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Gonorrheae Culture

Gonorrhea, N. gonorrhoeae, GC Screen

Test Codes

EPIC: LAB235

Department

Microbiology

Instructions

All genital and synovial specimens are routinely cultured for the presence of Neisseria gonorrhoeae. Culture of throat, rectal, and eye specimens for Neisseria gonorrhoeae must be specifically requested and ordered as Culture, GC.

Specimen Collection Criteria

Physician Office/Draw Specimen Preparation

Do NOT refrigerate specimen. Maintain at room temperature (20-26°C or 68-78.8°F) and transport to the Laboratory within 8 hours of collection.

Preparation for Courier Transport

Transport: All specimen types, at room temperature (20-26°C or 68-78.8°F).

Rejection Criteria

• Specimens delayed in transit (greater than 48 hours from the time of collection).
• Refrigerated specimens.
• Specimens submitted on dry swabs.
• Urine specimens for culture.
  • Molecular methods available.

• Specimens submitted using any transport swab other than Charcoal Amies or the ESwab transport system received greater than 2 hours after the time of collection.

Inpatient Specimen Preparation

Immediately transport specimens to the Laboratory for processing, at room temperature (20-26°C or 68-78.8°F).

In-Lab Processing

Do NOT refrigerate specimen. Maintain at room temperature (20-26°C or 68-78.8°F) prior to testing.

Storage

Specimen Stability for Testing:

ESwab
Room Temperature (20-26°C or 68-78.8°F): 48 hours
Refrigerated (2-8°C or 36-46°F): Unacceptable
Frozen (-20°C/-4°F or below): Unacceptable

Amies Transport Containers with Charcoal
Room Temperature (20-26°C or 68-78.8°F): 48 hours
Refrigerated (2-8°C or 36-46°F): Unacceptable
Frozen (-20°C/-4°F or below): Unacceptable

Amies Transport Containers without Charcoal (Not preferred as N. gonorrhoeae may not remain viable)
Room Temperature (20-26°C or 68-78.8°F): 2 hours
Refrigerated (2-8°C or 36-46°F): Unacceptable
Frozen (-20°C/-4°F or below): Unacceptable

Synovial Fluid in a Sterile Container
Room Temperature (20-26°C or 68-78.8°F): 24 hours
Refrigerated (2-8°C or 36-46°F): Unacceptable
Frozen (-20°C/-4°F or below): Unacceptable

*Specimens greater than 48 hours old will require approval of the Microbiology Supervisor or Medical/Technical Director before testing.

Specimen Storage in Department Prior to Disposal:

Room Temperature (20-26°C or 68-78.8°F): 4 days (Swabs)
Refrigerated (2-8°C or 36-46°F): 30 days (Body Fluids)

Laboratory

Royal Oak Microbiology Laboratory

Performed

Sunday – Saturday, 24 hours a day.
Preliminary results available within 24 hours.

Reference Range

No Neisseria gonorrhoeae recovered.

Test Methodology

Culture.

Clinical Utility

To aid in the diagnosis of Neisseria gonorrhoeae infections.

Clinical Disease

N. gonorrhoeae (Gram-negative diplococci) infections in newborn infants usually involve the eye. Other types of involvement include scalp abscess, vaginitis, and systemic disease with bacteremia, arthritis, meningitis, or endocarditis. In prepubertal children, gonococcal infections usually occur in the genital tract. Vaginitis is the most common manifestation; pelvic inflammatory disease (PID) and perihepatitis can occur but are uncommon, as is gonococcal urethritis in the prepubertal male. Anorectal and tonsillopharyngeal colonization can also occur in prepubertal children. In sexually active adolescents and adults, gonococcal infection of the genital tract in females is frequently asymptomatic or manifest by urethritis, endocervicitis, and PID. In adolescent males, the infection is often symptomatic, and the primary site is the urethra. Asymptomatic infection of the urethra, endocervix, rectum, and pharynx can occur. Extension from primary genital mucosal sites results in epididymitis, bartholinitis, PID, and perihepatitis, even asymptomatic infection can progress to PID with tubal scarring that can result in ectopic pregnancy or infertility. Infection involving other mucous membranes can produce conjunctivitis, pharyngitis, or proctitis. Hematogenous spread can involve skin and joints (arthritis-dermatitis syndrome); meningitis and endocarditis occur rarely (1).

Epidemiology

N. gonorrhoeae infections occur only in humans. The source of the organism is exudate and secretions of infected mucosal surfaces (1).

Incubation Period

Usually 2 to 7 days (1).

Transmission

Transmission results from intimate contact such as sexual acts or parturition. Sexual abuse should be strongly considered when genital, rectal or oral infections are diagnosed in children beyond the newborn period and before puberty, and in non-sexually active adolescents. Approximately 584,000 new cases of gonorrhea were reported in the United States in 2018. Young men, 20-24 years of age, have the highest reported incidence of infection, followed by those 15-19 years of age. In females, the highest rates are in adolescents 15-19 years old. Concurrent infection with Chlamydia trachomatis is very common. N. gonorrhoeae is communicable as long as an individual harbors the organism (1). 

Reference

1. Church, D. and W.W. Chan. 2016. Genital Cultures. In: Leber, A.L., et al. (eds.) Clinical Microbiology Procedures Manual 4^th ed., ASM. Washington, D.C. Section 3.9.
2. Wauters, G. and M. Vaneechouttee., 2015. Neisseria. In: Jorgensen, J.H. et. al. (eds.). Manual of Clinical Microbiology. 11^th ed. ASM Press. Washington, D.C. pp. 559-573.

CPT Codes

87081, 87205 (direct smear performed on male urethral specimens only).

Contacts

Last Updated

10/22/2024