Mycoplasma genitalium NAAT




Test Mnemonic

MYGAMP

CPT Codes

  • 87563 - QTY (1)

LOINC ®

88226-6 urine; 69935-5 non urine

Aliases

  • MYGPCR
  • m genitalium
  • m. gen
  • m. genitalium
  • mgen
  • MYGAMP
  • SQMYGAMP

Includes

  • Mycoplasma genitalium Result

Performing Laboratory

Cleveland Clinic Laboratories


Specimen Requirements

Volume Type Container Collect Temperature Transport Temperature Special Instructions
OneUrethralAPTIMA Collection Unisex swabAmbientAmbientMale Urethral Unisex (white tube blue swab): The patient should not have urinated for at least 1 hr prior to sample collection. Insert the blue swab 2-4 cm into the urethra. Gently rotate the swab clockwise for 2-3 seconds in the urethra. Place swab into Aptima transport tube. Snap off swab at the score line, and close the tube tightly.
OneEndocervicalAPTIMA Collection Unisex swabAmbientAmbientEndocervical Unisex (white tube blue swab): Remove excess mucus from cervical os and surrounding mucosa using the white cleaning swab, then DISCARD. Insert blue swab into the endocervical canal and gently rotate clockwise for 10-30 seconds. Place swab into Aptima transport tube. Snap off swab at the score line, and close the tube tightly.
2 mLUrine, first-catchAPTIMA Urine specimen collection kitAmbientAmbientFor female patients, vaginal specimens are preferred due to superior test performance characteristics. The patient should not have urinated for at least 1 hour prior to specimen collection. The patient should collect first portion of random voided urine (first part of stream) into a sterile, plastic, preservative-free container. Transfer 2 mL of urine into the Aptima urine specimen transport tube using the disposable pipette provided within 24 hours of collection. Close the tube tightly. Work with one specimen at a time. The correct volume of urine has been added when the fluid level is between the black fill lines (window) on the urine transport tube. Do not overfill or underfill the APTIMA Urine transport tube.
OneVaginalAptima Multitest Collection KitAmbientAmbientVaginal Multitest (orange tube pink swab): A vaginal swab is the recommended specimen for female patients due to superior test performance characteristics. Carefully insert the swab into the vagina about 2 inches past the introitus and gently rotate the swab for 10-30 seconds. Make sure the swab touches the vaginal walls so that moisture is absorbed by the swab. Place swab into Aptima transport tube. Snap off swab at the score line, and close the tube tightly.
OneOtherAptima Multitest Collection KitAmbientAmbientPenile Meatal (orange tube pink swab): Roll the swab on the tip of the penis, outside the opening of the penis (hole through which urine is passed). It is not necessary to put the swab inside the opening of the penis. Make sure to roll the swab all the way around the opening of the penis to get the best sample. Ensure the swab does not touch any other area of the skin. Place swab into Aptima transport tube. Snap off swab at the score line, and close the tube tightly.
2 mLUrine, first-catchSterile containerAmbientAmbientFor female patients, vaginal specimens are preferred due to superior test performance characteristics. The patient should not have urinated for at least 1 hour prior to specimen collection. The patient should collect first portion of random voided urine (first part of stream) into a sterile, plastic, preservative-free container.

Stability

Environmental Condition Description
Ambient15⁰C to 30⁰C. Swab in Aptima transport media: 60 days; Urine in Aptima transport media: 30 days; Urine unprocessed: 24 hours
Refrigerated2⁰C to 8⁰C. Swab in Aptima transport media: 60 days; Urine in Aptima transport media: 30 days; Urine unprocessed: 24 hours
Frozen-20⁰C to -70⁰C Swab in Aptima transport media: 4 months; Urine in Aptima transport media: 4 months; Urine unprocessed: unacceptable

Days Performed

Mon - Sun

Turnaround Time

1 - 4 days

Methodology

Name Description
Transcription-Mediated Amplification 

Reference Range

Mycoplasma genitalium RNA
Sex Age From Age To Type Range Range Unit
       NormalNot detected 

