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CLSI Publishes Revised Standard for Susceptibility Testing of Mycobacteria, Nocardiae, and Other Aerobic Actinomycetes | NEWS-Line for Laboratory Professionals

CLSI Publishes Revised Standard for Susceptibility Testing of Mycobacteria, Nocardiae, and Other Aerobic Actinomycetes


The Clinical and Laboratory Standards Institute (CLSI) recently published Susceptibility Testing of Mycobacteria, Nocardiae, and Other Aerobic Actinomycetes; Approved Standard-Second Edition (M24-A2), which provides protocols and related quality control parameters and interpretive criteria for the susceptibility testing of mycobacteria, Nocardia spp., and other aerobic actinomycetes. This document is a revision of M24-A, which was published in 2003.

Based on comments from laboratorians involved with regular testing of mycobacteria and/or aerobic actinomycetes, M24-A2 was revised to address the susceptibility testing of Mycobacterium tuberculosis complex (MTBC), clinically significant slowly and rapidly growing mycobacterial species, Nocardia spp., and other aerobic actinomycetes. Supported by the most current data available, this standard includes recommendations for the selection of agents for primary and secondary testing, organism group-specific methodologies, reporting recommendations, and quality control criteria for the above-listed organisms. The standard includes new recommendations for testing initial isolates from all patients for susceptibility to isoniazid, rifampin, ethambutol, and pyrazinamide, all of which are components of first-line therapy for tuberculosis.

For testing MTBC, M24-A2 recognizes agar proportion as the primary methodology on which all other methodologies are essentially based. This document also recommends the use of commercial broth susceptibility methods with shorter incubation times, which are now widely used in susceptibility testing of MTBC.

Laboratory tests for evaluating the susceptibility of mycobacteria and aerobic actinomycetes are important because they can confirm the choice of the initial course of chemotherapy and the emergence of drug resistance when a patient fails to show a satisfactory bacteriological response to treatment. Additionally, they can guide the choice of further treatment with different drugs. Susceptibility testing of MTBC can also be used to estimate the prevalence of primary and acquired drug resistance in a community. For each of these purposes, use of a reliable technique to perform the test is essential, and M24-A2 satisfies this demand.

CLSI is a volunteer-driven, membership-supported, nonprofit organization dedicated to developing standards and guidelines for the health care and medical testing community through a consensus process that balances the perspectives of industry, government, and the health care professions. For additional information, visit the CLSI web site at www.clsi.org or call 610-688-0100.

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