Ureaplasma species, PCR (URRP)

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Test Code: URRPSO

Overview
Ordering
Specimen
Performing
Clinical/Interpretive
Contacts
Coding

Synonyms/Keywords

Ureaplasma urealyticum, Ureaplasma parvum, PCR

Useful For

Rapid, sensitive, and specific identification of Ureaplasma urealyticum and U parvum from genitourinary, reproductive, bone, spine and joint, and lower respiratory sources.

Specimen Requirements

Specimen Type (Submit only 1 of the following)	Preferred Container/Tube	Acceptable Container/Tube	Specimen Volume	Specimen Minimum Volume (allows for 1 repeat)
Swab: Vaginal, cervix, urethra, urogenital, chest/mediastinal; bronchus or lung (donor swab), or upper respiratory sources (only infants <3 months: nasopharynx, nose, throat)	Culture swab transport system (Dacron or rayon swab with aluminum or plastic shaft with either Stuart or Amies liquid medium)	M4, M4-RT, M5, M6, Universal Transport Media, or ESwab	One swab	One swab
Urine: First void, kidney/bladder stone, or ureter	Sterile, screw-capped container		10 mL	2 mL
Fluid: Pelvic, peritoneal, amniotic, prostatic secretions, semen, reproductive drainage or fluid, pleural/chest, chest tube, pericardial	Sterile, screw-capped container		2 mL	1 mL
Synovial Fluid	EDTA Lavender top tube	EDTA Pink top tube, Royal blue EDTA top tube, sterile vial containing EDTA-derived aliquot, red top (no anticoagulant) or sterile container	1 mL
Tissue: Placenta, products of conception, urogenital, respiratory, bronchus, chest/mediastinal, bone, spine, joint	Sterile, screw-capped container		5 mm (3)
Respiratory: Sputum, tracheal secretions, bronchial washings, bronchoalveolar lavage, lung; or nasal washings (Note: Nasal washings may only be submitted for infants <3 months of age)	Sterile, screw-capped container		2 mL	1 mL

Collection Processing Instructions

Specimens should be delivered to the laboratory as soon as possible.

Do not use calcium alginate or wooden shaft swabs.

Samples should be taken without contact with antiseptics or lubricants.

Specimen source is required.

For more information on Specimen Collection Media/Swab, see Specimen Transport Pictorial.

Vaginal Swab: Collect specimen by swabbing back and forth over mucosa surface to maximize recovery of cells. Place swab back into swab cylinder.

Urethra or Cervical Swab: Collect specimen by inserting swab 1 to 3 cm and rotating 360 degrees. Place swab back into swab cylinder.

Wound Swab: Collect specimen by swabbing back and forth over wound surface to maximize recovery of cells. Place swab back into swab cylinder.

Synovial fluid: Send specimen in original tube.

Urine: 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.

Tissue: Collect fresh tissue specimen. Submit fresh tissue only, do not add fluid to tissue. Refrigerate or freeze specimen.

Specimen Stability Information

Specimen Type	Temperature	Time
M4, M5, M6 Transport Media	Refrigerate (preferred	7 days
M4, M5, M6 Transport Media	Frozen	7 days
All other specimens	Refrigerate	7 days

Rejection Criteria

Cotton or calcium alginate-tipped swab, wooden shaft swab, dry swabs, 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

Interference

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 flora, results should be interpreted accordingly.

Performing Laboratory Information

Performing Location	Day(s) Test Performed	Report Available	Methodology/Instrumentation
Mayo Clinic Laboratories	Monday through Friday	3-4 days	Real-Time Polymerase Chain Reaction (PCR) using LightCycler and Fluorescent Resonance Energy Transfer (FRET)

Reference Lab

Mayo Clinic Laboratories

Test Information

Ureaplasma urealyticum and U 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 flora. U urealyticum and U parvum have been associated with urethritis and epididymitis. They may cause upper urinary tract infection and they have been associated with infected renal 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. 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. 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.

Interpretation

A positive PCR result for the presence of a specific sequence found within the Ureaplasma urealyticum and U 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.

Outreach CPTs

CPT	Modifier (if needed)	Quantity	Description	Comments
87798		2