MTB)
TB (Tuberculosis)
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, the reflex test may be performed at an additional charge.
For more information see Meningitis/Encephalitis Panel Algorithm.
Specimen Type
Describes the specimen type validated for testing
Varies
Ordering Guidance
This test does not provide rifampin resistance information and is most useful for non-sputum specimens. For sputum specimens, the recommended test is MTBXS / Mycobacterium tuberculosis complex, Molecular Detection and Rifampin Resistance, PCR, Sputum. MTBXS provides rapid resistance information to aid with patient management.
Additional Testing Requirements
This test must always be performed in conjunction with mycobacterial culture. If your facility is unable to perform mycobacterial culture, order CTB / Mycobacteria and Nocardia Culture, Varies concurrently with this test.
Shipping Instructions
Specimen must arrive within 7 days of collection; if greater than 7 days of collection, the specimen will be rejected.
Necessary Information
Specimen source is required.
ORDER QUESTIONS AND ANSWERS
| Question ID | Description | Answers |
|---|---|---|
| SRC62 | MTB Complex PCR, Specimen Source |
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
Submit a raw clinical sample (not a culture isolate) for testing.
Fresh, undigested specimens are preferred. If no fresh specimen is available, digested respiratory specimens treated with N-acetyl-L-cysteine/sodium hydroxide (NALC/NaOH) are acceptable for some specimen types. For detailed information, see the Specimen Type information below.
The high sensitivity of amplification by polymerase chain reaction (PCR) requires the specimen to be processed in an environment in which contamination of the specimen by Mycobacterium tuberculosis DNA is unlikely.
If a single specimen is being shared between mycobacteria culture, acid-fast smear, and/or M tuberculosis PCR, a minimum volume of 2 mL for body fluid, 3 mL for respiratory specimen, or a pea-sized piece of tissue should be obtained. Specimen volumes less than indicated may decrease sensitivity of testing. If insufficient volume is submitted, test or tests will be canceled.
Submit only 1 of the following specimens:
Preferred Specimen Types
Specimen Type: Body fluid
Sources: Body, bone marrow aspirate, ocular, or CSF
Container/Tube: Sterile container
Specimen Volume: 1 mL
Additional Information: Only fresh, non-NALC/NaOH-digested body fluids are acceptable.
Specimen Type: Gastric washing
Container/Tube: Sterile container
Specimen Volume: 2 mL
Collection Instructions: Neutralize specimen within 4 hours of collection with 20 mg of sodium carbonate per 2 mL of gastric washing.
Specimen Type: Respiratory
Sources: BAL, bronchial washing, tracheal secretion, or sputum
Container/Tube: Sterile container
Specimen Volume: 1 mL if only PCR ordered or 3 mL if PCR ordered with smear and culture
Additional Information: Before collecting sputum specimens, see Ordering Guidance.
Specimen Type: Feces
Container/Tube: Sterile container
Specimen Volume: 5 to 10 g
Additional Information: Only fresh, non-NALC/NaOH-digested fecal specimens are acceptable.
Specimen Type: Tissue
Sources: Fresh tissue, bone, or bone marrow biopsy
Container/Tube: Sterile container
Specimen Volume: 5 to 10 mm
Collection Instructions: Keep moist with sterile water or sterile saline
Additional Information: Only fresh, non-NALC/NaOH-digested tissue is acceptable.
Specimen Type: Urine
Container/Tube: Sterile container
Specimen Volume: 1 mL
Collection Instructions: Collect a random urine specimen.
Acceptable Specimen Types
Specimen Type: NALC/NaOH-digested respiratory specimens
Sources: Lavage fluid, bronchial washing, gastric washing, respiratory fluid, sputum, or tracheal secretion
Container/Tube: Sterile container
Specimen Volume: 2 mL
Collection Instructions:
1. Submit digested specimen treated with NALC/NaOH.
2. Clearly indicate on container and order form that specimen is a digested specimen.
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.
Body fluid, nondigested respiratory specimen, urine: 0.5 mL; Fresh tissue or bone: 5 mm; NALC-NaOH-digested specimen, gastric washing: 1 mL; Stool: 5 g
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
| Blood Specimen in anaerobe vial or viral transport medium (including but not limited to M4, M5, BD viral transport media, thioglycolate broth) Swabs Tissues in formalin fluid | 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 | Refrigerated (preferred) | 7 days | |
| Frozen | 7 days |
Useful For
Suggests clinical disorders or settings where the test may be helpful
Rapid detection of Mycobacterium tuberculosis complex DNA (preferred method)
Detection of M tuberculosis, when used in conjunction with mycobacterial culture
This test does not assess M tuberculosis rifampin resistance.
This test should not be used to determine bacteriologic cure or to monitor response to therapy.
This test is not intended for the detection of latent tuberculosis and must not be used as a substitute for tests intended for detection of latent tuberculosis such as the tuberculin skin test or an interferon gamma release assay.
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 test may be performed at an additional charge.
For more information see Meningitis/Encephalitis Panel Algorithm.
