Nontuberculous Slowly-growing Mycobacterium Susceptibility−Broth Dilution

CPT: 87186
Updated on 11/1/2017
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Test Details

Synonyms

  • M kansasii Susceptibility Testing
  • AFB Susceptibility Testing
  • MOTT Susceptibility Testing
  • Slow-grower Susceptibility Testing

Test Includes

Susceptibility testing for amikacin, ciprofloxacin, clarithromycin, ethambutol, linezolid, streptomycin, and sulfamethoxazole-trimethoprim

Use

Determine the susceptibility of nontuberculous slowly-growing mycobacterial isolates to a profile of antimycobacterial agents. Interpretive categories for MICs are not yet available due to lack of clinical trial data that would indicate the clinical efficacy.1,2 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.

Results of this test are labeled for research purposes only by the assay's manufacturer. The performance characteristics of this assay have not been established by the manufacturer. The result should not be used for treatment or for diagnostic purposes without confirmation of the diagnosis by another medically established diagnostic product or procedure. The performance characteristics were determined by LabCorp.

Methodology

Sensititre® broth microdilution (MIC)

Additional Information

Failure to take all drugs in a multidrug regimen can lead to a shift toward resistant organisms and treatment failure.3 Susceptibility testing to rifampin is the only drug currently recommended for primary susceptibility testing of M kansasii.2 Isolates susceptible to rifampin are susceptible to rifabutin.

Test results are not intended to be used as the sole means for patient management.

Specimen Requirements

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

Container

Conventional or broth medium, tightly sealed, in etiologic agent packaging

Storage Instructions

Maintain media at room temperature.

Causes for Rejection

Specimen received in 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

Clinical Information

Footnotes

1. An Official ATS/IDSA Statement: Diagnosis, Treatment, and Prevention of Nontuberculous Mycobacterial Diseases. Am J Respir Crit Care Med. 2007; 175:367-416.17277290
2. 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.
3. Wolinsky E. Mycobacterial diseases other than tuberculosis. Clin Infect Dis. 1992; 15(1):1-10.1617048

References

Ahn CH, Lowell JR, Ahn SS, Ahn S, Hurst GA. Chemotherapy for pulmonary disease due to Efficacies of some individual drugs.Rev Infect Dis. 1981 Sep-Oct; 3(5):1028-1034.7339800
Francis PB, Jay SJ, Johanson WG Jr. The course of untreated Mycobacterium kansasii disease. Am Rev Respir Dis. 1975 Apr; 111(4):477-487.1124888
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 May; 137(5):1217-1222.3195815
Jenkins PA, Banks J, Campbell IA, et al. Mycobacterium kansasii pulmonary Infection: A prospective study of the results of nine months of treatment with rifampicin and ethambutol. Thorax. 1994; 49:442-445.8016763

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
182923 Slow Grower Broth Suscep. 182924 Organism ID 40699-1
182923 Slow Grower Broth Suscep. 998568 Amikacin 12-5
182923 Slow Grower Broth Suscep. 998569 Ciprofloxacin 185-9
182923 Slow Grower Broth Suscep. 998570 Clarithromycin 189-1
182923 Slow Grower Broth Suscep. 998571 Ethambutol 241-0
182923 Slow Grower Broth Suscep. 998572 Linezolid 29254-0
182923 Slow Grower Broth Suscep. 998573 Moxifloxacin 31037-5
182923 Slow Grower Broth Suscep. 998574 Rifampin 428-3
182923 Slow Grower Broth Suscep. 998576 Streptomycin 460-6
182923 Slow Grower Broth Suscep. 998577 Trimethoprim/Sulfa 516-5
182923 Slow Grower Broth Suscep. 182833 Please note: N/A
Reflex Table for Organism ID
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 000000 Antimicrobial Susceptibility 000000 Antimicrobial Susceptibility N/A

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