Test ID: MMLRG
Antimicrobial Susceptibility, Acid-Fast Bacilli, Rapidly Growing
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
Determination of resistance of rapidly growing mycobacteria to antimicrobial agents
Additional Tests Lists test(s) that are always performed, at an additional charge, with the initial test(s)
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| SRG | Susceptibility Rapid Grower | No, (Bill Only) | Yes |
Testing Algorithm Delineates situation(s) when tests are added to the initial order. This includes reflex and additional tests.
When this test is ordered, Susceptibility Rapid Grower will be performed and charged.
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
Minimum Inhibitory Concentration (MIC) by Microtiter Broth Dilution Method
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
AFB (Acid-Fast Bacilli)
Antibiotic Susceptibility
Bacillus, Acid-Fast
MIC (Minimum Inhibitory Concentration)
Minimum Inhibitory Concentration (MIC)
Mycobacteria Antimicrobial Susceptibility (MIC) (Minimum Inhibitory Concentration)
Mycobacterium abscessus Susceptibility Testing
Mycobacterium chelonae Susceptibility Testing
Mycobacterium fortuitum Susceptibility Testing
Mycobacterium mucogenicum Susceptibility Testing
Rapid Growing Mycobacteria to Antimicrobial Agents
Susceptibility Testing
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 agar slant or other appropriate media
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 and suspected organism identification are required.
2. CTB/8205 Mycobacterial Culture or CTBID/80278 Culture, Referred for Identification, Mycobacterium must also be ordered and will be charged separately unless identification of organism is provided.
3. For Mycobacterium tuberculosis complex, see MTBV2/56032 Antimicrobial Susceptibility, Mycobacterium tuberculosis Complex, Broth Method.
4. See Antimicrobial Susceptibility Tests and Infectious Specimen Shipping Guidelines in Special Instructions.
Forms: If not ordering electronically, submit a Microbiology Request Form (Supply T244) with the specimen.
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
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
The rapidly growing species of mycobacteria (eg, Mycobacterium fortuitum, Mycobacterium peregrinum, Mycobacterium chelonae, Mycobacterium abscessus, and Mycobacterium mucogenicum) are seen with increasing frequency as causes of infection. Some examples of infections caused by this group of mycobacteria are empyema, subcutaneous abscess, cutaneous ulcerative and nodular lesions, peritonitis, endometriosis, bacteremia, keratitis, and urinary tract, prosthetic joint, wound, and disseminated infections.
Rapidly growing mycobacteria differ from other species of mycobacteria by their growth rates, metabolic properties, and antimicrobial susceptibility profiles. Most species are susceptible to some of the traditional antimycobacterial agents, but rapidly growing species may exhibit resistance to certain antimycobacterial agents. In contrast, they often are susceptible to several of the antibacterial agents used to treat common bacterial infections. Therefore, the antimicrobial susceptibility profile of an organism within this group varies depending on the species. Isolates of Mycobacterium fortuitum and Mycobacterium peregrinum generally exhibit susceptibility to amikacin, ciprofloxacin, clarithromycin, imipenem, and sulfamethoxazole; while isolates of Mycobacterium chelonae are generally susceptible to amikacin and clarithromycin only. Mycobacterium abscessus is usually susceptibility to clarithromycin, imipenem, and amikacin.
Antimicrobials tested in this assay are amikacin, cefoxitin, ciprofloxacin, clarithromycin, doxycycline, imipenem, tobramycin, trimethoprim/sulfamethoxazole, linezolid, moxifloxacin, and tigecycline.
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.
| | Susceptible (mcg/mL) | Intermediate (mcg/mL) | Resistant (mcg/mL) |
| Amikacin | < or =16 | 32 | > or =64 |
| Cefoxitin | < or =16 | 32-64 | > or =128 |
| Ciprofloxacin | < or =1.0 | 2.0 | > or =4.0 |
| Clarithromycin | < or =2.0 | 4.0 | > or =8.0 |
| Doxycycline | < or =1.0 | 2.0-8.0 | > or =16 |
| Imipenem | < or =4.0 | 8.0 | > or =16 |
| Tobramycin | < or =4.0 | 8.0 | > or =16 |
| Linezolid | < or =8 | 16 | > or =32 |
| Trimethoprim/Sulfamethoxazole | < or =2/38 | - | > or =4/76 |
| Moxifloxacin | < or =1.0 | 2 | > or =4.0 |
| Tigecycline | No interpretations available | ||
Interpretation Provides information to assist in interpretation of the test results
Results are reported as the minimum inhibitory concentration in micrograms/mL.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Brown-Elliott BA, Wallace RJ Jr.: Clinical and taxonomic status of pathogenic nonpigmented or late-pigmenting rapidly growing mycobacteria. Clin Microbiol Rev 2002 October;15:716-746
2. Colombo RE, Olivier KN: Diagnosis and treatment of infections caused by rapidly growing mycobacteria. Semin Respir Crit Care Med 2008 October;29:577-588
Method Description Describes how the test is performed and provides a method-specific reference
The method employed in this assay is broth microtiter dilution commercially available from Trek Diagnostics, Inc. Antimicrobials included in the assay are tested according to the Clinical and Laboratory Standards Institute (CLSI) guidelines.(CLSI. Susceptibility Testing of Mycobacteria, Nocardiae, and Other Actinomycetes; Approved Standard. CLSI document M24-A. NCCLS, Wayne, PA, 2003; Woods GL, Warren NG, Inderleid CB: Susceptibility test methods: mycobacteria, nocardia, and other actinomycetes. In Manual of Clinical Microbiology. Vol 1. Ninth edition. Edited by PR Murray, EJ Baron, JH Jorgensen, et al. Washington, DC, ASM Press, 2007, pp 1223-1247)
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.
Varies
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
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.
87186
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 |
|---|---|---|
| MMLRG | Susceptibility, AFB, Rapid Grower | In Process |
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