Special Info

Microbiology Preanalytic Guidance: http://portals.ccf.org/plmi/Laboratory-Medicine/Microbiology-Specimen-Collection-Transport-Information. Up to two tests can be run on a single Aptima Multitest Swab specimen (ie. GCCT+MYGAMP) - if specimen sources have been correctly selected, the shared tests will print on the same label. Do not place more than one label on a single collection tube. Common reasons for specimen rejection: 1. Inappropriate collection device for source selected. 2. Transport tubes containing a cleaning swab or more than 1 swab. 3. Overfilled or underfilled urine transport tubes. 4. Collection device expired prior to specimen collection. Related alternative orders: 1. URMPCR: sendout PCR test for Ureaplasma parvum, Ureaplasma urealyticum, Mycoplasma hominis, and Mycoplasma genitalium from urogenital sites. Not recommended due to inconsistent data and unclear role for urogenital Ureaplasma and M. hominis testing. The majority of Ureaplasma infections are not associated with overt urethritis or cervicitis symptoms. 2. MYPLAS: in-house culture for Ureaplasma urealyticum and Mycoplasma hominis from urogenital sites. Not recommended due to inconsistent data and unclear role for urogenital Ureaplasma and M. hominis testing. Will not recover M. genitalium. 3. All other available mycoplasma and ureaplasma orders are for testing from non-urogenital sites.

Clinical Info

Mycoplasma genitalium is a sexually-transmitted gram-negative bacterium that lives on and in the epithelial cells of the urinary and genital tracts. M. genitalium can cause acute and chronic nongonoccal urethritis (NGU), cervicitis, and pelvic inflammatory disease. In lower risk populations, M. genitalium prevalence of approximately 1-3% has been reported in both men and women. In higher risk populations, prevalence of 10- 41% in men and 7.3-14% in women has been reported. The prevalence of M. genitalium in higher risk populations often exceeds that of Neisseria gonorrhoeae and is similar to the prevalence of Chlamydia trachomatis. M. genitalium infections largely go unrecognized, and infected individuals are either asymptomatic or have symptoms similar to those associated with other bacterial infections of the urogenital tract. Because M. genitalium is fastidious and difficult to culture, nucleic acid amplification testing (NAAT) is the diagnostic test of choice. The CDC recommends male patients with recurrent NGU should be tested for M. genitalium using an FDA-cleared NAAT. Female patients with recurrent cervicitis should be tested for M. genitalium, and testing should be considered for those with pelvic inflammatory disease. Screening of asymptomatic M. genitalium infection or extragenital testing for M. genitalium is not recommended. The Aptima Mycoplasma genitalium assay is an FDA-approved in vitro NAAT that utilizes target capture, transcription-mediated amplification (TMA), and hybridization protection assay (HPA) technologies to detect 16s rRNA of M. genitalium. It is intended for use as an aid in the diagnosis of M. genitalium urogenital infections from clinician-collected and self-collected vaginal swabs (in a clinical setting), clinician-collected endocervical swabs, female and male urine, clinician-collected male urethral swabs, and self-collected penile meatal swabs (in a clinical setting).

Clinical Limitation

1. The performance of the assay has not been evaluated in individuals <15 years of age. 2. Therapeutic failure or success cannot be determined with the assay since nucleic acid may persist following appropriate antimicrobial therapy. 3. A negative result does not preclude a possible infection. Test results may be affected by improper specimen collection, technical error, specimen mix-up, or target levels below the assay limit of detection (LoD). 4. The effects of tampon use, douching, and specimen collection variables have not been evaluated for their impact on assay detection. 5. For females patients, a vaginal swab is the preferred specimen type due to higher clinical sensitivity for detecting M. genitalium than other specimen types; however, female urine or clinician collected endocervical swabs may be used as alternative specimens when vaginal swab specimens are not available. If female urine or clinician-collected endocervical swab specimens test negative, testing with a vaginal swab may be indicated. 5. Assay interference may occur at high concentrations of mucus in the specimen. Competitive interference may preclude detection of M. genitalium in low quantities if M. pneumoniae is present in high quantities.

Clinical Reference

Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, Reno H, Zenilman JM, Bolan GA. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep. 2021 Jul 23;70(4):1-187. doi: 10.15585/mmwr.rr7004a1. PMID: 34292926; PMCID: PMC8344968.