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Antimicrobial Susceptibility, AFB/Mycobacteria
Ordering Recommendation
Identify 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.
New York DOH Approval Status
Specimen Required
Actively growing isolate in pure culture.
Transport sealed container with pure isolate on solid or liquid media. Place each isolate in an individually sealed bag.
Room temperature
Submit M. tuberculosis complex isolates according to Infectious Substance, Category A shipping guidelines.
Mixed isolates or nonviable organisms. M. tuberculosis complex isolates submitted on an agar plate.
Ambient: 2 weeks; Refrigerated: 2 weeks; Frozen: unacceptable
Methodology
Broth Macrodilution/Broth Microdilution
Performed
Sun-Sat
Reported
Varies
Reference Interval
Interpretive Data
| Test Name | Methodology | Drugs Tested | CPT Code |
|---|---|---|---|
| Antimicrobial Susceptibility - AFB/Mycobacterium tuberculosis Primary Panel | MGIT960 Broth Macro dilution | The interpretation provided is based on results for the following drugs at the stated concentrations: Drugs tested: Ethambutol: 5.0 ug/mL; Isoniazid: 0.1 ug/mL (0.4 ug/mL if resistant to 0.1 ug/mL); Rifampin: 1.0 ug/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 |
| Antimicrobial Susceptibility - AFB/Mycobacterium tuberculosis Secondary Panel | Agar proportion and Broth dilution |
Note: If M. tuberculosis complex isolate is resistant to rifampin or any two primary drugs, a secondary panel is available as a send-out test. The interpretation provided is based on testing for the following drugs at the stated concentrations: Drugs tested: Amikacin: 6 ug/mL; capreomycin: 10 ug/mL; cycloserine: 60 ug/mL; ethionamide: 10 ug/mL; kanamycin: 6 ug/mL; PAS: 8 ug/mL; streptomycin at a low level (2.0 ug/mL) and a high level (4.0 ug/mL). Levofloxacin and moxifloxacin are tested at 2, 4 and 8 ug/mL |
87190 x6, 87188 x3 |
| Antimicrobial Susceptibility - AFB/Mycobacteria | Broth Microdilution | See organism-specific panels below. | 87186 |
| Mycobacterium aviumintracellularae Complex | Broth Microdilution | Drugs tested: Amikacin, clarithromycin, linezolid, moxifloxacin. Clofazimine at request only Clarithromycin results predict azithromycin. Because MIC results do not predict clinical response and may be misleading, rifampin, rifabutin, and ethambutol MICs are not tested. |
87186 |
| Rapid Growing Mycobacteria | Broth Microdilution | Drugs tested: Amikacin, cefoxitin, ciprofloxacin, clarithromycin, clofazimine, doxycycline, imipenem, linezolid, moxifloxacin, tigecycline, tobramycin (M. chelonae only), and trimethoprim/sulfamethoxazole (TMP/SXT). Extended 14-day incubation is performed on isolates initially susceptible to clarithromycin to detect Erm-dependent inducible macrolide resistance. Extended drugs at an additional charge: bedaquiline, omadacycline, and eravacycline |
87186 |
| Miscellaneous Slowly Growing Non-tuberculosis Mycobacteria (NTM, non-fastidious species) | Broth Microdilution | Drugs tested: Amikacin, ciprofloxacin, clarithromycin, doxycycline, 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, linezolid, moxifloxacin, rifabutin, streptomycin and trimethoprim-sulfamethoxazole. M. marinum isolates are tested against amikacin, ciprofloxacin, clarithromycin, doxycycline, moxifloxacin, rifabutin, rifampin, and trimethoprim-sulfamethoxazole. Slowly-growing NTM other than M. kansasii and M. marinum are tested against amikacin, ciprofloxacin, clarithromycin, linezolid, moxifloxacin, rifabutin, rifampin, streptomycin, and trimethoprim-sulfamethoxazole. |
|
| Miscellaneous Slowly Growing Non-tuberculosis Mycobacteria (NTM, fastidious species) | Susceptibility testing is not available for M. haemophilum, M. genavense, and M. ulcerans |
Laboratory Developed Test (LDT)
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 or if incorrect identification is provided, identification will be performed at ARUP. Additional charges apply.
M. tuberculosis complex isolates mono-resistant to pyrazinamide (PZA) will be further identified to species by PCR at an additional charge.
An additional charge will be added for drug requests that are not tested at ARUP and require sendout.
Hotline History
Hotline History
CPT Codes
CPT codes vary based on method
Components
| Component Test Code* | Component Chart Name | LOINC |
|---|---|---|
| 0060217 | Susceptibility, Mycobacteria | 29579-0 |
