Rapidly-growing Mycobacterium Susceptibility−Broth Dilution

CPT: 87186
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Synonyms

  • M abscessus Susceptibility Testing
  • M chelonae Susceptibility Testing
  • M fortuitum Complex Susceptibility Testing
  • AFB Susceptibility Testing
  • Rapid-grower Susceptibility Testing

Test Includes

Susceptibility testing for amikacin, cefoxitin, ciprofloxacin, clarithromycin, clofazimine, imipenem, linezolid, moxifloxacin, tigecycline, tobramycin, trimethoprim-sulfamethoxazole. MIC values will be reported with CLSI interpretive comments, if available.


Expected Turnaround Time

20 - 35 days



Related Documents


Specimen Requirements


Specimen

Rapidly-growing mycobacteria 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


Test Details


Use

Determine the susceptibility of rapidly-growing mycobacterial isolates to a profile of antimycobacterial agents. If cultures remain positive after 6 months of treatment, repeat susceptibility testing is recommended.


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 test was developed and its performance characteristics determined by Labcorp. It has not been cleared or approved by the Food and Drug Administration.


Methodology

Sensititre® broth microdilution (MIC)


Additional Information

There is no interpretive criteria for tigecycline and clofazimine as there is insufficient clinical data available. Tobramycin is primarily used for M. chelonae treatment. Other rapid growers are generally resistant to this drug. Inducible resistance for clarithromycin is achieved through an extended incubation of up to 14 days. The following organisms do not have a functional erm gene and do not undergo extended incubation: M. chelonae, M. immunogenum, M. mucogenicum, M. peregrinum, and M. senegalense. Clarithromycin is the class representative drug for macrolides. Imipenem results do not predict results for meropenem or ertapenem, as imipenem activity against rapidly growing mycobacteria is greater than meropenem or ertapenem.


References

Clinical Laboratory Standards Institute (CLSI). Performance Standards for Susceptibility Testing of Mycobacteria, Nocardia spp., and Other Aerobic Actinomycetes. 1st ed. CLSI supplement M62. Wayne, PA: CLSI; 2018.
Clinical Laboratory Standards Institute (CLSI). Susceptibility Testing of Mycobacteria, Nocardia spp., and Other Aerobic Actinomycetes. 3rd ed. CLSI standard M24. Wayne, PA: CLSI; 2018.
Griffith DE, Aksamit T, Brown-Elliott BA, et al. An official ATS/IDSA statement: Diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med. 2007 Feb 15;175(4):367-416.17277290
Woods GL, Lin SYG, Brown BA, Desmond EP. Susceptibility Test Methods: Mycobacteria, Nocardia and Other Actinomycetes. Manual of Clinical Microbiology, 12th ed. 2018; 78:1398-1419.

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
182915 Rapid Grower Broth Suscep. 182916 Organism ID 40699-1
182915 Rapid Grower Broth Suscep. 998565 Amikacin 12-5
182915 Rapid Grower Broth Suscep. 998558 Cefoxitin 116-4
182915 Rapid Grower Broth Suscep. 998566 Ciprofloxacin 185-9
182915 Rapid Grower Broth Suscep. 998560 Clarithromycin 189-1
182915 Rapid Grower Broth Suscep. 998242 Clofazimine 16623-1
182915 Rapid Grower Broth Suscep. 998211 Doxycycline 225-3
182915 Rapid Grower Broth Suscep. 998561 Imipenem 279-0
182915 Rapid Grower Broth Suscep. 998562 Linezolid 29254-0
182915 Rapid Grower Broth Suscep. 998210 Moxifloxacin 31037-5
182915 Rapid Grower Broth Suscep. 998213 Tigecycline 42355-8
182915 Rapid Grower Broth Suscep. 998564 Tobramycin 508-2
182915 Rapid Grower Broth Suscep. 998563 Trimethoprim/Sulfa 516-5
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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