Acid-fast (Mycobacteria) Antibiotic Susceptibilities

CPT: 87190(x4). Variable depending on identification.
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Test Details

Synonyms

  • AFB Susceptibility Testing
  • Rapid-grower Susceptibility Testing
  • Susceptibility Testing, AFB
  • TB Susceptibility Testing

Test Includes

Antimycobacterial agents tested against isolates at appropriate concentrations and drugs depending on identification of the isolate. Identification is required to perform or provide an accurate interpretation for susceptibility testing, it will be done at an additional charge automatically.

Use

Determine the susceptibility of the isolated organism to a profile of antimycobacterial agents

Limitations

Susceptibilities cannot be reported if the organism fails to grow on test media.

Methodology

Bactec® or other broth-based method, conventional proportion method. Newer methods (eg, MIC) will be introduced when validated.

Additional Information

Susceptibilities should be performed on the first organism isolated from a patient, and at one- to three-month intervals if that organism continues to be isolated while the patient is on therapy. Susceptibility tests should be performed in patients with recurrent tuberculosis as resistant strains are common in recurrent infection. Outbreaks have occurred in health care workers, prison inmates, and prison employees.1,2 Failure to take all drugs in a multidrug regimen can lead to a shift toward resistant organisms and treatment failure. Nontuberculous mycobacteria, particularly strains of the M avium complex, are resistant to those drugs used for therapy of M tuberculosis.3

Specimen Requirements

Specimen

Isolated mycobacteria from primary clinical specimen on media slant or in broth

Container

Media slant, tightly sealed, in etiologic agent packaging

Storage Instructions

Maintain culture at room temperature.

Causes for Rejection

Specimen received leaking or in broken transport tube or vial; specimen received in expired transport media; mixed culture; unlabeled culture or name discrepancy between specimen and request label

Clinical Information

Special Instructions

Culture must be in special etiologic agent packaging for shipment to LabCorp.

Footnotes

1. Beck-Sague C, Dooley Sw, Hutton MD, et al. Hospital outbreak of multidrug-resistant Mycobacterium tuberculosis infections. Factors in transmission to staff and HIV-infected patients. JAMA. 1992 Sep 9; 268(10):1280-1286. 1507374
2. Dooley SW, Villarino ME, Lawrence M, et al. Nosocomial transmission of tuberculosis in a hospital unit for HIV-infected patients. JAMA. 1992 May 20; 267(19):2632-2634. 1573751
3. Wolinsky E. Mycobacterial diseases other than tuberculosis. Clin Infect Dis. 1992 Jul; 15(1):1-10. 1617048

References

Heifets L. Qualitative and quantitative drug-susceptibility tests in mycobacteriology. Am Rev Respir Dis. 1988 May; 137(5):1217-1222. 3195815
Mor N, Heifets L. MICs and MBCs of clarithromycin against Mycobacterium avium within human macrophages. Antimicrob Agents Chemother. 1993 Jan; 37(1):111-114. 8431006
Rastogi N, Goh KS. Effect of pH on radiometric MICs of clarithromycin against 18 species of mycobacteria. Antimicrob Agents Chemother. 1992 Dec; 36(12):2841-2842. 1482156
Van Scoy RE, Wilkowske CJ. Antituberculous agents. Mayo Clin Proc. 1992 Feb; 67(2):179-187. 1347579

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
088161 AFB Antibiotic Suscep 9825-1 088161 AFB Antibiotic Suscep 9825-1
Reflex Table for AFB Antibiotic Suscep
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 080543 Result 080544 Result 1 9825-1
Reflex Table for AFB Antibiotic Suscep
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 080543 Result 080545 Result 2 N/A
Reflex Table for AFB Antibiotic Suscep
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 080543 Result 080546 Result 3 N/A
Reflex Table for AFB Antibiotic Suscep
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 080543 Result 080547 Result 4 N/A
Reflex Table for AFB Antibiotic Suscep
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 080543 Result 080548 Antimicrobial Susceptibility 23658-8

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