CLSI M24-2018

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M24

Susceptibility Testing of Mycobacteria,

Nocardia spp., and Other Aerobic

Actinomycetes

This standard provides protocols and related quality control

parameters for antimicrobial susceptibility testing of

mycobacteria, Nocardia spp., and other aerobic actinomycetes.

A standard for global application developed through the Clinical and Laboratory Standards Institute consensus process.

3rd Edition

Clinical and Laboratory Standards Institute

Setting the standard for quality in medical laboratory testing around the world.

The Clinical and Laboratory Standards Institute (CLSI) is a not-for-prot membership organization that brings

together the varied perspectives and expertise of the worldwide laboratory community for the advancement of a

common cause: to foster excellence in laboratory medicine by developing and implementing medical laboratory

standards and guidelines that help laboratories fulll their responsibilities with eﬃciency, eﬀectiveness, and global

applicability.

Consensus Process

Consensus—the substantial agreement by materially aﬀected, competent, and interested parties—is core to the

development of all CLSI documents. It does not always connote unanimous agreement but does mean that the

participants in the development of a consensus document have considered and resolved all relevant objections

and accept the resulting agreement.

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CLSI documents undergo periodic evaluation and modication to keep pace with advances in technologies,

procedures, methods, and protocols aﬀecting the laboratory or health care.

CLSI’s consensus process depends on experts who volunteer to serve as contributing authors and/or as participants

in the reviewing and commenting process. At the end of each comment period, the committee that developed

the document is obligated to review all comments, respond in writing to all substantive comments, and revise the

draft document as appropriate.

Comments on published CLSI documents are equally essential and may be submitted by anyone, at any time, on

any document. All comments are managed according to the consensus process by a committee of experts.

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When it is believed that an objection has not been adequately considered and responded to, the process for

appeal, documented in the CLSI Standards Development Policies and Processes, is followed.

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available upon request.

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Do you use CLSI documents in your workplace? Do you see room for improvement? Would you like to get

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For additional information on committee participation or to submit comments, contact CLSI.

Clinical and Laboratory Standards Institute

950 West Valley Road, Suite 2500

Wayne, PA 19087 USA

P: +1.610.688.0100

F: +1.610.688.0700

www.clsi.org

standard@clsi.org

M24, 3rd ed.

November 2018

laces M24-A2

Susceptibility Testing of Mycobacteria, Nocardia spp., and Other

Aerobic Actinomycetes

Gail L. Woods, MD

Nancy L. Wengenack, PhD, D(ABMM)

Grace Lin, MS

Barbara A. Brown-Elliott, MS, MT(ASCP)SM

Daniela Maria Cirillo, MD, PhD

Patricia S. Conville, MS, MT(ASCP)

Edward P. Desmond, PhD, D(ABMM)

Scott B. Killian, BS

Nicole M. Parrish, PhD, MHS, D(ABMM)

Richard Pfeltz, PhD

Elvira Richter, PhD

John D. Turnidge, MD, BS, FRACP, FRCPA, FASM

Abstract

Clinical and Laboratory Standards Institute standard M24—Susceptibility Testing of Mycobacteria, Nocardia spp., and Other

Aerobic Actinomycetes includes susceptibility testing procedures for Mycobacterium tuberculosis complex (MTBC), clinically

significant slowly and rapidly growing mycobacterial species, Nocardia spp., and other aerobic actinomycetes. Also included in

this standard are recommendations for selecting agents for first-line and second-line drug testing, organism group–specific

methodologies, reporting recommendations, and organism quality control criteria. Recommendations regarding agent selection for

testing mycobacteria are based primarily on published guidelines. For testing MTBC, M24 recognizes agar proportion as the

reference methodology on which all other methodologies are based. In addition, this standard includes recommendations for using

commercial broth susceptibility methods with shorter incubation times, which are now in widespread use for MTBC susceptibility

testing, and information on molecular methods for detecting drug resistance and their integration with culture-based methods.

Clinical and Laboratory Standards Institute (CLSI). Susceptibility Testing of Mycobacteria, Nocardia spp., and Other Aerobic

Actinomycetes. 3rd ed. CLSI standard M24 (ISBN 978-1-68440-025-6 [Print]; 978-1-68440-026-3 [Electronic]). Clinical and

Laboratory Standards Institute, 950 West Valley Road, Suite 2500, Wayne, Pennsylvania 19087 USA, 2018.

The Clinical and Laboratory Standards Institute consensus process, which is the mechanism for moving a document through

two or more levels of review by the health care community, is an ongoing process. Users should expect revised editions of any

given document. Because rapid changes in technology may affect the procedures, methods, and protocols in a standard or

guideline, users should replace outdated editions with the current editions of CLSI documents. Current editions are listed in the

CLSI catalog and posted on our website at www.clsi.org. If you or your organization is not a member and would like to become

one, or to request a copy of the catalog, contact us at: Telephone: +1.610.688.0100; Fax: +1.610.688.0700; E-Mail:

customerservice@clsi.org; Website: www.clsi.org.

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