Advanced Diagnostic Laboratories

Appropriate phenotypic and genotypic susceptibilities for antimicrobial susceptibility testing of Acid Fast Bacilli

Test Code

APPRO

Description

This is the recommended orderable for susceptibility testing. Selection of this orderable triggers the appropriate phenotypic and molecular drug resistance testing for each type of organism (Table 1). Note that testing is not performed, reported, or billed if it is not appropriate for the organism.

APPRO can be ordered on clinical specimens sent for culture.  If an organism is grown, the appropriate drugs are automatically added; testing will not be performed if no organism is cultured. APPRO may also be ordered on isolates. Note that if a customized selection of antibiotics are needed, they can be selected individually.  See "Individual Drug Testing for Acid Fast Bacilli" for the full selection of antibiotics that can be ordered. 


Table 1. Phenotypic and genotypic susceptibilities performed based on the organism type when APPRO is ordered.

Organism Phenotypic testing Molecular drug resistance testing (see AFB6 for more details)
Billing code Drugs Billing code Testing
M. avium complex NTM13 AMK, CIP, CLO, CLR, DOX, LZD, MIN, MXF, RFB, RIF, STR, TMP/SXT NTMDR Macrolides and aminoglycosides
Slowly growing mycobacteria other than M. avium complex and fastidious mycobacteria NTM13 AMK, CIP, CLO, CLR, DOX, LZD, MIN, MXF, RFB, RIF, STR, TMP/SXT (billing code: NTM13) N/A Does not apply to these organisms
Fastidious slowly growing mycobacteria such as M. haemophilum and M. shimoidei BMX12 CIP, RFB, STR, AMK, CLR, MXF, CLO, LZD, RIF, EMB N/A Does not apply to these organisms.
M. tuberculosis complex (First line drugs) MTB2 INH, PZA, RIF, EMB MTB4T Rifampin and isoniazid
Drug resistant M. tuberculosis complex (Second line drugs) MTB1 AMK, CAP, CS, EMB, ETH, INH, KAN, PAS, RIF, STR MTB5T Fluoroquinolones, aminoglycosides, and kanamycin
M. abscessus and M. chelonae NTM6, NTM6V (vet) AMK, AUG, AXO, AZM, CIP, CLO, CLR, DOX, FEP, FOT, FOX, GEN, IPM, KAN, LZD, MIN, MXF, TGC, TOB, TMP/SXT NTMDR Inducible and acquired macrolides, aminoglycosides
Other rapidly growing mycobacteria (e.g. M. fortuitum, M. peregrinum) NTM6 AMK, AUG, AXO, AZM, CIP, CLO, CLR, DOX, FEP, FOT, FOX, GEN, IPM, KAN, LZD, MIN, MXF, TGC, TOB, TMP/SXT N/A Does not apply to these organisms
Partial acid fast bacteria (e.g. ​Nocardia sp., Gordonia sp.,   Tskuamurella sp.) NTM4,
NTM4V (vet)		 AMK, AUG, AXO, AZM, CIP, CLO, CLR, DOX, FEP, FOT, FOX, GEN, IPM, KAN, LZD, MIN, MXF, TGC, TOB, TMP/SXT N/A Does not apply to these organisms



Table 2. Drug abbreviations (used on the requisition)

Abbreviation Drug Abbreviation cont'd Drug cont'd
AMK Amikacin INH Isoniazid
AUG Augmentin IPM Imipenem
AXO Ceftriaxone KAN Kanamycin
AZM Azithromycin LZD Linezolid
CIP Ciprofloxacin MIN Minocycline
CLO Clofazimine MXF Moxifloxacin
CLO/AMK Clofazimine & Amikacin synergy OMC Omadacycline
CLR Clarithromycin PAS p- Aminosalicyclic acid
CAP Capreomycin PZA Pyrazinamide
CS Cycloserine RFB Rifabutin
DOX Doxycycline RIF Rifampin
EMB Ethambutol RIF/EMB Rifampin & Ethambutol synergy
ETH Ethionamide STR Streptomycin
FEP Cefepime TGC Tigecycline
FOT Cefotaxime TMP/SXT Trimethoprim/sulfamethoxazole
FOX Cefoxitin TOB Tobramycin
GEN Gentamicin    

 

Find a Test