Test Catalog

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
TBMP Mycobacteria Probe Ident No, Bill Only No
TBPB Mycobacteria Probe Ident Broth 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, the reflex antimicrobial susceptibility test will be performed at an additional charge. All mycobacteria and Nocardia (including aerobic actinomycetes) submitted will be identified and billed as appropriate.

 

Nucleic acid probes used for identification, when applicable, include those for Mycobacterium avium-intracellulare complex, Mycobacterium gordonae, and Mycobacterium tuberculosis complex. 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 (including Nocardia species and Streptomyces species). The M tuberculosis complex can be further identified to the species level upon request, using a separate rapid PCR test. 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.

 

See Culture Referred for Identification and Susceptibility for Mycobacterium and Nocardia Algorithm in Special Instructions.

Special Instructions
Library of PDFs including pertinent information and forms related to the test

Method Name
A short description of the method used to perform the test

Nucleic Acid Probe/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.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Mycobacteria Culture Refer ID+Susc

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, the reflex antimicrobial susceptibility test will be performed at an additional charge. All mycobacteria and Nocardia (including aerobic actinomycetes) submitted will be identified and billed as appropriate.

 

Nucleic acid probes used for identification, when applicable, include those for Mycobacterium avium-intracellulare complex, Mycobacterium gordonae, and Mycobacterium tuberculosis complex. 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 (including Nocardia species and Streptomyces species). The M tuberculosis complex can be further identified to the species level upon request, using a separate rapid PCR test. 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.

 

See Culture Referred for Identification and Susceptibility for Mycobacterium and Nocardia Algorithm in Special Instructions.

Specimen Type
Describes the specimen type validated for testing

Varies

Shipping Instructions

1. See Infectious Specimen Shipping Guidelines in Special Instructions 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
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: Organism must be in pure culture, actively growing. Do not submit mixed cultures.

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, the reflex antimicrobial susceptibility test will be performed at an additional charge. All mycobacteria and Nocardia (including aerobic actinomycetes) submitted will be identified and billed as appropriate.

 

Nucleic acid probes used for identification, when applicable, include those for Mycobacterium avium-intracellulare complex, Mycobacterium gordonae, and Mycobacterium tuberculosis complex. 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 (including Nocardia species and Streptomyces species). The M tuberculosis complex can be further identified to the species level upon request, using a separate rapid PCR test. 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.

 

See Culture Referred for Identification and Susceptibility for Mycobacterium and Nocardia Algorithm in Special Instructions.

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

There are nearly 200 recognized species of mycobacteria and more than 100 Nocardia species. Many 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.

 

Nucleic acid hybridization probes are utilized that identify specific ribosomal RNA sequences of Mycobacterium tuberculosis complex, Mycobacterium avium complex, and Mycobacterium gordonae. Other Mycobacteria species, Nocardia species, and other aerobic actinomycete genera are identified using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI TOF MS) or nucleic acid sequencing of a 500-base pair region of the 16S ribosomal RNA gene.

 

After identification, antimicrobial susceptibility testing is performed following Clinical and Laboratory Standards Institute (CLSI) 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. Pfyffer GE: Mycobacterium: general characteristics, laboratory detection, and staining procedures. In: Jorgensen JH, Pfaller MA, eds. Manual of Clinical Microbiology. 11th ed. Vol 1. ASM Press; 2015:536-569

2. Clinical and Laboratory Standards Institute: Susceptibility Testing of Mycobacteria, Nocardiae, and Other Aerobic Actinomycetes. 2nd ed. CLSI document M24-A2. Clinical and Laboratory Standards Institute; 2011

Special Instructions
Library of PDFs including pertinent information and forms related to the test

Method Description
Describes how the test is performed and provides a method-specific reference

The Gen-Probe AccuProbe system uses an acridinium-labeled, single-stranded DNA probe that is complementary to the ribosomal RNA of the target organism. After the ribosomal RNA is released from the organism, the labeled DNA probe combines with the target organism's ribosomal RNA to form a stable DNA:RNA hybrid. Chemiluminescence is used as an indicator to detect specific hybrids.(Musial CE, Tice LS, Stockman L, Roberts GD: Identification of Mycobacteria from culture by using Gen-Probe rapid diagnostic system for Mycobacterium avium complex and Mycobacterium tuberculosis complex. J Clin Microbiol. 1988 Oct;26[10]:2120-2123)

 

The 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.

 

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.(CLSI: Susceptibility Testing of Mycobacteria, Nocardiae, and Other Aerobic Actinomycetes. 2nd ed. CLSI document M24-A2. CLSI; 2011; Woods GL, Lin SYG, Desmond EP: Susceptibility test methods: Mycobacteria, Nocardia, and Other Actinomycetes. In: Jorgensen JH, Pfaller MA, Carroll KC, et al, eds. Manual of Clinical Microbiology. Vol 1. 11th ed. ASM Press; 2015:1356-1378)

 

M tuberculosis first-line susceptibilities are tested with the presence of critical concentrations of the antimycobacterial drugs isoniazid, rifampin, and ethambutol. One of 2 FDA-cleared platforms may be used. Second-line susceptibilities utilize the MycoTB broth microtiter dilution plate.(Trek Diagnostic Systems Inc.)

 

Antimicrobials included in the assay are tested according to the CLSI guidelines. The plate contains lyophilized antimicrobials, which are rehydrated prior to testing. A standardized suspension of the M tuberculosis isolate is added to the plate wells and the plate is incubated at 36 degrees C in 5% to 10% CO2 for up to 14 days. The first drug-containing well with no visible growth is determined to be the endpoint.(CLSI: Susceptibility Testing of Mycobacteria, Nocardiae, and Other Actinomycetes; Approved Standard. CLSI document M24-A2, 2011; Hall L, Jude KP, Clark SL, et al: Evaluation of the Sensititre MycoTB plate for susceptibility testing of the Mycobacterium tuberculosis complex against first- and second-line agents. J Clin Microbiol. 2012;50:3732-3734)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

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.

60 to 70 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

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 Regional Manager. 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. This test 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.

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-Mycobacteria Probe Ident, Solid (if appropriate)

87150-Mycobacteria Probe Ident, Broth (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

Test Id Test Order Name Order LOINC Value
TBIDS Mycobacteria Culture Refer ID+Susc 543-9
Result Id Test Result Name Result LOINC Value
Result LOINC Value Tooltip
TBIDS Mycobacteria Culture Refer ID+Susc 543-9

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports