Rapid identification to the species level for Mycobacterium species, Nocardia species, and other aerobic actinomycete genera and species from pure culture isolates
Nucleic acid probes used for identification, when applicable, include those for Mycobacterium avium-intracellulare complex, Mycobacterium gordonae, and Mycobacterium tuberculosis complex.
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 (including Nocardia species and Streptomyces species).
The Mycobacterium tuberculosis complex will be further identified to the species level upon request, using rapid polymerase chain reaction testing.
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 |
TBMP | Mycobacteria Probe Ident | No, (Bill Only) | No |
TBPB | Mycobacteria Probe Ident Broth | No, (Bill Only) | No |
ISMY | ID by 16S Sequencing | No, (Bill Only) | No |
LCTB | Id, MTB complex Rapid PCR | No, (Bill Only) | No |
When this test is ordered, the reflex test 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.
Nucleic Acid Probe/16S rDNA Sequencing/Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS)/Rapid PCR
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
When this test is ordered, the reflex test 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.
Varies
1. See Infectious Specimen Shipping Guidelines in Special Instructions.
2. Place specimen in a large infectious container (T146) and label as an etiologic agent/infectious substance.
1. Specimen source is required.
2. Isolate description is required: Gram stain reaction, morphology, tests performed.
Question ID | Description | Answers |
---|---|---|
Q00M0016 | Specimen Source (Required) and Isolate Description-Stain reaction, morphology, tests performed (Required) |
Specimen Type: Organism in pure culture
Supplies: Infectious Container, Large (T146)
Specimen Volume:
Visible growth of isolate on solid media
Isolate in broth media: > or =3 mL
A minimum volume of 3 mL is recommended in order 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 <3 mL, initial testing may be limited, and increased turnaround time is likely.
Collection Instructions:
If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.
Agar plate | Reject |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Varies | Ambient (preferred) | ||
Refrigerated |
Rapid identification to the species level for Mycobacterium species, Nocardia species, and other aerobic actinomycete genera and species from pure culture isolates
When this test is ordered, the reflex test 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.
There are approximately 200 recognized species of mycobacteria and more than 100 Nocardia species. Many of these species are human pathogens and, therefore, identification to the species level is important to help guide patient care. In addition, there are other aerobic actinomycete genera that can be human pathogens including, but not limited to, Tsukamurella, Rhodococcus, and Gordonia species.
Nucleic acid hybridization probes are utilized that identify specific ribosomal RNA sequences of Mycobacterium tuberculosis complex, Mycobacterium avium complex, and Mycobacterium gordonae. Other Mycobacteria species, Nocardia species and other aerobic actinomycete genera are identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) or nucleic acid sequencing of a 500-base pair region of the 16S ribosomal RNA gene.
Not applicable
Organisms growing in pure culture are identified to the species level whenever possible.
If the organism is received in mixed culture or contaminated, the report may be delayed or identification may not be possible.
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 eerobic Actinomycetes. In: Carroll KC, Pfaller MA, Landry ML, et al, eds. Manual of Clinical Microbiology. 12th ed. Vol 1. ASM Press; 2019:525-557
The Gen-Probe AccuProbe system uses an acridinium-labeled, single-stranded DNA probe that is complementary to the ribosomal RNA of the target organism. After the ribosomal RNA is released from the organism, the labeled DNA probe combines with the target organism's ribosomal RNA to form a stable DNA:RNA hybrid. Chemiluminescence is used as an indicator to detect specific hybrids.(Musial CE, Tice LS, Stockman L, Roberts GE: Identification of mycobacteria from culture by using Gen-Probe rapid diagnosis system for Mycobacterium avium complex and Mycobacterium tuberculosis complex. J Clin Microbiol. 1988 Oct;26(10):2120-2123)
The 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 Apr;41[4]:1447-1453)
Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) 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 > or =2.0 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 Feb;54[2]:376-384)
Monday through Sunday
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.
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-Mycobacteria Probe Ident, Solid (if appropriate)
87150-Mycobacteria Probe Ident, Broth (if appropriate)
87150-Id, Mtb Speciation, PCR (if appropriate)
87150- Id, MTB complex Rapid PCR (if appropriate)
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 | 543-9 |