Ureaplasma/Mycoplasma – Culture and Reference Identification

Consistent with O. Reg. 671/92 of the French Language Services Act, laboratory testing information on this page is only available in English because it is scientific or technical in nature and is for use only by qualified health care providers and not by members of the 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).

*Uncontrolled print copy. Valid only on day of print: 01 May 2024.

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:

Patient is symptomatic with persistent or recurrent urethritis, cervicitis, or PID.
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	General Test Requisition	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	General Test Requisition	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	General Test Requisition	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	General Test Requisition	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	General Test Requisition	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	General Test Requisition	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	General Test Requisition	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	Reference Bacteriology Requisition	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	General Test Requisition	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

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

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.

*Uncontrolled print copy. Valid only on day of print: 01 May 2024.

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Updated 8 May 2023