Metamycoplasma hominis, Molecular Detection, PCR, Varies

Message
Specimen source is required.

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


Test Code
MHRP


Alias/See Also
Epic: LAB14546
Mayo: MHRP


CPT Codes
87798

Includes


Preferred Specimen
Specimen source is required.

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: Container with 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 clot tube (no anticoagulant), or sterile container
Specimen Volume: 0.5 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 Metamycoplasma hominis may be part of the normal flora, results should be interpreted accordingly.

This test does not detect other Metamycoplasma or Ureaplasma species (including Metamycoplasma pneumoniae, a common cause of community acquired pneumonia).


Reference Range
REFERENCE VALUES 
Not applicable

INTERPRETATION 
A positive polymerase chain reaction (PCR) result for the presence of a specific sequence found within the Metamycoplasma hominis tuf gene indicates the presence of M hominis DNA in the specimen.

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


Clinical Significance
USEFUL FOR 
Rapid, sensitive, and specific identification of Metamycoplasma hominis from synovial fluid, genitourinary, reproductive, lower respiratory sources, pleural/chest fluid, pericardial fluid, and wound specimens

This test is not intended for medicolegal use.

TESTING ALGORITHM 
For more information see  
Infective Endocarditis: Diagnostic Testing for Identification of Microbiological Etiology

CLINICAL INFORMATION 
Metamycoplasma hominis, formerly Mycoplasma hominis, has been associated with a number of clinically significant infections, although it is also part of the normal genital microbiota.

M hominis may be found in the respiratory specimens and spinal fluid of neonates. Although the clinical significance of such findings is often unclear as spontaneous clinical recovery may occur without specific treatment, clinical manifestations of meningoencephalitis in premature infants have been reported.

M hominis may play a role in some cases of pelvic inflammatory disease, usually in combination with other organisms. M hominis may be isolated from amniotic fluid of women with preterm labor, premature rupture of membranes, spontaneous term labor, or chorioamnionitis; there is evidence that it may be involved in postpartum fever or fever following abortion, usually as a complication of endometritis.

M hominis has rarely been associated with septic arthritis (including prosthetic joint infection), pyelonephritis, intraabdominal infection, wound infection, endocarditis, central nervous system infection (including meningoencephalitis, brain abscess, central nervous system shunt infection, and subdural empyema), pneumonia, and infected pleural and pericardial effusions. Extragenital infection typically occurs in those with hypogammaglobulinemia or depressed cell-mediated immunity; in lung transplant recipients in particular, M hominis has been associated with pleuritis and mediastinitis. Recent evidence implicates donor transmission in some cases of M hominis infection in lung transplant recipients.

Polymerase chain reaction (PCR) detection of M hominis is sensitive, specific, and provides same-day results. Although this organism can occasionally be detected in routine plate cultures, this is neither a rapid nor a sensitive approach to detection. Specialized cultures are more time consuming than the described PCR assay. The described PCR assay has replaced conventional culture for M hominis 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
Metamycoplasma hominis, 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.