Ureaplasma/Mycoplasma – Culture and Reference Identification

Conformément au Règlement de l’Ontario 671/92 de la Loi sur les services en français, les renseignements d’analyses de laboratoire liés à la présente page ne sont offerts qu’en anglais parce qu’ils sont de nature scientifique ou technique et destinés uniquement à l’usage des fournisseurs de soins de santé qualifiés et non aux membres du public.

This page provides testing information for urogenital and non-respiratory Ureaplasma and Mycoplasma culture at Public Health Ontario (PHO) and reference PCR testing for Mycoplasma genitalium at the National Microbiology Laboratory (NML).

Testing Indications

Mycoplasma spp., including M. hominis and M. genitalium, and Ureaplasma spp. have been associated with urogenital infections (eg. pelvic inflammatory disease (PID), nongonococcal urethritis and cervicitis), complications in pregnancy, and more rarely, severe extragenital infections in neonates and immunocompromised individuals. 

Please note that M. genitalium is not detected by Mycoplasma culture and testing is not currently offered at PHO’s laboratory. Requests for M. genitalium testing will be forwarded to the NML in Winnipeg if the following criteria are met and indicated on the requisition:

  1. Patient is symptomatic with persistent or recurrent urethritis, cervicitis, or PID.
  2. Patient has negative test results for Chlamydia trachomatis and Neisseria gonorrhoeae.

Acceptance/Rejection Criteria

The following are rejected for testing:

  • Specimens for donor screening: Donor testing is not available through PHO’s laboratory. Specimens from patients being screened as potential donors (e.g. organ, tissue, cells, fertility, etc.) should be referred to a laboratory that performs donor screening assays. Specimens received for donor screening at PHO’s laboratory will be rejected.
  • Specimens received in an expired kit
  • Incorrect sites: Rectal swabs, adult respiratory/throat swabs, and seminal fluid are not acceptable specimen sites for Ureaplasma/Mycoplasma culture. 
  • Incorrect kits: Dry swabs and swabs in bacteriology transport media (gel) are not acceptable collection kits and testing will not be performed.

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

Genital swabs, including endometrial, placental swabs

  • swab
  • 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

Neonatal specimens – auger suction, nasopharyngeal/ endotracheal aspirates

  • as much fluid as possible; if < 1.0 mL, transfer to a UTM
  • piece of tubing with aspirated material

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

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

Autopsy tissues/swabs

  • tissue
  • swab

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

Placenta, products of conception

  • tissue
  • swab

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

Body fluids, wound exudates/aspirates, joint fluids, needle aspirates

  • swab
  • 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

Blood

blood culture 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

Pure viable culture of suspect organism on appropriate media or a swab of the pure subcultured isolate

  • agar plate with growth
  • swab
  • 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.

Mycoplasma genitalium

Urethral/urogenital swabs, vaginal swabs, rectal swabs, urine, Aptima tube remnants, ESwab or DNA extracts

1.0 mL of fluid or appropriate transport medium (eg. UTM)

Submission and Collection Notes

1

Complete all fields of the requisition form, including:

  • Test(s) requests and indications for testing
  • Patient setting/population/source
  • Patient’s first and last name, date of birth, health card number
  • Specimen source and date of collection
  • Physician name and address
2

For clinical specimens, label the specimen container(s) with the patient’s first and last name, date of collection, specimen site/source and one other unique identifier such as the patient’s date of birth or health card number. For additional information see: Criteria for Acceptance of Patient Specimens. Failure to provide this information may result in rejection or testing delay.

Limitations

Serology testing for urogenital Mycoplasma/Ureaplasma is not available.

Storage and Transport

Specimens should be stored at 2-8°C following collection and shipped to PHO’s laboratory on ice 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.

All clinical specimens must be shipped in accordance to the Transportation of Dangerous Good Act.

Requisitions and Kit Ordering

Test Frequency and Turnaround Time (TAT)

Urogenital Ureaplasma/Mycoplasma culture is performed daily, Monday to Friday, at PHO’s Toronto laboratory.

Turnaround time is up to 17 business days from receipt at PHO’s laboratory.

Test Methods

Urogenital Ureaplasma/Mycoplasma culture is performed by standard culture techniques. All specimens requesting Ureaplasma or Mycoplasma culture are simultaneously tested for both.

Speciation will only be done for M. hominis if specifically requested. Speciation is not available by routine culture methods for other Mycoplasma spp. or Ureaplasma spp. Antibiotic sensitivity testing is not available for these organisms.

Mycoplasma genitalium is not detected by Mycoplasma culture. Requests for M. genitalium testing are forwarded to the NML for PCR testing if the patient meets criteria outlined in Testing Indications above. Routine culture will not be done if only testing for M. genitalium is requested. If culture is required, please request both M. genitalium and Ureaplasma/Mycoplasma culture.

Interpretation

The following table provides possible results with associated interpretations for culture testing:


Result

Interpretation

Comments

Negative routine culture

Ureaplasma spp. and/or Large colony Mycoplasma not isolated

 

Positive routine culture

Ureaplasma spp. and/or Large colony Mycoplasma isolated

 

Negative reference isolate

Ureaplasma spp. and/or Large colony Mycoplasma not confirmed

 

Positive reference isolate

Ureaplasma spp. and/or Large colony Mycoplasma confirmed

 

Results from referred out M. genitalium PCR testing are reported as an attachment as per the NML.

Reporting

Results are reported to the physician, authorized health care provider (General O. Reg 45/22, s.18) or submitter as indicated on the requisition.

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.
Mis à jour le 8 mai 2023