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HelpTest ID 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.
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 FibroSpecimen Type
VariesSpecimen 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.
Cautions
Recovery of mycobacteria is dependent on the number of organisms present in the specimen, specimen collection methods, methods of processing, and patient factors such as use of anti-mycobacteria therapy.
Clinical Reference
1. Martin I, Pfyffer GE, Parrish N: Mycobacterium: General characteristics, laboratory detection and staining procedures. In: Carroll KC, Pfaller MA, Landry ML, et al, eds. Manual of Clinical Microbiology. 12th ed. Vol 1. ASM Press; 2011:472-502
2. Caldwell M, Tisdale J, Khare R. Improved recovery of nontuberculous mycobacteria in culture with adjunctive use of a selective agar. J Clin Microbiol. 2024;62(3):e0167823. doi:10.1128/jcm.01678-23
3. Broncano-Lavado A, Barrado L, Lopez-Roa P, et al. Clinical evaluation of nontuberculous mycobacteria (NTM) elite agar, a new medium for the isolation of NTM: a multicenter study. J Clin Microbiol. 2023;61(4):e0003623. doi:10.1128/jcm.00036-23
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
Report Available
42 to 45 daysTest 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)