Culture Referred for Identification, Mycobacterium and Nocardia, Varies

Test Code: MISC

Overview
Ordering
Specimen
Performing
Clinical/Interpretive
Contacts
Coding

Synonyms/Keywords

Culture Ref for ID Mycobacterium & Nocardia (CTBID), Culture Referred for Identification, Mycobacterium and Nocardia, Varies (CTBID), 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

Useful For

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

Specimen Requirements

Fasting Required

Specimen Type

Preferred Container/Tube

Acceptable Container/Tube

Specimen Volume

Specimen Minimum Volume
(allows for 1 repeat)

Pediatric Minimum Volume
(no repeat)

Varies: Organism in pure culture

Middlebrook or Lowenstein-Jensen medium slant or in broth

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 Processing Instructions

Specimen source is required.

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

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

Specimen Stability Information

Specimen Type	Temperature
Varies	Ambient (preferred)
Varies	Refrigerated

Rejection Criteria

Agar plate	Reject

Interference

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

Performing Laboratory Information

Performing Location	Day(s) Test Performed	Analytical Time	Methodology/Instrumentation
Mayo Clinic Laboratories	Monday through Sunday	60-70 Days	Nucleic Acid Probe/16S rDNA Sequencing/Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS)/Rapid PCR

Reference Lab

Mayo Clinic Laboratories

Test Information

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.

Reference Range Information

Performing Location	Reference Range
Mayo Clinic Laboratories	Not applicable

Interpretation

Organisms growing in pure culture are identified to the species level whenever possible.

Outreach CPTs

CPT	Quantity	Description	Comments
87118	1	Identification of mycobacteria
87158	1	Identification of mycobacteria by other methods	if appropriate
87118	1	Id MALDI-TOF Mass Spec AFB	if appropriate
87153	1	Mycobacteria Identification by Sequencing	if appropriate
87150	1	Mycobacteria Probe Ident, Solid	if appropriate
87150	1	Mycobacteria Probe Ident, Broth	if appropriate
87150	1	Id, Mtb Speciation, PCR	if appropriate
87150	1	Id, MTB complex Rapid PCR	if appropriate