Test Catalog

Test Id : MMLNS

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Antimicrobial Susceptibility, Nocardia species and other Aerobic Actinomycetes, Varies

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Overview

Test Catalog

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

Determining the resistance of species of Nocardia and other aerobic actinomycetes to antimicrobial agents

Highlights

Antimicrobials tested for Nocardia species and other aerobic actinomycete susceptibility include: amikacin, amoxicillin/clavulanic acid, ceftriaxone, ciprofloxacin, clarithromycin, doxycycline, imipenem, linezolid, minocycline, moxifloxacin, trimethoprim/sulfamethoxazole, and tobramycin.

 

For Rhodococcus equi, rifampin and vancomycin will also be tested.

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
MIC Susceptibility, MIC No, (Bill Only) No

Additional Tests
Lists tests that are always performed, at an additional charge, with the initial tests.

Test Id Reporting Name Available Separately Always Performed
SSNS Susceptibility Nocardia species No, (Bill Only) Yes

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

When this test is ordered, susceptibility for Nocardia species will be performed at an additional charge.

 

When the organism identification is Rhodococcus equi the additional reflex test will be performed at an additional charge for the additional antimicrobials vancomycin and rifampin.

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

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

Minimum Inhibitory Concentration (MIC)

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

Susc, Aerobic Actinomycetes

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

Amikacin

Amikacin Sulfate (Amikin)

Amikin (Amikacin Sulfate)

Amoxicillin and Clavulanate Potassium (Augmentin)

Augmentin (Amoxicillin and Clavulanate Potassium)

Ciprofloxacin

Clarithromycin

Linezolid (Zyvox)

MIC (Minimum Inhibitory Concentration)

Minimum Inhibitory Concentration (MIC)

Minocycline

Moxifloxacin

Nocardia Susceptibilities

Sulfamethoxazole

Susceptibility Testing

Tobramycin

Zyvox (Linezolid)

Ceftriaxone

Trimethoprim/sulfamethoxazole

Doxycycline

Imipenem

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

When this test is ordered, susceptibility for Nocardia species will be performed at an additional charge.

 

When the organism identification is Rhodococcus equi the additional reflex test will be performed at an additional charge for the additional antimicrobials vancomycin and rifampin.

Specimen Type
Describes the specimen type validated for testing

Varies

Shipping Instructions

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.

Necessary Information

Specimen source is required.

ORDER QUESTIONS AND ANSWERS

Question ID Description Answers
Q00M0037 Specimen Source (Required) and Organism Identification (Required unless concurrent identification test is ordered)

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

Specimen Type: Organism in pure culture

Supplies: Infectious Container, Large (T146)

Container/Tube:

Preferred: Middlebrook 7H10 agar slant without antimicrobials

Acceptable: Sabouraud's dextrose agar slant or similar media without antimicrobials (eg, 7H11 agar slant, LJ, MGIT [7H9] broth media)

Specimen Volume: Isolate

Collection Instructions: Organism must be in pure culture, actively growing.

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.

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

Agar plate 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

Determining the resistance of species of Nocardia and other aerobic actinomycetes to antimicrobial agents

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

When this test is ordered, susceptibility for Nocardia species will be performed at an additional charge.

 

When the organism identification is Rhodococcus equi the additional reflex test will be performed at an additional charge for the additional antimicrobials vancomycin and rifampin.

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

Nocardia species and other aerobic actinomycetes can cause significant disease, often in immunocompromised patients. Clinical presentation can include, but is not limited to, pneumonia, skin abscess, bacteremia, brain abscess, eye infection, and joint infection.

 

Antimicrobial susceptibility testing may aid with selection of appropriate antimicrobial agents for patient care.

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.

The following are interpretive values for susceptibility testing of Nocardia species and other aerobic actinomycetes using a broth microdilution method. 

Antimicrobial agent

Concentration range mcg/mL

Interpretations

S

I

R

Amikacin

0.5-32

< or =8

-

> or =16

Amoxicillin/clavulanate

2/1-128/64

< or =8/4

16/8

> or =32/16

Ceftriaxone

1-64

< or =8

16-32

> or =64

Ciprofloxacin

0.12-16

< or =1

2

> or =4

Clarithromycin

0.03-16

< or =2

4

> or =8

Doxycycline

0.12-16

< or =1

2-4

> or =8

Imipenem

0.12-32

< or =4

8

> or =16

Linezolid

0.5-16

< or =8

-

-

Minocycline

0.06-16

< or =1

2-4

> or =8

Moxifloxacin

0.015-8

< or =1

2

> or =4

Tobramycin

2-64

< or =4

8

> or =16

Trimethoprim/ Sulfamethoxazole

0.06/1.19-8/152

< or =2/38

-

> or =4/76

For Rhodococcus equi only

 

 

 

 

Rifampin

0.5-2

< or =1

2

> or =4

Vancomycin

0.5-16

< or =2

4-8

> or =16

Interpretation
Provides information to assist in interpretation of the test results

Interpretive values for susceptibility testing of Nocardia species using a broth microdilution method are included in the report, as appropriate.

 

For Rhodococcus equi, the interpretive values for vancomycin and rifampin will also be included.

 

See Reference Values for additional information.

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

No significant cautionary statements

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

1. Duggai SD, Chugh TD: Nocardiosis: A neglected disease. [published online ahead of print, 2020 May 18]. Med Princ Pract. 2020;10.1159/000508717. doi:10.1159/000508717

2. Conville PS, Brown-Elliott BA, Smith T, Zelazny AM: The complexities of Nocardia taxonomy and identification. J Clin Microbiol. 2017;56(1):e01419-17

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

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

A standardized inoculum made from a pure culture of aerobic actinomycete is prepared and inoculated into wells of a microtiter plate containing different concentrations of antimicrobial agents.

 

Growth at specified breakpoints is indicative of resistance.(Clinical and Laboratory Standards Institute (CLSI): Susceptibility Testing of Mycobacteria, Nocardia spp., and Other Aerobic Actinomycetes. 3rd ed. CLSI standard M24. CLSI; 2018; CLSI: Performance Standards for Susceptibility Testing of Mycobacteria, Nocardia spp., and Other Aerobic Actinomycetes. CLSI supplement M62. CLSI; 2018)

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.

12 to 28 days

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 was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.

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.

87186

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
MMLNS Susc, Aerobic Actinomycetes 29577-4
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.
MMLNS Susc, Aerobic Actinomycetes 29577-4

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 | PHP Pdf | CMS 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