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Epic Code LAB848 Metamycoplasma hominis, Molecular Detection, PCR, Varies

Important Note

Order as Reference Miscellaneous #LAB848; indicate complete test name when ordering.

Additional Codes

Mayo Code: MHRP

Performing Laboratory

Mayo Clinic Laboratories in Rochester

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.

Specimen Type

Varies


Shipping Instructions


 



Necessary Information


Specimen source is required.



Specimen 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.

 

Submit only 1 of the following specimens:

 

Specimen Type: Swab

Supplies:

-Culturette (BBL Culture Swab) (T092)

-BD E-Swab (T853)

-Bartels FlexTrans VTM-3 mL (T892)

-Jiangsu VTM-3 mL (T891)

-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:

-Bartels FlexTrans VTM-3 mL (T892)

-Jiangsu VTM-3 mL (T891)

-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.


Specimen Minimum Volume

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

Forms

If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.

Specimen Stability Information

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

Reject Due To

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
Reject

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).

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 flora.

 

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.

Method Name

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

Report Available

3 to 4 days

Reporting Name

Mycoplasma hominis PCR

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.

Method Description

This polymerase chain reaction (PCR) method employs a target-specific detection system including primers, as well as fluorescent resonance energy transfer (FRET) hybridization probes designed for tuf gene of Mycoplasma hominis. The LightCycler instrument amplifies and monitors target nucleic acid sequences by fluorescence during PCR cycling. This is an automated PCR system that can rapidly detect amplified product development. The detection of amplified products is based on the FRET principle. For FRET product detection, a hybridization probe with a donor fluorophore, fluorescein, on the 3' end is excited by an external light source, which emits light that is absorbed by a second hybridization probe with an acceptor fluorophore, LC-Red 640, on the 5' end. The acceptor fluorophore then emits light of a different wavelength that is measured with a signal that is proportional to the amount of specific PCR product. The process is completed in a closed-tube system.(Cunningham SA, Mandrekar JN, Rosenblatt JE, Patel R: Rapid PCR detection of Mycoplasma hominis, Ureaplasma urealyticum, and Ureaplasma parvum. Int J Bacteriol. 2013;2013:168742. doi: 10.1155/2013/168742)

Day(s) Performed

Monday through Friday

Clinical Reference

1. Sampath R, Patel R, Cunningham SA, et al: Cardiothoracic transplant recipient Mycoplasma hominis: An uncommon infection with probable donor transmission. EBioMedicine. 2017 May;19:84-90

2. Waites KB, Bebear C: Mycoplasma and Ureaplasma. In: Carroll KC, Pfaller MA, eds. Manual of Clinical Microbiology. 12th ed. ASM Press; 2019:1117-1136

Test Classification

This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

87798

LOINC Code Information

Test ID Test Order Name Order LOINC Value
MHRP Mycoplasma hominis PCR 68546-1

 

Result ID Test Result Name Result LOINC Value
SRC86 Specimen source 31208-2
32536 Mycoplasma hominis PCR 68546-1