The gonococcus is very fragile; it does not survive in the external environment. It is through direct contact during sexual intercourse that the contamination occurs. Gonorrhea often goes unnoticed, especially in women and asymptomatic patients, who harbor gonococci in the urogenital tract or the nasopharynx and play a major role in the interhuman spread of the disease. Screening and rapid treatment of a patient is therefore very important in order to break the chain of transmission. They must always be supplemented by the screening and treatment of partners.
Who should get tested?
It’s recommended you get tested if:
- you or your partner think you have symptoms of gonorrhea
- you’ve had sex with a new partner
- you or your partner have had sex with other people
- you have another STI (sexual transmitted infection)
- they have an STI during a vaginal examination, your nurse or doctor tells you that the cells of your cervix are inflamed or there
- you’re pregnant or planning a pregnancy
Where to get tested?
The diagnosis of gonorrhea is made in the laboratory by the detection of gonococci on direct examination in the specimens, supplemented by a culture and an antibiogram when possible.
Collection of samples
- In acute urethritis, a small amount of urethral pus is removed, preferably at a distance from urination.
- In subacute forms, where flow is often minimal and intermittent, sampling should be done in the morning before first urination.
- In the case of high involvement, it is possible to collect urethroprostatic secretions after careful massage of the prostate. It is necessary for homosexuals to practice anorectal sampling.
Several samples will be made systematically:
- At the level of the urethra,
- at the vulvar glandular orifices of Bartholin or Skene in case of inflammatory
- at the endocervix, with a speculum,
- At the level of the anus.
- It should be known that there is a physiological reactivation at the time of the rules (4th day).
In both sexes
If there is a possibility that your rectum or throat is infected, the doctor or nurse may need to use a swab to collect a sample from these areas.
If you have symptoms of conjunctivitis, such as red, inflamed eyes with discharge, a sample of the discharge may be collected from your eye.
After taking a male urethral and cervical-vaginal swab with the appropriate swabs, a smear is performed for Gram staining and cultured on specific media. When gram-negative is observed under a microscope and culture is positive, the antibiogram is used to determine the antibiotic susceptibility of the bacteria. When detected antibiotic susceptibility, proceed to treatment.
The detection of Neisseria gonorrhoeae can also be done in urine samples and other samples mentioned above by molecular biology (PCR: polymerase chain reaction). This technique makes it possible to search the DNA of bacteria in the samples is also very sensitive and fast. But the antimicrobial susceptibility test cannot be done by this technique.