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Each year, Mycobacterium tuberculosis accounts for more than a million deaths and is responsible for millions of newly diagnosed cases of tuberculosis worldwide. M tuberculosis is spread from person-to-person via respiratory transmission and has the potential to become resistant to many or all antibiotics currently used if antimycobacterial treatment is not promptly initiated. Therefore, rapid and accurate detection of M tuberculosis in patient specimens is of clinical and public health importance.
Conventional culture methods can generally detect M tuberculosis in 2 to 3 weeks, although up to 8 weeks of incubation may be required in some instances. Developed at Mayo Clinic, this rapid polymerase chain reaction (PCR) assay detects M tuberculosis complex DNA directly from specimens without waiting for growth in culture and, therefore, the results are available rapidly after receipt in the laboratory. A mycobacterial culture must always be performed in addition to the PCR assay. The PCR assay is rapid, but the culture has increased sensitivity over the PCR assay. The PCR assay targets a unique sequence within the katG gene, which is present in members of the M tuberculosis complex. In addition, the assay can detect genotypic resistance to isoniazid mediated by mutations in the katG target, when present.
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
A positive result indicates the presence of Mycobacterium tuberculosis complex DNA. Members of the M tuberculosis complex detected by this assay include M tuberculosis, Mycobacterium bovis, Mycobacterium bovis bacillus Calmette-Guerin, Mycobacterium africanum, Mycobacterium canettii, and Mycobacterium microti. Other species within the M tuberculosis complex (eg, Mycobacterium caprae, Mycobacterium pinnipedii, and Mycobacterium mungi) should, in theory, be detected using the primer and probe sequences in this assay, but they have not been tested. This assay method does not distinguish between the species of the M tuberculosis complex. If an isolate of M tuberculosis complex is already available, species identification can be performed; order TBSP / Mycobacterium tuberculosis Complex Species Identification, PCR, Varies.
A negative result indicates the absence of detectable M tuberculosis complex DNA.
Isoniazid (INH) resistance mediated through a katG variant will be reported when observed but lack of a katG variant does not imply that the isolate is susceptible to INH. There are other genetic loci in addition to katG that can contribute to resistance for this drug.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
A mycobacterial culture must always be performed in addition to the polymerase chain reaction (PCR) test. If your facility is unable to perform mycobacterial culture, the Mycobacteria Culture test (CTB / Mycobacteria and Nocardia Culture, Varies) should be ordered. The overall sensitivity of the PCR from acid-fast smear positive specimens is approximately 96% compared to mycobacterial culture but sensitivity of the PCR from a smear negative specimen is lower and a negative result does not rule out M. tuberculosis complex.
This rapid PCR assay detects Mycobacterium tuberculosis complex nucleic acid and, therefore, does not distinguish between viable, disease-related organisms and nucleic acid persisting from prior infection. Test results should be correlated with patient symptoms and clinical presentation before a definitive diagnosis is made.
A negative result does not rule out the presence of M tuberculosis complex or active disease because the organism may be present at levels below the limit of detection for this assay.
This test has not been studied for use with specimens from patients being treated with antituberculous agents and, therefore, should not be used to determine bacteriologic cure or to monitor response to therapy. It is not known how long the PCR assay can remain positive following treatment for M tuberculosis.
The sensitivity of this test with stool specimens is 80% and testing of additional stool specimens should be considered if the result from the first specimen is negative.
This test does not provide information on rifampin susceptibility. For sputum, the MTBXS / Mycobacterium tuberculosis complex, Molecular Detection and Rifampin Resistance, PCR, Sputum (Cepheid GeneXpert PCR) test is recommended instead as MTBXS will provide rapid resistance information for rifampin to aid with patient management.
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. Lewinsohn DM, Leonard MK, LoBue PA, et al. Official American Thoracic Society/Infectious Diseases Society of America/Centers for Disease Control and Prevention Clinical Practice Guidelines: Diagnosis of Tuberculosis in Adults and Children. Clin Infect Dis. 2017;64(2):e1-e33. doi:10.1093/cid/ciw694
2. Nahid P, Dorman SE, Alipanah N, et al. Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis. Clin Infect Dis. 2016;63(7):e147-e195. doi:10.1093/cid/ciw376
3. Ortiz-Brizuela E, Menzies D, Behr MA. Testing and treating Mycobacterium tuberculosis infection. Med Clin North Am. 2022;106(6):929-947. doi:10.1016/j.mcna.2022.08.001
Method Description
Describes how the test is performed and provides a method-specific reference
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 polymerase chain reaction (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 Mycobacterium tuberculosis complex in pulmonary and extrapulmonary specimens. J Clin Tuberc Other Mycobact Dis. 2022;29:100340. doi:10.1016/j.jctube.2022.100340)
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.
87556-Mycobacterium tuberculosis, complex, molecular detection, PCR
87015-Mycobacteria culture, concentration (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 |
|---|---|---|
| MTBRP | M tuberculosis Complex PCR | 38379-4 |
| 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.
|
|---|---|---|
| SRC62 | MTB Complex PCR, Specimen Source | 31208-2 |
| 56044 | MTB Complex PCR, Result | 38379-4 |