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Test Code LAB3056 Mycobacterium tuberculosis Complex, Molecular Detection, PCR, Varies

Additional Codes

SQ: PCRMTB

MAYO: MTBRP

Reporting Name

M tuberculosis Complex PCR

Useful For

Rapid detection of Mycobacterium tuberculosis complex DNA (preferred method)

 

Detection of M tuberculosis, when used in conjunction with mycobacterial culture

 

This test should not be used to determine bacteriologic cure or to monitor response to therapy.

 

This test is not intended for the detection of latent tuberculosis and must not be used as a substitute for tests intended for detection of latent tuberculosis such as the tuberculin skin test or an interferon gamma release assay.

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Varies


Additional Testing Requirements


This test must always be performed in conjunction with mycobacterial culture. If your facility is unable to perform mycobacterial culture, order CTB / Mycobacteria and Nocardia Culture, Varies concurrently with this test.



Shipping Instructions


Specimen must arrive within 7 days of collection; if greater than 7 days of collection, the specimen will be rejected.



Necessary Information


Specimen source is required.



Specimen Required


The high sensitivity of amplification by polymerase chain reaction (PCR) requires the specimen to be processed in an environment in which contamination of the specimen by Mycobacterium tuberculosis DNA is unlikely.

 

If a single specimen is being shared between mycobacteria culture, acid-fast smear, and/or M tuberculosis PCR, a minimum volume of 2 mL for body fluid, 3 mL for respiratory specimen, or a pea-sized piece of tissue should be obtained. Specimen volumes less than indicated may decrease sensitivity of testing. If insufficient volume is submitted, test or tests will be canceled.

 

Preferred Specimens: Body fluid, cerebrospinal fluid (CSF), ocular fluid, respiratory (eg, bronchoalveolar lavage [BAL], bronchial washing, sputum), feces, fresh tissue, bone, bone marrow, or urine

Submit a raw clinical sample (not a culture isolate) for testing.

Acceptable Specimens: If no fresh specimen is available, digested respiratory specimens treated with N-acetyl-L-cysteine/sodium hydroxide (NALC/NaOH) are acceptable (eg, BAL, bronchial washing, respiratory fluid, sputum, or tracheal secretion), as are NALC/NaOH-treated gastric washings.

 

Submit only 1 of the following specimens:

 

Specimen Type: Body fluid

Sources: Body, bone marrow aspirate, ocular, or CSF

Container/Tube: Sterile container

Specimen Volume: 1 mL

Additional Information: Only fresh, non-NALC/NaOH-digested body fluids are acceptable.

 

Specimen Type: Gastric washing

Container/Tube: Sterile container

Specimen Volume: 2 mL

Collection Instructions: Neutralize specimen within 4 hours of collection with 20 mg of sodium carbonate per 2 mL of gastric washing.

 

Specimen Type: Respiratory

Sources: BAL, bronchial washing, or sputum

Container/Tube: Sterile container

Specimen Volume: 1 mL if only PCR ordered or 3 mL if PCR ordered with smear and culture

 

Specimen Type: Feces

Container/Tube: Sterile container

Specimen Volume: 5 to 10 g

Additional Information: Only fresh, non-NALC/NaOH-digested fecal specimens are acceptable.

 

Specimen Type: Tissue

Sources: Fresh tissue, bone, or bone marrow biopsy

Container/Tube: Sterile container

Specimen Volume: 5 to 10 mm

Collection Instructions: Keep moist with sterile water or sterile saline

Additional Information: Only fresh, non-NALC/NaOH-digested tissue is acceptable.

 

Specimen Type: Urine

Container/Tube: Sterile container

Specimen Volume: 1 mL

Collection Instructions: Collect a random urine specimen.

 

Acceptable

Specimen Type: NALC/NaOH-digested respiratory specimens

Sources: Lavage fluid, bronchial washing, gastric washing, respiratory fluid, sputum, or tracheal secretion

Container/Tube: Sterile container

Specimen Volume: 2 mL

Collection Instructions:

1. Submit digested specimen treated with NALC/NaOH.

2. Clearly indicate on container and order form that specimen is a digested specimen.


Specimen Minimum Volume

Body fluid, nondigested respiratory specimen, urine: 0.5 mL; Fresh tissue or bone: 5 mm; NALC-NaOH-digested specimen, gastric washing: 1 mL; Stool: 5 g

Specimen Stability Information

Specimen Type Temperature Time Special Container
Varies Refrigerated (preferred) 7 days
  Frozen  7 days

Reference Values

Not applicable

Day(s) Performed

Monday through Sunday

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

87556-Mycobacterium tuberculosis, complex, molecular detection, PCR

87015-Mycobacteria culture, concentration (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
MTBRP M tuberculosis Complex PCR 38379-4

 

Result ID Test Result Name Result LOINC Value
SRC62 MTB Complex PCR, Specimen Source 31208-2
56044 MTB Complex PCR, Result 38379-4

Method Description

Following specimen digestion and decontamination using N-acetyl cysteine and sodium hydroxide, genomic DNA is extracted using the MagNA Pure (Roche Applied Sciences) extraction platform. The purified genomic DNA is placed on the LightCycler instrument, which amplifies and monitors, by fluorescence, the development of target nucleotide sequences after each polymerase chain reaction (PCR) cycle. A specific target sequence from a portion of the katG gene from Mycobacterium tuberculosis complex is amplified and the resulting segment is detected by melt-curve analysis using sequence-specific fluorescence resonance energy transfer hybridization probes. The LightCycler PCR assay is a closed PCR system that greatly reduces the potential for false-positive results due to specimen cross-contamination as compared with traditional open-system PCR or other amplification methods like transcription-mediated amplification.(Buckwalter SP, Connelly BJ, Louison LK, et al: Description, validation, and review of a decade of experience with a laboratory-developed PCR test for detection of Mycobacterium tuberculosis complex in pulmonary and extrapulmonary specimens. J Clin Tuberc Other Mycobact Dis. 2022 Nov 12;29:100340. doi: 10.1016/j.jctube.2022.100340)

Report Available

1 to 3 days

Reject Due To

Blood
Specimen in anaerobe vial or viral transport medium (including but not limited to M4, M5, BD viral transport media, thioglycolate broth)
Swabs
Tissues in formalin fluid
Reject
 

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
TBT Concentration, Mycobacteria No, ( Bill Only) No

Testing Algorithm

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

 

For more information see Meningitis/Encephalitis Panel Algorithm.

Method Name

Real-Time Polymerase Chain Reaction (PCR)

Forms

If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.

Secondary ID

88807