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Test Code CFCTB Mycobacteria and Nocardia Culture, Cystic Fibrosis, Varies


Ordering Guidance


If the patient does not have cystic fibrosis, chronic obstructive pulmonary disease, or bronchiectasis, routine mycobacterial culture should be ordered, see CTB / Mycobacteria and Nocardia Culture, Varies.



Necessary Information


1. Specimen source (anatomical body site) is required.

2. Alert the laboratory if Mycobacterium genavense is suspected, as this species requires addition of mycobactin J to the culture medium for optimal growth and recovery.



Specimen Required


Specimen Type: Respiratory fluid

Sources: Bronchoalveolar lavage fluid, bronchial washing, sputum (saliva is not acceptable)

Container/Tube: Sterile container

Specimen Volume: 3 to 5 mL

Collection Instructions:

1. Collect 3 separate respiratory specimens for acid-fast smears and culture in patients with clinical and chest X-ray findings compatible with tuberculosis.

2. These 3 specimens should be collected at 8 to 24-hour intervals (24 hours when possible) and should include at least 1 first-morning specimen.


Secondary ID

623130

Useful For

Detection and identification of nontuberculous Mycobacterium species from respiratory specimens of patients with cystic fibrosis

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
ISMY ID by 16S Sequencing No, (Bill Only) No
RMALM Id MALDI-TOF Mass Spec AFB No, (Bill Only) No
RTBSP Id, Mtb Speciation, PCR No, (Bill Only) No
TBT Concentration, Mycobacteria No, (Bill Only) No
TISSR Tissue Processing No, (Bill Only) No
LCTB Id, MTB complex Rapid PCR No, (Bill Only) No

Testing Algorithm

When this test is ordered, a reflex test may be performed at an additional charge.

Method Name

Automated Detection of Positive Cultures followed by Organism Identification /DNA Sequencing/Matrix Assisted Laser Desorption/Ionization Time-of-Flight (MALDI-TOF) Mass Spectrometry

Reporting Name

Mycobacterial Culture, Cystic Fibro

Specimen Type

Varies

Specimen Minimum Volume

See Specimen Required

Specimen Stability Information

Specimen Type Temperature Time
Varies Refrigerated (preferred) 7 days
  Ambient  7 days

Reject Due To

Sources other than respiratory specimens, including blood, serum or fixed tissue Reject
Environmental sources Reject
Boric acid tubes Reject
Saliva Reject
Specimen in viral transport medium (including but not limited to M4, M5, BD viral transport media, thioglycolate broth) Reject
Swabs (any type, source, or transport system) Reject
Petri dish Reject

Clinical Information

This culture combines a traditional mycobacterial culture with an additional plate medium called NTM (nontuberculous mycobacteria) Elite agar, which enhances recovery of nontuberculous mycobacteria from respiratory specimens of patients with cystic fibrosis or other chronic pulmonary infections such as chronic obstructive pulmonary disease or bronchiectasis.

Reference Values

Negative

Interpretation

A final negative report is issued after 42 days of incubation.

 

Positive cultures are reported as soon as detected.

Method Description

The BACTEC MGIT 960 System is a broth system designed for the rapid detection of mycobacteria in clinical specimens. Mycobacteria growth indicator tubes (MGITs) are incubated for up to 42 days and growth is evaluated with mycobacteria identified as soon as an MGIT signals positive on the instrument.

 

In addition to the MGIT tube, Middlebrook 7H10/7H10S agar biplates and an NTM Elite agar plate is inoculated and incubated at 37° C for 42 days. Growth from positive MGITs or agar plates is identified using a variety of techniques as appropriate including rapid polymerase chain reaction, matrix assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry, or 500 base pair 16S rRNA gene sequencing.(Plongla R, Preece CL, Perry JD, Gilligan PH. Evaluation of RGM medium for isolation of nontuberculous mycobacteria from respiratory samples from patients with cystic fibrosis in the United States. J Clin Microbiol. 2017;55[5]:1469-1477. doi:10.1128/JCM.02423-16; Stephenson D, Perry A, Appleby MR, et al. An evaluation of methods for the isolation of nontuberculous mycobacteria from patients with cystic fibrosis, bronchiectasis and patients assessed for lung transplantation. BMC Pulm Med. 2019;19[1]:19. Published 2019 Jan 21. doi:10.1186/s12890-019-0781-2)

Day(s) Performed

Monday through Sunday

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

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.

CPT Code Information

87116-Mycobacterial Culture

87015-Mycobacteria Culture, Concentration (if appropriate)

87118-Id MALDI-TOF Mass Spec AFB (if appropriate)

87150-Id, Mtb Speciation, PCR (if appropriate)

87153-Mycobacteria Identification by Sequencing (if appropriate)

87176-Tissue Processing (if appropriate)

87150- Id, MTB complex Rapid PCR (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
CFCTB Mycobacterial Culture, Cystic Fibro 543-9

 

Result ID Test Result Name Result LOINC Value
CFCTB Mycobacterial Culture, Cystic Fibro 543-9