Test Catalog

Test Id : CTBID

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Culture Referred for Identification, Mycobacterium and Nocardia, Varies

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

Rapid identification to the species level for Mycobacterium species, Nocardia species, and other aerobic actinomycete genera and species from pure culture isolates

Highlights

Matrix-assisted laser desorption ionization time-of-flight mass spectrometry and/or 16S rDNA sequencing is used for identification, when applicable, for slowly and rapidly growing Mycobacterium species and aerobic actinomycetes.

 

Mycobacterium tuberculosis (Mtb) complex rapid polymerase chain reaction is used to rule out Mtb complex from all broth specimens received with sufficient volume. Testing on solid growth is determined based on growth rate, colony morphology, or specific request by clients.

 

The Mtb complex will be further identified to the species level upon request using rapid PCR testing.

Reflex Tests
Lists tests that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial tests.

Test Id Reporting Name Available Separately Always Performed
RMALM Id MALDI-TOF Mass Spec AFB No, (Bill Only) No
RTBSP Id, Mtb Speciation, PCR No, (Bill Only) No
ISMY ID by 16S Sequencing No, (Bill Only) No
LCTB Id, MTB complex Rapid PCR No, (Bill Only) No

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

Reflex tests may be performed at an additional charge. All mycobacteria and Nocardia (including aerobic actinomycetes) submitted will be identified and billed as appropriate.

 

See Culture Referred for Identification Mycobacterium and Nocardia Algorithm.

Method Name
A short description of the method used to perform the test

Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS)/16S rDNA Sequencing/Rapid Polymerase Chain Reaction (PCR)

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Culture Refer for ID, Mycobacterium

Aliases
Lists additional common names for a test, as an aid in searching

Acid-Fast Bacilli (AFB)

Aerobic Actinomycetes

Bacillus, Acid-Fast

Culture Referred for Identification, Nocardia (Aerobic Actinomycetes)

Culture Referred for Identification, TB (Tuberculosis)

Culture, TB (Tuberculosis)

Mycobacteria Culture

Mycobacterium tuberculosis (MTB)

Nocardia Referred for Identification

Organism Referred for Identification, Mycobacterium

Organism Referred for Identification, Nocardia (Aerobic Actinomycetes)

Referral for Identification

Tuberculosis (TB)

Tubercle Bacilli: Mycobacterium tuberculosis

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

Reflex tests may be performed at an additional charge. All mycobacteria and Nocardia (including aerobic actinomycetes) submitted will be identified and billed as appropriate.

 

See Culture Referred for Identification Mycobacterium and Nocardia Algorithm.

Specimen Type
Describes the specimen type validated for testing

Varies

Shipping Instructions

1. See Infectious Specimen Shipping Guidelines.

2. Place specimen in a large infectious container (T146) and label as an etiologic agent/infectious substance.

Necessary Information

1. Specimen source is required.

2. Isolate description is required: Gram stain reaction, morphology, tests performed.

ORDER QUESTIONS AND ANSWERS

Question ID Description Answers
Q00M0016 Specimen Source (Required) and Isolate Description-Stain reaction, morphology, tests performed (Required)

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Specimen Type: Mycobacterium species or aerobic actinomycetes organism in pure culture

Supplies: Infectious Container, Large (T146)

Container/Tube: Middlebrook (7H10 or 7H11) or Lowenstein-Jensen medium slant or in broth (eg, Mycobacteria Growth Indicator Tube [7H9] broth)

Specimen Volume:

Solid media: Visible growth of isolate

Isolate in broth media: > or =3 mL

Collection Instructions: Organism must be in pure culture, actively growing. Do not submit mixed cultures.

Additional Information: A minimum volume of 3 mL is recommended to perform all initial testing, this may include: stains, sub-culture media, nucleic acid probes, and any additional testing that may be required to determine the identification. If the broth sample volume is less than 3 mL, initial testing may be limited, and increased turnaround time is likely.

Special Instructions
Library of PDFs including pertinent information and forms related to the test

Forms

If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.

See Specimen Required

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Agar plate Reject
Isolates other than Mycobacterium species or aerobic actinomycetes Reject

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Varies Ambient (preferred)
Refrigerated

Useful For
Suggests clinical disorders or settings where the test may be helpful

Rapid identification to the species level for Mycobacterium species, Nocardia species, and other aerobic actinomycete genera and species from pure culture isolates

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

Reflex tests may be performed at an additional charge. All mycobacteria and Nocardia (including aerobic actinomycetes) submitted will be identified and billed as appropriate.

 

See Culture Referred for Identification Mycobacterium and Nocardia Algorithm.

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Approximately 200 recognized species of mycobacteria and more than 100 Nocardia species exist. Many of these species are human pathogens and, therefore, identification to the species level is important to help guide patient care. In addition, other aerobic actinomycete genera can be human pathogens including, but not limited to, Tsukamurella, Rhodococcus, and Gordonia species.

