Ureaplasma/Mycoplasma – Culture and Reference Identification

* Copie d'impression non contrôlée. Valide uniquement le jour de l'impression : 28 mars 2023.

Testing Indications

Mycoplasma genitalium is not detected by Mycoplasma culture. Testing for Mycoplasma genitalium is not currently offered at Public Health Ontario.

Testing for Mycoplasma genitalium may be requested and specimens will be forwarded to the National Microbiology Laboratory in Winnipeg for testing if the following criteria are met:

1. Symptomatic ,in the presence of persistent or recurrent urethritis, cervicitis, or PID

2. Negative test results for Chlamydia trachomatis and Neisseria gonorrhoeae
3. PHO laboratory microbiologist approval

Swab specimens may be submitted in at least 1 mL appropriate transport medium (such as Universal Transport Medium). Store samples refrigerated or frozen until shipped for testing. Ship frozen samples on dry ice and refrigerated samples on cold packs.

Specimen Collection and Handling

Specimen Requirements

Test Requested	Required Requisition(s)	Specimen Type	Minimum Volume	Collection Kit
Urogenital Ureaplasma / Mycoplasma Ureaplasma / Mycoplasma Urea/Myco culture	General Test Requisition	Genital swabs, including endometrial, placental swabs	1.0 mL of fluid	MP kit / Genital Mycoplasma/ Ureaplasma culture kit order # 390064 or a universal transport medium (UTM) for swabs or fluids. A sterile container can also be used for fluids / tissue / tubing. Anaerobic / aerobic blood culture bottles are the only acceptable collection devices for blood.
Urogenital Ureaplasma / Mycoplasma Ureaplasma / Mycoplasma Urea / Myco culture	General Test Requisition	Neonatal specimens – auger suction, nasopharyngeal/ endotracheal aspirates	As much fluid as possible; if < 1.0 mL, transfer to a UTM	MP kit / Genital Mycoplasma/ Ureaplasma culture kit order # 390064 or a universal transport medium (UTM) for swabs or fluids. A sterile container can also be used for fluids / tissue / tubing. Anaerobic / aerobic blood culture bottles are the only acceptable collection devices for blood.
Urogenital Ureaplasma / Mycoplasma Ureaplasma / Mycoplasma Urea / Myco culture	General Test Requisition	Urine	1.0 mL of fluid	MP kit / Genital Mycoplasma/ Ureaplasma culture kit order # 390064 or a universal transport medium (UTM) for swabs or fluids. A sterile container can also be used for fluids / tissue / tubing. Anaerobic / aerobic blood culture bottles are the only acceptable collection devices for blood.
Urogenital Ureaplasma / Mycoplasma Ureaplasma / Mycoplasma Urea / Myco culture	General Test Requisition	Autopsy tissues/swabs	Available tissue	MP kit / Genital Mycoplasma/ Ureaplasma culture kit order # 390064 or a universal transport medium (UTM) for swabs or fluids. A sterile container can also be used for fluids / tissue / tubing. Anaerobic / aerobic blood culture bottles are the only acceptable collection devices for blood.
Urogenital Ureaplasma / Mycoplasma Ureaplasma / Mycoplasma Urea / Myco culture	General Test Requisition	Placenta, products of conception	Available tissue	MP kit / Genital Mycoplasma/ Ureaplasma culture kit order # 390064 or a universal transport medium (UTM) for swabs or fluids. A sterile container can also be used for fluids / tissue / tubing. Anaerobic / aerobic blood culture bottles are the only acceptable collection devices for blood.
Urogenital Ureaplasma / Mycoplasma Ureaplasma / Mycoplasma Urea/Myco culture	General Test Requisition	Body fluids, wound exudates/aspirates, joint fluids, needle aspirates	1.0 mL of fluid	MP kit / Genital Mycoplasma/ Ureaplasma culture kit order # 390064 or a universal transport medium (UTM) for swabs or fluids. A sterile container can also be used for fluids / tissue / tubing. Anaerobic / aerobic blood culture bottles are the only acceptable collection devices for blood.
Urogenital Ureaplasma / Mycoplasma Ureaplasma / Mycoplasma Urea/Myco culture	General Test Requisition	Blood	Blood culture broth/bottle	MP kit / Genital Mycoplasma/ Ureaplasma culture kit order # 390064 or a universal transport medium (UTM) for swabs or fluids. A sterile container can also be used for fluids / tissue / tubing. Anaerobic / aerobic blood culture bottles are the only acceptable collection devices for blood.
Ureaplasma / Mycoplasma identification / confirmation, with or without presumptive species indicated	Reference Bacteriology Requisition	Pure viable culture of suspect organism on appropriate media or a swab of the pure subcultured isolate	1.0 mL of fluid	Submit a subculture of the organism on an appropriate agar medium that supports growth (i.e. chocolate, Columbia blood). MP kit / Genital Mycoplasma/ Ureaplasma culture kit order # 390064 or a universal transport medium (UTM) for swabs.

