Drug Susceptibility Testing (DST)
Brief Description
Drug Susceptibility Testing (DST) determines the ability of the four primary antitubercular drugs to inhibit the growth (in vitro) of Mycobacterium tuberculosis complex (MTBC) in a broth macrodilution matrix which utilizes critical concentrations of drugs tested. DST is important to the proper treatment and management of patients with tuberculosis (TB). DST guides the physician in the selection of the most appropriate drug treatment regimen and alerts the physician when drug resistance may be a consideration in patient management.
Laboratory Unit
Tuberculosis
Methodology
Broth macrodilution using BACTEC MGIT system
Specimen Collection
Viable isolate of M. tuberculosis complex in pure culture of solid or liquid media
Storage/Transport
Submit isolates using the TB Category A carrier provided by the MSPHL in accordance with the Infectious Substance, Category A shipping guidelines.
Acceptable Specimen
Type(s)
Pure culture of M. tuberculosis complex.
Test Request Form(s)
Possible Results
Susceptible
Resistant
Reference Range
Isoniazid (0.1 & 0.4 mcg/mL)
Rifampin (1.0 mcg/mL)
Ethambutol (5.0 mcg/mL)
Pyrazinamide (100 mcg/mL)
Unacceptable Conditions
Leaked during transport
No name on specimen
Mixed culture
Nonviable organism
Interfering Substances
N/A
Result Reported
4 – 28 days after receipt of specimen
Fees
N/A
CPT Codes
87188 x5
LOINC/SNOMED Codes
29579-0
Additional Information
M. tuberculosis complex showing resistances to any drug are referred to the Centers for Disease Control and Prevention (CDC) for secondary drug susceptibility testing.
19 CSR 20-20.080 Duties of Laboratories
"Isolates or specimens positive for [M. tuberculosis complex] must be submitted to the State Public Health Laboratory for epidemiological or confirmation purposes"
Missouri Department of Health & Senior Services