Ureaplasma species, Molecular Detection, PCR, Varies

Message
Specimen source is required.

The high sensitivity of amplification by polymerase chain reaction requires the specimen to be processed in an environment in which contamination of the specimen by Ureaplasma DNA is not likely.



Test Code
URRP


Alias/See Also
Epic: LAB12929
Mayo: URRP 


CPT Codes
87798 x 2 87999 (if appropriate for government payers)

Preferred Specimen
Submit only 1 of the following specimens:

Specimen Type: Swab
Supplies:
-Culturette (BBL Culture Swab) (T092)
-BD E-Swab (T853)
-M4-RT (T605)
Sources: Vaginal, cervix, urethra, urogenital, chest/mediastinal; bronchus or lung (donor swab), or upper respiratory sources (only infants <3 months: nasopharynx, nose, throat)
Container/Tube:
Preferred: Culture swab transport system (Dacron or rayon swab with aluminum or plastic shaft with either Stuart or Amies liquid medium)
Acceptable: Swab in transport media: M4, M4-RT, M5, M6, universal transport media, or ESwab
Specimen Volume: 1 swab
Collection Instructions:
Vaginal:
1. Collect specimen by swabbing back and forth over mucosa surface to maximize recovery of cells.
2. Place swab back into swab cylinder.
Urethra or cervical:
1. Collect specimen by inserting swab 1 to 3 cm and rotating 360 degrees.
2. Place swab back into swab cylinder.
Wound:
1. Collect specimen by swabbing back and forth over wound surface to maximize recovery of cells.
2. Place swab back into swab cylinder.

Specimen Type: Fluid
Supplies: M4-RT (T605)
Sources: Pelvic, peritoneal, amniotic, prostatic secretions, semen, reproductive drainage or fluid, pleural/chest, chest tube, pericardial, sputum, tracheal secretions, bronchial washings, bronchoalveolar lavage, lung; or nasal washings (only infants <3 months)
Container/Tube:
Preferred: Sterile container
Acceptable: Specimen in 3 mL of transport media: M4, M4-RT, M5, M6, or universal transport media
Specimen Volume: 1 to 2 mL

Specimen Type: Synovial fluid
Container/Tube:
Preferred: Lavender top (EDTA)
Acceptable: Pink top (EDTA), royal blue top (EDTA), sterile vial containing EDTA-derived aliquot, red top (no anticoagulant), or sterile container
Specimen Volume: 1 mL
Collection Instructions: Send specimen in original tube.

Specimen Type: Urine-first void, kidney/bladder stone, or ureter
Container/Tube: Sterile container
Specimen Volume: 10 mL or entire specimen
Collection instructions: Urine first void: Specimen can be collected at any time during the day. The patient should not have urinated for at least 1 hour prior to specimen collection. The first voided portion is the initial 20 to 30 mL of the urine stream obtained without cleaning the external urethra.

Specimen Type: Tissue
Sources: Placenta, products of conception, urogenital, respiratory, bronchus, chest/mediastinal, bone, spine, or joint
Container/Tube: Sterile container
Specimen Volume: 5 mm(3)
Collection Instructions:
1. Collect fresh tissue specimen.
2. Submit fresh tissue only, do not add fluid to tissue
3. Refrigerate or freeze specimen.


Minimum Volume
Fluid: 1 mL
Urine-first void: 2 mL
Swab: 1 swab
Tissue: 5 mm(3)


Specimen Stability
Specimen Type Temperature Time Special Container
Varies Refrigerated (preferred) 7 days  
  Frozen 7 days


Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Cotton or calcium alginate-tipped swab, wooden shaft swab, transport swab containing gel or charcoal
Formalin-fixed and/or paraffin-embedded tissues,
Port-a-Cul tube
Anaerobic fluid vials
Dry swab (no pledget or sponge)
Bone marrow
Decalcified bone
Slides


Methodology
Real-Time Polymerase Chain Reaction (PCR) using LightCycler and Fluorescent Resonance Energy Transfer (FRET)


Setup Schedule
Monday through Friday


Report Available
3 to 4 days


Limitations
CAUTIONS 
Interfering substances may affect the accuracy of this assay; results should always be interpreted in conjunction with clinical and epidemiological findings.

Since Ureaplasma species may be part of the normal microbiota, results should be interpreted accordingly.


Reference Range
REFERENCE VALUES 
Not applicable

INTERPRETATION 
A positive polymerase chain reaction (PCR) result for the presence of a specific sequence found within the Ureaplasma urealyticum and Ureaplasma parvum ureC gene indicates the presence of U urealyticum or U parvum DNA in the specimen.

A negative PCR result indicates the absence of detectable U urealyticum and U parvum DNA in the specimen but does not rule out infection as false-negative results may occur due to inhibition of PCR, sequence variability underlying the primers and probes, or the presence of U urealyticum or U parvum in quantities less than the limit of detection of the assay.


Clinical Significance
USEFUL FOR 
Rapid, sensitive, and specific identification of Ureaplasma urealyticum and Ureaplasma parvum from genitourinary, reproductive, bone, spine, joint, and lower respiratory sources

This test is not intended for medicolegal use.

CLINICAL INFORMATION 
Ureaplasma urealyticum and Ureaplasma parvum have been associated with a number of clinically significant infections, although their clinical significance may not always be clear as they are part of the normal genital microbiota. U urealyticum and U parvum have been associated with urethritis and epididymitis. They may cause upper urinary tract infection and have been associated with infected kidney stones. U urealyticum and U parvum may be isolated from amniotic fluid of women with preterm labor, premature rupture of membranes, spontaneous term labor, or chorioamnionitis. They may also cause neonatal infections, including meningoencephalitis and pneumonia. In addition, U urealyticum and U parvum have been reported to cause unusual infections, such as prosthetic joint infection and infections in transplant recipients.

Recently, U urealyticum and U parvum have been found to cause hyperammonemia in lung transplant recipients.(1) In lung transplant recipients with hyperammonemia, the ideal diagnostic specimen is a lower respiratory specimen (eg, bronchoalveolar lavage fluid), although U urealyticum and U parvum may also be detected in blood. Treatment directed against these organisms has resulted in resolution of hyperammonemia.

Culture of Ureaplasma species is laborious, requiring a high degree of technical skill and taking several days. Polymerase chain reaction (PCR) detection is sensitive, specific, and provides same-day results. In addition, PCR allows the differentiation of U urealyticum and U parvum, which is not easily accomplished with culture. The PCR assay has replaced conventional culture for U urealyticum and U parvum at Mayo Clinic Laboratories due to its speed and equivalent performance to culture.


Performing Laboratory
Mayo Clinic Laboratories - Rochester
3050 Superior Drive NW
Rochester, MN 55901


Additional Information
Ureaplasma species, Molecular Detection, PCR, Varies

Last Updated: July 18, 2023
Last Review: N. Wolford, July 18, 2023


The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.