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Neisseria gonorrhoeae is the obligate human pathogen that causes the sexually transmitted disease (STD) gonorrhea.This Gram-negative diplococci/gonococci does not infect other animals or experimental animals and does not survive freely in the environment. The gonococcal infection occurs in the upper or lower tract, pharynx, ophthalmic area, rectum, and bloodstream. During the 1980’s gonorrhea was also referred to as “clap” when public awareness was quite minimal. This was one of the venereal diseases prostitutes hoped to contract since it resulted in infertility by pelvic inflammatory disease (PID). As documentation, diagnostic testing, and public awareness improved, there has been a decline in incidence reports, however, it is still considered a very common infectious disease. Neisseria are fastidious Gram-negative cocci that require nutrient supplementation to grow in laboratory cultures. To be specific, they grow on chocolate agar with carbon dioxide. These cocci are facultatively intracellular and typically appear in pairs (diplococci), in the shape of coffee beans. Of the eleven species of Neisseria that colonize humans, only two are pathogens.
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Scope and Importance
Neisseria gonorrhoeae is transmitted from person to person during sexual relations. Traditionally the bacteria was thought to move attached to spermatozoon, but this hypothesis did not explain female to male transmission of the disease. A recent study suggests that rather than “surf” on wiggling sperm, N. gonorrhoeae bacteria uses hairlike structures called pili to anchor onto proteins in the sperm and move through coital liquid. Vertical transmission occurs from mother to child during pregnancy or birth. Consequently, the child contracts gonorrhea in the eyes which can lead to blindness. Culture is the most common diagnostic test for gonorrhea, followed by the deoxyribonucleic acid (DNA) probe and then the polymerase chain reaction (PCR) assay and ligand chain reaction (LCR). The DNA probe is an antigen detection test that uses a probe to detect gonorrhea DNA in specimens. Specific culture of a swab from the site of infection is a criterion standard for diagnosis at all potential sites of gonococcal infection. Cultures are particularly useful when the clinical diagnosis is unclear, when a failure of treatment has occurred, when contact tracing is problematic, and when legal questions arise. In patients who may have DGI, all possible mucosal sites should be cultured (eg: pharynx, cervix, urethra, rectum), as should blood and synovial fluid (in cases of septic arthritis). Three sets of blood cultures should also be obtained.
Geographically, the market is majorly driven by developed economic regions such as North America and Europe owing to presence of large number of point of care tests and high awareness among people with respect to sexually transmitted diseases. In 2013, the total number of new cases of gonorrhea diagnosed in genitourinary medicine (GUM) clinics in England was 29,291. Recently in 2014, a new strain of gonorrhea known as A8806 was reported in Australia which is also multi-drug resistant. Such instances have raised concerns among researchers and government agencies owing to which, number of clinical trials in Asia Pacific region has drastically increased which will eventually boost the demand for diagnostic tests and kits.
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This page was last updated on January 27, 2021