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Culture, Ureaplasma

Mycoplasma hominis Culture, Ureaplasma Culture

Test Codes

EPIC: LAB7122, Beaker: XCXUG, ARUP: 65031

Department

Send Outs

Instructions

• This culture is for genital and/or urinary specimens ONLY.
• Mycoplasma and Ureaplasma are highly fastidious in their requirements for growth. Specimens must be kept moist.
• Samples must be collected in Universal Transport Media that has been validated for Mycoplasma/Ureaplasma transport, such as M4. Media only validated for viral transport is not acceptable.

Specimen Collection Criteria

Collect: One of the following specimen types:

1. Fluid (amniotic, semen, prostatic secretions, and urine).
• Collect in a sterile collection container. Fluid must be transferred to UTM after collection: Place 0.5mL (minimum 0.3mL) of fluid, swab, or tissue in UTM (Universal Transport Medium).
• Collect urine specimen from women by urethral catheterization. A first-void urine specimen should be collected from men.
• NOTE: Urethral swabs from men and vaginal or cervical swabs from women are preferred over urine specimens for detection of genital mycoplasmas.
2. Swab specimens in UTM (urethra, vagina, cervix).
• Flocked, Dacron and polyester swabs are acceptable.
• Collect by swabbing back and forth over the mucosa or surface to maximize recovery of cells.
• Place and swirl swab into UTM (Universal Transport Medium).
• NOTE: Do not use cotton swabs, vaginal lubricants or antiseptics prior to collection. They are inhibitory to these microorganisms.
3. Tissue.
• Collect in a sterile container with sufficient UTM to prevent drying.

Physician Office/Draw Specimen Preparation

Place 0.5mL (minimum 0.3mL) of fluid, swab, or tissue in UTM (Universal Transport Medium). Arrange for transport to the Laboratory prior to specimen collection. Maintain specimens frozen (-20°C/-4°F or below) prior to transport.

Preparation for Courier Transport

Transport: All specimen types in an appropriate container, frozen (-20°C/-4°F or below).

Rejection Criteria

• Ruhof-brand Transport Media (VTM)
• Any Viral Transport Media not indicated for Mycoplasma/Ureaplasma transport.
• Specimens in leaking containers.
• Specimens submitted in expired transport media.
• Specimens received greater than 24 hours after collection.
• Specimens not received in transport media.
• Specimens no collected and processed as indicated.

In-Lab Processing

Place 0.5 mL (minimum. 0.3mL) of fluid, swab, or tissue in UTM (Universal Transport Medium).

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 8 hours
Refrigerated (2-8°C or 36-46°F): 12 hours (preferred), 48 hours
Frozen (-20°C Unacceptable/-4°F or below): 1 month

Specimen Storage in Department Prior to Disposal:

Specimen retention time is determined by the policy of the reference laboratory. Contact the Send Outs Laboratory with any questions.

Laboratory

Sent to ARUP laboratories, Salt Lake City, UT.

Performed

Sunday – Saturday.
Final negative results available in 10 days.

Average time to positive: 4 days.

Reference Range

No Ureaplasma recovered.
No Mycoplasma hominis recovered.

Test Methodology

Culture.

Interpretation

• Mycoplasma hominis and Ureaplasma spp. can be cultured on urea-containing agar. Isolation of Ureaplasma spp. in any quantity from normally sterile body fluids or tissues is significantly associated with disease. Recovery of Ureaplasma spp. from the lower genital tract is more problematic. This organism may be the etiologic agent in nongonococcal urethritis in males and urethral syndrome in females.
• Isolation of M. hominis in any quantity from normally sterile body fluids or tissue is significantly associated with disease. The presence of M. hominis in nonsterile body sites may be significant if the organism is isolated in large quantities and is associated with compatible clinical illness.

Clinical Utility

This assay aids in the diagnosis of diseases by Ureaplasma urealyticum and Mycoplasma hominis. This test will not detect M. genitalium.

Clinical Disease

• The most common syndrome associated with Ureaplasma urealyticum in men is nongonococcal urethritis (NGU). The etiology of NGU remains uncertain but U. urealyticum has been more frequently isolated from patients with NGU than from appropriate controls in several well-designed studies. Without treatment, the disease continues for 1 to 3 months.
• Ureaplasma urealyticum has been isolated from nasopharyngeal secretions and endotracheal aspirates of infants 3 months or younger with pneumonia. It may be a cause of lower respiratory tract disease in neonates and young infants. In women, U. urealyticum has been isolated in pure culture from Bartholin gland abscesses, tubo-ovarian and pelvic abscesses, and salpingitis (1).
• M. hominis is associated with both genitourinary and nongenital infections. These include: cervicitis and pelvic inflammatory disease, urinary tract infections, chorioammnionitis, postpartum fever and bacteremia as well as arthritis, wound infections, endocarditis and respiratory tract infections. In neonates, it can cause meningoencephalitis, bacteremia and abscesses. Specimens to be tested for M. hominis are those normally obtained for cultures from the infected sites. M. hominis may be part of the normal genital flora. 

Epidemiology

The primary reservoir of the human U. urealyticum is the genital tract of sexually active adults. Colonization is found in approximately one half of sexually active adults, can be prolonged, but is rare in prepubertal children and in those not sexually active. Mycoplasma hominis can be isolated from a variety body fluids from the genital tract (1). Newborns who are colonized are presumed to have been exposed during passage through the birth canal. Neonatal colonization is transient and decreases with age.

Incubation Period

After sexual transmission the incubation period is 10-20 days (1).

Transmission

Transmission during delivery is likely from an asymptomatic infected mother to her newborn. U. urealyticum may colonize the throat, eyes, umbilicus, and perineum of newborns. U. urealyticum has been isolated from the lower airways and lung biopsies of preterm infants with pneumonia and chronic lung disease (1). M. hominis can be acquired by neonates during delivery.

Reference

1. Waites, K.B., C.M. Bebear, J.A. Robertson, D.F. Talkington and G.E. Kenny, 2001. Cumitech 34. Laboratory diagnosis of mycoplasmal infections. Coordinating ed., F.S. Nolte. American Society for Microbiology, Washington, D.C.
2. Waites, K.B., B.Katz, R.L.Schelonka. 2005. Mycoplasmas and Ureaplasmas as neonatal pathogens. Clin. Microbiol. Rev. 18: 757-89.

CPT Codes

87109

Contacts

Last Updated

10/3/2023