Submission and Collection Notes

Unsuitable specimens: Rectal and throat swabs, and seminal fluid are not acceptable specimen sites for Ureaplasma/Mycoplasma culture. Serological testing is not available. Dry swabs and swabs in bacteriology transport media (gel) are not acceptable collection kits and testing will not be performed.

Do not use expired kits.

NOTE: Urogenital Ureaplasma/Mycoplasma testing for in-vitro fertility programs or infertility screens will not be done.

Storage and Transport

Label the specimen container with the patient’s full name, date of collection, and one other unique identifier such as the patient’s date of birth or Health Card Number. Failure to provide this information may result in rejection or testing delay.

Special Instructions

Specimens should be stored at 2-8°C after collection and shipped on ice. Transport to the laboratory as soon as possible. Culture specimens should be received at the testing laboratory within 72 hours of collection; this is especially important for neonatal specimens. Presumptive growth on plated media should be sent in as is, as soon as possible, to conserve organism integrity. In situations of delayed transportation, specimens should be frozen at -70°C and transported on dry ice.

Follow the instructions found in the Urogenital Mycoplasma/Ureaplasma Kit Instruction Sheet.

Requisitions and Kit Ordering

Test Frequency and Turnaround Time (TAT)

Ureaplasma and Mycoplasma culture is performed daily, Monday to Friday.

Turnaround time is up to 17 days from receipt by PHO laboratory.

Test Methods

Specimens are tested using standard culture technique.

Interpretation

Routine culture results may be interpreted as isolated or not isolated.

Reference identification results may be interpreted as confirmed or not confirmed.

Reporting

Results are reported to the ordering physician or health care provider as indicated on the requisition.

All positives are reported as soon as the results are available. Final and all negative results are kept for 12-14 days after receipt before reporting.

Critical positive reports (results from neonatal specimens or specimens from pregnant patients) are phoned and faxed if the client is registered for auto fax.

Other positives are only faxed if client is registered for auto fax.

References

LAB-SD-125, Reference Bacteriology and Antimicrobial Susceptibility: New Requisition and Testing Algorithm for Improved Test Utilization

Additional Information

All specimens submitted are simultaneously tested for urogenital Ureaplasmas and urogenital Mycoplasmas (with the exception of Mycoplasma genitalium).
Speciation is not available by routine culture methods.
Antibiotic sensitivity testing is not available for these organisms.
Mycoplasma genitalium is not detected by Mycoplasma culture. Testing for Mycoplasma genitalium is not currently offered at Public Health Ontario, but can be obtained at the National Microbiology Laboratory after PHO microbiologist approval. Please see criteria under Testing Indications above.

* Copie d'impression non contrôlée. Valide uniquement le jour de l'impression : 28 mars 2023.

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Mis à jour le 25 sept. 2019