Neisseria gonorrhoeae
| Neisseria gonorrhoeae | ||||||||||||||
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 Neisseria gonorrhoeae cultured on two different media types.
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| Neisseria gonorrhoeae Zopf, 1885 |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Neisseria gonorrhoeae (also known as Gonococci) is a species of Gram-negative bacteria responsible for the sexually transmitted disease gonorrhoea.[1] Neisseria are highly fastidious cocci, requiring nutrient supplementation to survive. Thus, they grow on Chocolate agar (heated blood agar) with carbon dioxide. These cocci are facultatively intracellular and typically appear in pairs (diplococci).
Gonorrhoea symptoms include a purulent (or pus-like) discharge from the genitals which may be foul smelling, a burning sensation during urination and conjunctivitis commonly in neonates; that's why silver nitrate is used as a preventive measure. It also occurs occasionally in adults. Neisseria is usually isolated on a Thayer-Martin agar — an agar plate with 3 different antibiotics and nutrients which not only facilitate the growth of Neisseria species, but inhibit the growth of Gram-positive organisms and most bacilli and fungi. Further testing to differentiate the species includes testing for oxidase (all Neisseria show a positive reaction) and the carbohydrates maltose, sucrose, and glucose test in which N. gonorrhoeae will only oxidize (that is, utilize) the glucose.
If N. gonorrhoeae is resistant to the penicillin family of antibiotics, then ceftriaxone (a third-generation cephalosporin) is often used.
Patients should also be tested for Chlamydia infections, since co-infection is frequent.
Diagnosis
Pathology
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Treatment
- Gonococcal Infections
- Gonococcal Infections [3]
- Gonococcal Infections in Adolescents and AdultsUncomplicated Gonococcal Infections of the Cervix, Urethra, and Rectum
- Uncomplicated Gonococcal Infections of the Cervix, Urethra, and Rectum
- Preferred regimen : Doxycycline 100 mg PO bid for 7 days OR Azithromycin 1 g PO in a single dose
- Alternative regimen (1): Erythromycin base 500 mg PO qid for 7 days OR Erythromycin ethylsuccinate 800 mg PO qid for 7 days
- Alternative regimen (2): Levofloxacin 500 mg PO qd for 7 days OR Ofloxacin 300 mg PO bid for 7 days.
- Note: Patients should be instructed to refer their sex partners for evaluation, testing, and treatment if they had sexual contact with the patient during the 60 days preceding onset of the patient's symptoms or chlamydia diagnosis.
- Chlamydial Infections in patients with HIV Infection
- Preferred regimen : Doxycycline 100 mg PO bid for 7 days OR Azithromycin 1 g PO in a single dose
- Alternative regimen (1): Erythromycin base 500 mg PO qid for 7 days OR Erythromycin ethylsuccinate 800 mg PO qid for 7 days
- Alternative regimen (2): Levofloxacin 500 mg PO qd for 7 days OR Ofloxacin 300 mg PO bid for 7 days.
- Pregancy
- Preferred regimen :Azithromycin 1 g PO in a single dose
- Alternative regimen (1):Amoxicillin 500 mg PO tid for 7 days
- Alternative regimen (2):Erythromycin base 500 mg PO qid for 7 days OR Erythromycinbase 250 mg PO qid for 14 days
- Alternative regimen (3):Erythromycin ethylsuccinate 800 mg PO qid for 7 days OR Erythromycin ethylsuccinate 400 mg PO four qid for 14days
- Note:Doxycycline, Ofloxacin, and Levofloxacin are contraindicated in pregnant women.
- Chlamydial infection among neonates
- Ophthalmia Neonatorumcaused by C. trachomatis
- Preferred regimen :Erythromycin base or ethylsuccinate ,PO 50 mg/kg/ day divided into 4 doses daily for 14 days
- Alternative regimen : Azithromycin suspension, PO 20 mg/kg /day qd for 3 days
- Note: The mothers of infants who have chlamydial infection and the sex partners of these women should be evaluated and treated.
- Infant Pneumonia
- Preferred regimen :Erythromycin base or ethylsuccinate PO 50 mg/kg/ day divided into 4 doses daily for 14 days
- Alternative regimen : Azithromycin suspension, PO 20 mg/kg /day qd for 3 days
- Chlamydial infection among infants and childern
- Infants and childern who weigh < 45 kg
- Preferred regimen :Erythromycin base or ethylsuccinate PO 50 mg/kg/ day divided into 4 doses daily for 14 days
- Infants and childern who weigh ≥45 kg but who are aged <8 years
- Preferred regimen :Azithromycin 1 g PO in a single dose
- Infants and childern aged ≥8 years
- Preferred regimen :Azithromycin 1 g PO in a single dose OR Doxycycline 100 mg PO bid for 7 days
References
- ↑ Ryan KJ, Ray CG (editors) (2004). Sherris Medical Microbiology (4th ed. ed.). McGraw Hill. ISBN 0838585299.
- ↑ http://picasaweb.google.com/mcmumbi/USMLEIIImages
- ↑ "Chlamydial Infections".
de:Neisseria gonorrhoeae it:Neisseria gonorrhoeae hu:Neisseria gonorrhoeae nl:Neisseria gonorrhea no:Neisseria gonorrhoeae