 

Mycobacteria species, Nocardia species and other aerobic actinomycete genera are identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry or nucleic acid sequencing of a 500-base pair region of the 16S ribosomal RNA gene.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Not applicable

Interpretation
Provides information to assist in interpretation of the test results

Organisms growing in pure culture are identified to the species level where indicated.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

If the organism is received in mixed culture or contaminated, the report may be delayed or identification may not be possible.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Martin I, Pfyffer GE, Parrish N. Mycobacterium: General characteristics, laboratory detection and staining procedures. In: Carroll KC, Pfaller MA, Landry ML, et al, eds. Manual of Clinical Microbiology. 12th ed. Vol 1. ASM Press; 2019:558-575

2. Warshauer DM, Salfinger M, Desmond E, Lin SYG. Mycobacterium tuberculosis complex. In: Carroll KC, Pfaller MA, Landry ML, et al, eds. Manual of Clinical Microbiology. 12th ed. Vol 1. ASM Press; 2019:576-594

3. Caulfield AJ, Richter E, Brown-Elliott BA, Wallace RJ Jr, Wengenack NL. Mycobacterium: Laboratory characteristics of slowly growing mycobacteria other than Mycobacterium tuberculosis. In: Carroll KC, Pfaller MA, Landry ML, et al, eds. Manual of Clinical Microbiology. 12th ed. Vol 1. ASM Press; 2019:595-611

4. Brown-Elliott BA, Wallace RJ Jr. Mycobacterium: Clinical and laboratory characteristics of rapidly growing mycobacteria. In: Carroll KC, Pfaller MA, Landry ML, et al, eds. Manual of Clinical Microbiology. 12th ed. Vol 1. ASM Press; 2019:612-629

5. Conville PS, Brown-Elliott BA, Witebsky FG. Nocarida, rhodococcus, gordonia, actinomadura, streptomyces and other aerobic actinomycetes. In: Carroll KC, Pfaller MA, Landry ML, et al, eds. Manual of Clinical Microbiology. 12th ed. Vol 1. ASM Press; 2019:525-557

Method Description
Describes how the test is performed and provides a method-specific reference

DNA sequence analysis utilizes a 500 base pair region of the 16S rRNA gene as the target for identification of mycobacteria and is performed using the MicroSeq kit from Applied Biosystems. Sequence data generated is compared to several different databases of known mycobacterial and aerobic actinomycete sequences to obtain organism identification. These include MicroSeq, NCBI GenBank, and Mayo Clinic Mycobacteria database. A 100% or greater agreement with a database strain is needed for an acceptable identification to the species level.(Hall L, Doerr KA, Wohlfiel SL, Roberts GD. Evaluation of the MicroSeq system for identification of mycobacteria by 16S ribosomal DNA sequencing and its integration into a routine clinical mycobacteriology laboratory. J Clin Microbiol. 2003;41[4]:1447-1453)

 

Matrix-assisted laser desorption ionization time-of-flight mass spectrometry analysis is done using the Bruker BioTyper platform and the Bruker BDAL library, Bruker Mycobacterial Library and the Mayo Clinic Library. A spectral score of 2.0 or more is required for identification to the species level.(Buckwalter SP, Olson SL, Connelly BJ, et al. Evaluation of matrix-assisted laser desorption ionization-time of flight mass spectrometry for identification of Mycobacterium species, Nocardia species, and other aerobic actinomycetes. J Clin Microbiol. 2016;54[2]:376-384)

 

Rapid polymerase chain reaction (PCR) is performed following specimen digestion and decontamination using N-acetyl cysteine and sodium hydroxide. Genomic DNA is extracted using the MagNA Pure (Roche Applied Sciences) extraction platform. The purified genomic DNA is placed on the LightCycler instrument, which amplifies and monitors, by fluorescence, the development of target nucleotide sequences after each PCR cycle. A specific target sequence from a portion of the katG gene from Mycobacterium tuberculosis complex is amplified and the resulting segment is detected by melt-curve analysis using sequence-specific fluorescence resonance energy transfer hybridization probes. The LightCycler PCR assay is a closed PCR system that greatly reduces the potential for false-positive results due to specimen cross-contamination as compared with traditional open-system PCR or other amplification methods like transcription-mediated amplification.(Buckwalter SP, Connelly BJ, Louison LK, et al. Description, validation, and review of a decade of experience with a laboratory-developed PCR test for detection of Mycobacterium tuberculosis complex in pulmonary and extrapulmonary specimens. J Clin Tuberc Other Mycobact Dis. 2022;29:100340. doi:10.1016/j.jctube.2022.100340)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Sunday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

60 to 70 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

2 years

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

Culture Referred for Identification, Mycobacterium

87118-Identification of mycobacteria

87158-Identification of mycobacteria by other methods (if appropriate)

87118 -Id MALDI-TOF Mass Spec AFB (if appropriate)

87153-Mycobacteria Identification by Sequencing (if appropriate)

87150-Id, Mtb Speciation, PCR (if appropriate)

87150- Id, MTB complex Rapid PCR (if appropriate)

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
CTBID Culture Refer for ID, Mycobacterium 543-9
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
CTBID Culture Refer for ID, Mycobacterium In Process

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports