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Antimicrobial Susceptibility, AFB/Mycobacteria
0060217
Ordering Recommendation
Order for SUSCEPTIBILITY of clinically significant isolates of M. tuberculosis complex (MTBC), M. kansasii, M. avium-intracellulare complex, M. fortuitum complex, M. abscessus complex, M. chelonae, M. immunogenum, and any isolate from a significant source.
Mnemonic
MA AFB
Methodology
Macrobroth Dilution/Microbroth Dilution
Performed
Mon-Fri
Reported
Varies
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
 
Collect
Actively growing isolate in pure culture.  
Specimen Preparation
Transport sealed container with pure culture on solid or liquid media. Place each specimen in an individually sealed bag.  
Storage/Transport Temperature
Room temperature. If culture is suspected of being a microorganism listed as infectious substance affecting humans on IATA list, submit specimen according to Biological Substance, Category A, shipping guidelines.  
Unacceptable Conditions
Mixed cultures or non-viable organisms. Organisms submitted on an agar plate.  
Remarks
 
Stability
Ambient: 2 weeks; Refrigerated: 2 weeks; Frozen: 2 weeks  
Reference Interval
Available Separately
Test Name
Methodology
Reference Interval/Drugs Tested
CPT Code
Yes (0060347)Antimicrobial Susceptibility - AFB/Mycobacterium tuberculosis Primary PanelMGIT960The interpretation provided is based on results for the following drugs at the stated concentrations:

Drugs tested: Ethambutol: 5.0 µg/mL; Isoniazid: 0.1 µg/mL (0.4 µg/mL if resistant to 0.1 µg/mL); Pyrazinamide: 100 µg/mL; Rifampin: 1.0 µg/mL.

This procedure screens isolates of M. tuberculosis complex for drug resistance. The procedure does not use serial dilutions to provide quantitative MIC values. Single critical concentrations for each antimycobacterial agent used have been defined by the United States Public Health Service.
87188 x4
NoAntimicrobial Susceptibility - AFB/Mycobacterium tuberculosis Secondary PanelAgar proportion
and Broth dilution
Effective February 21, 2012

Note: If M. tuberculosis isolate is resistant to rifampin or any two primary drugs, a secondary panel will be performed as a send-out test. The interpretation provided is based on testing for the following drugs at the stated concentrations:

Drugs tested: Amikacin: 6 µg/mL; capreomycin: 10 µg/mL; cycloserine: 60 µg/mL; ethionamide: 10 µg/mL; kanamycin: 6 µg/mL; PAS: 8 µg/mL; streptomycin at a low level (2.0 µg/mL) and a high level (4.0 µg/mL). Levofloxacin and moxifloxacin are tested at 2, 4 and 8 µg/mL
87190 x6, 87188 x3
NoAntimicrobial Susceptibility - AFB/MycobacteriaBroth MicrodilutionSee organism-specific panels below.87186
NoMycobacterium avium-intracellularae ComplexBroth MicrodilutionEffective May 16, 2016

Drugs tested: Amikacin, ciprofloxacin, clarithromycin, doxycycline, ethambutol, ethionamide, isoniazide, linezolid, moxifloxacin, rifabutin, rifampin streptomycin and trimethoprim/sulfamethoxazole (TMP/SXT).

Selective reporting by organism.

Clarithromycin, moxifloxacin and linezolid are the only drugs for which CLSI provides interpretive guidelines. Clarithromycin results predict azithromycin. For Amikacin and Ciprofloxacin only MIC is reported. Because MIC results do not predict clinical response and may be misleading, rifampin, rifabutin, and ethambutol MICs are not routinely reported and must be specifically requested.
87186
NoRapid Growing MycobacteriaBroth MicrodilutionEffective August 17, 2015

Drugs tested: Amikacin, cefoxitin, ciprofloxacin, clarithromycin, doxycycline, imipenem, linezolid, minocycline, moxifloxacin, tigecycline, tobramycin (M. chelonae only), and trimethoprim/sulfamethoxazole (TMP/SXT). Selective reporting by organism.
87186
NoOther Slowly-Growing
Nontuberculosus Mycobacteria
(NTM)
Broth MicrodilutionEffective May 20, 2013

Drugs tested: Amikacin, ciprofloxacin, clarithromycin, doxycycline, ethambutol, ethionamide, isoniazide, linezolid, moxifloxacin, rifabutin, rifampin, streptomycin and trimethoprim/sulfamethoxazole (TMP/SXT). Selective reporting by organism.

CLSI recommends that isolates of M. kansasii be tested against rifampin and clarithromycin only. Rifampin-susceptible isolates are also susceptible to rifabutin. If the isolate is rifampin-resistant, the following secondary drugs will also be reported: Amikacin, ciprofloxacin, ethambutol, linezolid, moxifloxacin, rifabutin, streptomycin and trimethoprim-sulfamethoxazole.

M. marinum isolates are tested against amikacin, ciprofloxacin, clarithromycin, doxycycline, ethambutol, moxifloxacin, rifabutin, rifampin, and trimethoprim-sulfamethoxazole. Interpretation is based on CLSI guidelines.

Slowly-growing NTM other than M. kansasii and M. marinum are tested against amikacin, ciprofloxacin, clarithromycin, ethambutol, linezolid, moxifloxacin, rifabutin, rifampin, streptomycin, and trimethoprim-sulfamethoxazole.

Interpretive criteria are based on CLSI guidelines for M. kansasii..
87186

Interpretive Data


Compliance Statement B: This test was developed and its performance characteristics determined by ARUP Laboratories. The U.S. Food and Drug Administration has not approved or cleared this test; however, FDA clearance or approval is not currently required for clinical use. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions.
Note
AFB susceptibility testing is billed at the panel level.  Charges will vary based on organism identified.  An additional handling fee will be billed for all organisms submitted that are not in pure culture as indicated in the specimen requirements. If species identification is not provided, identification will be performed at ARUP.  Additional charges apply.
CPT Code(s)
CPT codes vary based on method
Components
Component Test Code*Component Chart NameLOINC
0060217Susceptibility, Mycobacteria29579-0
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.
Aliases
  • Acid Fast Bacilli
  • AFB Susceptibility Panel
  • Amikacin susceptibility
  • Amoxicillin/clavulanic acid susceptibility
  • Capreomycin susceptibility
  • Cefepime susceptibility
  • Cefoxitin susceptibility
  • Ceftriaxone susceptibility
  • Ciprofloxacin susceptibility
  • Clarithromycin susceptibility
  • Cycloserine susceptibility
  • Doxycycline susceptibility
  • Ethambutol susceptibility
  • Ethionamide susceptibility
  • Imipenem susceptibility
  • Isoniazid susceptibility
  • Kanamycin susceptibility
  • Levofloxacin  susceptibility
  • Linezolid susceptibility
  • Minocycline susceptibility
  • Moxifloxacin susceptibility
  • Mycobacterium
  • Mycobacterium tuberculosis susceptibility testing
  • PAS susceptibility
  • Pyrazinamide susceptibility
  • Rapidly-Growing Mycobacterium species
  • RGM
  • Rifabutin susceptibility
  • Rifampin susceptibility
  • SGM
  • Slow-Growing Mycobacterium species
  • Streptomycin susceptibility
  • Tigecycline susceptibility
  • TMP/SXT susceptibility
  • tobramycin (M. chelonae only) susceptibility
  • Trimethoprim/sulfamethoxazole susceptibility