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Order Code RPMPM Mycoplasma (Mycoplasmoides) pneumoniae Macrolide (Azithromycin) Resistance Prediction, Molecular Detection, PCR, Varies


Ordering Guidance


This test should only be ordered on specimens that have tested positive for Mycoplasma (Mycoplasmoides) pneumoniae. This assay predicts M pneumoniae macrolide (Azithromycin) resistance only.

 

For detection of M pneumoniae prior to macrolide resistance testing , order MPRP / Mycoplasma (Mycoplasmoides) pneumoniae with Macrolide Resistance Reflex, Molecular Detection, PCR, Varies.



Necessary Information


Specimen source is required; include the specific anatomic source.



Specimen Required


The high sensitivity of amplification by polymerase chain reaction requires the specimen to be processed in an environment in which contamination of the specimen by Mycoplasma (Mycoplasmoides) pneumoniae DNA is unlikely.

 

Submit only 1 of the following specimens:

 

Specimen Type: Swab

Supplies:

-Culturette (BBL Culture Swab) (T092)

-BD E-swab (T853)

-Nasopharyngeal Swab (Nylon Mini-Tip Swab) (T861)

-Culture Swab-Liquid Stuarts/Single Swab (NP Swab) (T515)

-M4-RT (T605)

Sources: Throat, nasal, or nasopharyngeal

Container/Tube:

Preferred: Culture swab transport system (Dacron or rayon swab with aluminum or plastic shaft with either Stuart or Amies liquid medium)

Acceptable: Culture transport swab (Stuart's media) or place swab in M4, M4-RT, M5, M6, universal transport media, or ESwab

Specimen Volume: Swab

Collection Instructions:

1. Collect specimen by swabbing back and forth over mucosa surface to maximize recovery of cells.

2. Place swab back into swab cylinder.

 

Specimen Type: Fluid

Sources: Pleural, pericardial, cerebrospinal

Container/Tube: Sterile container

Specimen Volume: 0.5 mL

 

Specimen Type: Respiratory

Sources: Bronchial washing, bronchoalveolar lavage, tracheal secretions, sputum

Container/Tube: Sterile container

Specimen Volume: 1 mL


Useful For

Predicting macrolide susceptibility in Mycoplasma (Mycoplasmoides) pneumoniae

Method Name

Rapid Polymerase Chain Reaction (PCR) using Light Cycler and Fluorescent Resonance Energy Transfer (FRET)

Reporting Name

M. pneumoniae Macrolide Resist PCR

Specimen Type

Varies

Specimen Minimum Volume

Respiratory: 0.5 mL
Other specimen types: See Specimen Required

Specimen Stability Information

Specimen Type Temperature Time
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
Port-a-Cul tube
Anaerobic fluid vials
Dry swab (no pledget or sponge)
Respiratory fluid specimens placed in viral transport medium (VTM) or placed on a swab and then into VTM (M4-RT, M4, or M5)
Body fluid specimens placed in viral transport medium (VTM) or placed on a swab and then in VTM (M4-RT, M4, or M5)		 Reject

Reference Values

Not Predicted

Method Description

When Mycoplasma (Mycoplasmoides) pneumoniae is detected via previous nucleic acid amplification test, a reflexive polymerase chain reaction (PCR) is performed to assess the 23S ribosomal RNA (rRNA) gene region of M pneumoniae and predict macrolide resistance based on the most common, high-level point mutations at positions 2064 and 2063 via melting curve analysis. Note, samples deemed positive outside of Mayo Clinic Laboratories may be processed according to specimen type prior to PCR testing. This includes extraction by the MagNA Pure 96 automated instrument (Roche Applied Science).

 

A specific target sequence of the 23S rRNA gene from M pneumoniae is targeted by primers and fluorescence resonance energy transfer hybridization probes. The LightCycler 480 II instrument (Roche Applied Science) amplifies and monitors the development of target nucleic acid sequences after the annealing step during PCR cycling. Detection and prediction of the M pneumoniae target is performed through melting curve analysis using the LightCycler software. While the wild-type genotype will display a stable melting temperature, the designed primer and probe combinations will be highly sensitive to single nucleotide mutations resulting in a cooler (left-shift) melting temperature value. PCR inhibition is monitored through use of a recovery template.(Schmitt BH, Sloan LM, Patel R: Real-time PCR detection of Mycoplasma pneumoniae in respiratory specimens. Diagn Microbiol Infect Dis. 2013 Nov;77[3]:202-205; Schmitt BH, Sloan LM, Patel R. Real-time PCR detection of Mycoplasma pneumoniae in respiratory specimens. Diagn Microbiol Infect Dis. 2013 Nov;77[3]:202-205)

Day(s) Performed

Monday through Sunday

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

87798

Forms

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