Non-tuberculous Slowly Growing Mycobacterium
Susceptibility - Broth Dilution
Non-tuberculous Slowly Growing Mycobacterium
Susceptibility - Broth Dilution | | | |
| Number | | 182923 |
| CPT | | 87186 |
| Related Information | | Acid-Fast (Mycobacteria)
Broth-Based Culture and Smear and Susceptibility (182675)
Acid-Fast (Mycobacteria)
Antibiotic Susceptibilities (088161) |
| Synonyms | | Slow Grower Susceptibility Testing ; M. kansasii
Susceptibility Testing ; AFB Susceptibility Testing ; MOTT
Susceptibility Testing |
| Test Includes | | Susceptibility testing for amikacin, ciprofloxacin,
clarithromycin, ethambutol, linezolid, streptomycin, and
trimethoprim/sulfamethoxazole. |
| Specimen | | Slowly growing mycobacteria, NOT M. tuberculosis, isolated
from a primary clinical specimen, on a submitted AFB
conventional solid medium, or an AFB broth medium. |
| Volume | | Pure culture isolate on an AFB conventional solid medium or
a minimum of 1 mL of AFB broth medium. |
| Minimum Volume | | Refer to specimen volume comment. |
| Container | | Conventional or broth medium, tightly sealed, in etiologic
agent packaging. |
| Storage Instructions | | Maintain media at room temperature. |
| Causes for Rejection | | Specimen received leaking or in broken transport tube or
vial; specimen received in expired transport medium; mixed
culture; unlabeled culture or name discrepancy between
specimen and request label. |
| Use | | Determine the susceptibility of non-tuberculous slowly
growing mycobacterial isolates to a profile of
antimycobacterial agents. Interpretive categories for MIC's
are not yet available due to lack of clinical trial data
that would indicate the clinical
efficacy.2,3 For the
unusual mycobacteria, susceptibility data is often useful
as an aid in identification. |
| Limitations | | Susceptibilities cannot be reported if the organism fails
to grow in the test medium. Susceptibilities cannot be
performed on mixed cultures. An organism identification is
required prior to reporting susceptibility results. This
procedure may be considered by Medicare and other carriers
as investigational and, therefore, may not be payable as a
covered benefit for patients. |
| Methodology | | Sensititre® broth microdilution (MIC) method. |
| Additional Information | | Failure to take all drugs in a multidrug regimen can lead
to a shift toward resistant organisms and treatment
failure.1 Susceptibility
testing to rifampin is the only drug currently recommended
for primary susceptibility testing of M.
kansasii.3 Isolates
susceptible to rifampin are susceptible to rifabutin.
Test results are not intended to be used as the sole means
for patient management. |
| Footnotes | |
- Wolinsky E. Mycobacterial diseases other
than tuberculosis. Clin Infect Dis. 1992;
15(1):1-10.
- An official ATS/IDSA statement: Diagnosis,
treatment, and prevention of nontuberculous mycobacterial
diseases. Am J Respir Crit Care Med. 2007;
175:367-416.
- Clinical and Laboratory Standards Institute
(CLSI). Susceptibility Testing of Mycobacteria, Nocardia,
and Other Aerobic Actinomycetes; Approved Standard. Vol
23, No 18. Villanova, Pa: CLSI; 2003.
Document M24-A.
|
| References | |
Ahn CH, Lowell JR, Ahn SA, Ahn S, Hurst GA.
Chemotherapy for pulmonary disease due to Mycobacterium
kansasii: Efficacies of some individual drugs. Rev
Infect Dis. 1981; 3:1028-1034.
An official ATS/IDSA statement: Diagnosis, treatment,
and prevention of nontuberculous mycobacterial diseases.
Am J Respir Crit Care Med. 2007; 175:367-416.
Clinical and Laboratory Standards Institute (CLSI).
Susceptibility Testing of Mycobacteria, Nocardia,
and Other Aerobic Actinomycetes; Approved Standard. Vol 23,
No 18. Villanova, Pa: CLSI; 2003. Document M24-A.
Francis PB, Jay SJ, Johanson WG Jr. Course of
untreated Mycobacterium kansasii disease. Am Rev
Respir Dis. 1975; 111:477-487.
Heifets L. Drug Susceptibility in the Chemotherapy of
Mycobacterial Infections. Boca Raton, Fla: CRC Press;
1991.
Heifets L. Qualitative and quantitative drug
susceptibility tests in mycobacteriology. Am Rev Respir
Dis. 1988; 137(5):1217-1222.
Jenkins PA, Banks J, Campbell IA, Smith AP.
Mycobacterium kansasii pulmonary infection: A
prospective study of the results of nine months of
treatment with rifampicin and ethambutol. Thorax.
1994; 49:442-445. |
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