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HelpTest ID: TB2LN Susceptibility, Mycobacterium tuberculosis Complex, Second Line, Varies
Infectious
Reporting Name
Susceptibility, Mtb Complex, 2 LineUseful For
Determination of Mycobacterium tuberculosis complex minimal inhibitory concentrations to second-line antimicrobial agents
Clinical Information
The Clinical and Laboratory Standards Institute (CLSI) provides a consensus protocol for the methods, antimycobacterial agents, and concentrations of each agent to be tested to permit standardized interpretation of Mycobacterium tuberculosis complex susceptibility testing results. CLSI guidelines suggest that additional agents should be tested when an isolate of M tuberculosis complex is resistant to rifampin, is monoresistant to the critical concentration of isoniazid and the physician intends to use a fluoroquinolone for therapy or is resistant to any combination of two first-line agents.
This test uses a broth microdilution minimal inhibitory concentration (MIC) method for susceptibility testing of M tuberculosis complex against antimycobacterial agents. Agents tested are amikacin, ethionamide, kanamycin, moxifloxacin, ofloxacin, p-aminosalicylic acid, rifabutin, and streptomycin.
Interpretation
Results are reported as minimal inhibitory concentrations in mcg/mL.
This test is used as an alternative to TB1LN / Antimicrobial Susceptibility, Mycobacterium tuberculosis Complex, First Line, Varies for ethambutol, isoniazid and rifampin when reagents are not available to perform the TB1LN test. Ethambutol, isoniazid, and rifampin are not routinely reported with this test.
Testing Algorithm
When this test is ordered, the additional test will always be performed at an additional charge.
Report Available
21 to 30 daysDay(s) Performed
Monday through Sunday
Clinical Reference
1. Hall L, Jude KP, Clark SL, et al. Evaluation of the Sensititre MycoTB plate for susceptibility testing of the Mycobacterium tuberculosis complex against first- and second-line agents. J Clin Microbiol. 2012;50:3732-3734
2. Nahid P, Mase SR, Migliori GB, et al. Treatment of Drug-Resistant Tuberculosis. An Official ATS/CDC/ERS/IDSA Clinical Practice Guideline [published correction appears in Am J Respir Crit Care Med. 2020 Feb 15;201(4):500-501
3. Clinical and Laboratory Standards Institute (CLSI). Susceptibility Testing of Mycobacteria, Nocardia spp., and Other Aerobic Actinomycetes. 3rd ed. CLSI standard M24. CLSI; 2018
4. Clinical and Laboratory Standards Institute (CLSI). Performance Standards for Susceptibility Testing of Mycobacteria, Nocardia spp., and Other Aerobic Actinomycetes. 2nd ed. CLSI supplement M24S. CLSI; 2023
Method Name
Minimum Inhibitory Concentration (MIC) by Microtiter Broth Dilution Method
Specimen Type
VariesAdditional Testing Requirements
If organism identification is not provided, CTB / Mycobacteria and Nocardia Culture, Varies or CTBID / Culture Referred for Identification, Mycobacterium and Nocardia, Varies must also be ordered and will be charged separately.
Shipping Instructions
1. For shipping information see Infectious Specimen Shipping Guidelines.
2. Place specimen in a large infectious container and label as an etiologic agent/infectious substance.
Necessary Information
Specimen source and suspected organism identification are required.
Specimen Required
Specimen Type: Organism
Supplies: Infectious Container, Large (T146)
Container/Tube: Middlebrook 7H10 agar slant
Specimen Volume: Isolate
Collection Instructions: Organism must be in pure culture, actively growing.
Specimen Minimum Volume
See Specimen Required
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Varies | Ambient (preferred) | ||
| Refrigerated | |||
Special Instructions
Reference Values
Interpretive criteria and reporting guidelines are followed using the Clinical Laboratory Standards Institute (CLSI) M24S document.
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
87186-Susceptibility, Mtb Cx, 2nd Line
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| TB2LN | Susceptibility, Mtb Complex, 2 Line | 29579-0 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| TB2LN | Susceptibility, Mtb Complex, 2 Line | 29579-0 |
Additional Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| STV2 | Susceptibility, Mtb Cx, 2nd Line | No, (Bill Only) | Yes |
mml-CNS-Infections