Test ID: CTBID
Culture Referred for Identification, Mycobacterium
NY State Approved 
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
Rapid identification to the species level of Mycobacterium, Nocardia, and other aerobic actinomycetes from pure cultures
Testing Algorithm Delineates situation(s) when tests are added to the initial order. This includes reflex and additional tests.
See Culture Referred for Identification Mycobacterium Algorithm in Special Instructions.
Special Instructions and Forms Describes specimen collection and preparation information, test algorithms, and other information pertinent to test. Also includes pertinent information and consent forms to be used when requesting a particular test
Method Name A short description of the method used to perform the test
Nucleic Acid Probe/16S rDNA Sequencing
Nucleic acid probes used for identification, when applicable, include those for Mycobacterium avium-intracellulare complex, Mycobacterium gordonae, and Mycobacterium tuberculosis complex. 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).
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
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)
50024-CTBID
Tubercle Bacilli: Mybobacterium tuberculosis
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Specimen Type: Organism
Container/Tube: Middlebrook (7H10 or 7H11) or Lowenstein-Jensen medium slant or in broth (eg, Mycobacteria Growth Indicator Tube [7H9] broth)
Specimen Volume: Isolate
Collection Instructions:
1. Organism must be in pure culture, actively growing.
2. Place specimen in a large infectious container (Supply T146) and label as an etiologic agent.
Additional Information:
1. Specimen source is required.
2. Isolate description is required: Gram stain reaction, morphology, tests performed.
3. See Infectious Specimen Shipping Guidelines in Special Instructions for shipping information.
Forms: If not ordering electronically, submit a Microbiology Request Form (Supply T244) with the specimen.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | NA |
| Lipemia | NA |
| Icterus | NA |
| Other | Agar plate |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Varies | Ambient (preferred) | |
| Refrigerated | ||
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Both Mycobacterium and Nocardia include pathogenic and nonpathogenic species. Traditional speciation based on growth characteristics and biochemical reaction patterns is time-consuming and often does not differentiate between closely related species.
In this test, nucleic acid hybridization probes are utilized that identify specific ribosomal RNA sequences of Mycobacterium tuberculosis complex, Mycobacterium avium complex, and Mycobacterium gordonae. Organisms that are not identified by nucleic acid hybridization probes are further tested and speciated by 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 whenever possible.
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 Provides recommendations for further in-depth reading of a clinical nature
Pfyffer GE: Mycobacterium: general characteristics, laboratory detection, and staining procedures. In Manual of Clinical Microbiology
Method Description Describes how the test is performed and provides a method-specific reference
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 Mycobacterium from culture by using Gen-Probe rapid diagnosis system for Mycobacterium avium complex and Mycobacterium tuberculosis complex. J Clin Microbiol 1988;26:2120-2123)
The DNA sequence analysis utilizes 16S rRNA as the target for identification of mycobacteria. The molecule is approximately 1,500 nucleotides in length and contains several highly variable regions flanked by area of high conservation. 16S rDNA sequence data is available for a wide variety of prokaryotic organisms. The assay procedure uses the MicroSeq kit from Applied Biosystems.
Sequence data generated from the 16S rRNA sequencing procedure is approximately 500-base pairs long and is compared to several different databases of known mycobacterial and aerobic actinomycete sequences to obtain an organism identification. These include MicroSeq, GenBank, and Mayo Clinic Mycobacteria database. A 99% or greater agreement with a database strain is needed for an acceptable identification.(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)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Sunday; Continuously
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
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's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
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 Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
Culture Referred for Identification, Mycobacterium
87150-Identification of mycobacteria by nucleic acid probe, each (if appropriate)
87153-Identification of mycobacteria by nucleic acid sequencing, each isolate (if appropriate)
87158-Identification of mycobacteria by other methods (if appropriate)
Mycobacteria Identification by Sequencing
87153 (if appropriate)
Mycobacteria Probe Ident, Solid
87150 (if appropriate)
Mycobacteria Probe Ident, Both
87150 (if appropriate)
Ident, M. chelonae and M. abscessus, PCR
87149 (if appropriate)
Susc, Mtb MOP, 1 drug
87190 (if appropriate)
Mtb PZA Confirmation, pcnA sequence
87153 (if appropriate)
Id, Mtb Speciation, PCR (each)
87150 (if appropriate)
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| CTBID | Culture Refer for ID, Mycobacterium | In Process |
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