Reference Interval:
| Available Separately
| Test Name
| Methodology
| Reference Interval/Drugs Tested
| CPT Code
| | Yes (0060347)
| Antimicrobial Susceptibility - AFB/Mycobacterium tuberculosis Primary Panel
| MGIT960
| The 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
| | Yes (0060348)
| Antimicrobial Susceptibility - AFB/Mycobacterium tuberculosis Secondary Panel
| Agar proportion
and Broth dilution
| Note: If M. tuberculosis isolate is resistant to rifampin or any two primary drugs, a secondary panel is indicated. This panel will be performed by request as a sendout 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
| | No
| Antimicrobial Susceptibility - AFB/Mycobacteria
| Broth Microdilution
| See organism-specific panels below.
| 87186
| | No
| Mycobacterium avium Intracellularae Complex
| Broth Microdilution
| Drugs tested: Amikacin, ciprofloxacin, clarithromycin, doxycycline, ethambutol, ethionamide, isoniazide, linezolid, moxifloxacin, rifabutin, rifampin streptomycin and trimethoprim/sulfamethoxazole (TMP/SXT).
Selective reporting by organism.
Clarithromycin is the only drug for which CLSI provides interpretive guidelines. Clarithromycin results predict azithromycin. For drugs other than clarithromycin or azithromycin, there are no CLSI interpretive guidelines; therefore, only MIC is reported. Because MIC results do not predict clinical response, rifampin, rifabutin, and ethambutol MICs are not reported.
| 87186
| | No
| Rapid Growing Mycobacteria
| Broth Microdilution
| Drugs tested: Amikacin, amoxicillin/clavulanic acid, cefepime, cefoxitin, ceftriaxone, ciprofloxacin, clarithromycin, doxycycline, imipenem (M. fortuitum complex only), linezolid, minocycline, moxifloxacin, tigecycline, tobramycin (M. chelonae only), and trimethoprim/sulfamethoxazole (TMP/SXT). Selective reporting by organism.
| 87186
| | No
| Other Slowly-Growing
Nontuberculosus Mycobacteria
(NTM)
| Broth Microdilution
| 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 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, clarithromycin, ethambutol, linezolid, moxifloxacin, rifabutin, streptomycin and trimethoprim-sulfamethoxazole. Currently there are no CLSI interpretive criteria for linezolid and moxifloxacin; therefore, only the MIC is reported.
M. marinum isolates are tested against amikacin, clarithromycin, doxycycline, ethambutol, 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 for all but linezolid and moxifloxacin are based on proposed CLSI guidelines. Currently there are no CLSI interpretive criteria for linezolid and moxifloxacin; therefore, only the MIC is reported.
| 87186
|
|
| Interpretive Data: |
Refer to Statement B under Testing Information at http://www.aruplab.com.
|
| 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. Isolates submitted without species identification will be identified at ARUP for an additional charge.
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Cross References: |
Acid Fast Bacilli (Antimicrobial Susceptibility - AFB/Mycobacteria), AFB Susceptibility Panel (Antimicrobial Susceptibility - AFB/Mycobacteria), Mycobacterium (Antimicrobial Susceptibility - AFB/Mycobacteria) |
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