Neisseria gonorrhoeae

Neisseria gonorrhoeae
Gram-stain of gonococcal urethritis. Note distribution in neutrophils and presence of both intracellular and extracellular bacteria. (CDC)
Gram-stain of gonococcal urethritis. Note distribution in neutrophils and presence of both intracellular and extracellular bacteria. (CDC)
Scientific classification Edit this classification
Domain: Bacteria
Phylum: Pseudomonadota
Class: Betaproteobacteria
Order: Neisseriales
Family: Neisseriaceae
Genus: Neisseria
Species:
N. gonorrhoeae
Binomial name
Neisseria gonorrhoeae
(Zopf 1885) Trevisan 1885[1]
Synonyms

Neisseria gonorrhoeae, also known as gonococcus (singular) or gonococci (plural), is a species of Gram-negative diplococci bacteria first isolated by Albert Neisser in 1879.[3] An obligate human pathogen, it primarily colonizes the mucosal lining of the urogenital tract; however, it is also capable of adhering to the mucosa of the nose,[4] pharynx, rectum, and conjunctiva.[5] It causes the sexually transmitted genitourinary infection gonorrhea[6] as well as other forms of gonococcal disease including disseminated gonococcemia, septic arthritis, and gonococcal ophthalmia neonatorum.

N. gonorrhoeae is oxidase positive and a microaerophile that is capable of surviving phagocytosis and growing inside neutrophils.[6] Culturing it requires carbon dioxide supplementation and enriched agar (chocolate agar) with various antibiotics (Thayer–Martin). It exhibits antigenic variation through genetic recombination of its pili and surface proteins that interact with the immune system.[3]

Sexual transmission is through vaginal, anal, or oral sex.[7] Sexual transmission may be prevented through the use of barrier protection.[8] Perinatal transmission may occur during childbirth, though it is preventable through antibiotic treatment of the mother before birth and application of antibiotic eye gel on the eyes of the newborn.[8] Gonococcal infections do not result in protective immunity; therefore, individuals may be infected multiple times. Reinfection is possible due to N. gonorrhoeae's ability to evade the immune system by varying its surface proteins.[9]

Asymptomatic infection is common in both males and females.[8][10] Untreated infection may spread to the rest of the body (disseminated gonorrhea infection), especially the joints (septic arthritis). Untreated infection in women may cause pelvic inflammatory disease and possible infertility due to the resulting scarring.[11] Gonorrhoea is diagnosed through cultures, Gram staining, or nucleic acid tests (i.e. polymerase chain reaction) of urine samples, urethral swabs, or cervical swabs.[12][13] Chlamydia co-testing and testing for other STIs is recommended due to high rates of co-infection.[14]

Antibiotic resistance in N. gonorrhoeae is a growing public health concern, especially given its propensity to develop resistance easily.[15] This ability of N. gonorrhoeae to rapidly adapt to novel antimicrobial treatments has been seen several times since the 1930s, making numerous treatment plans obsolete. Some strains have exhibited resistance to the current ceftriaxone treatments.[16]

  1. ^ Euzéby JP, Parte AC. "Genus Neisseria". List of Prokaryotic Names with Standing in Nomenclature (LPSN). Retrieved 7 July 2017.
  2. ^ Neisser A (1879). "Ueber eine der Gonorrhoe eigentümliche Micrococusform" [About a micrococus form peculiar to gonorrhea]. Centralblatt für die medizinischen Wissenschaften (in German). 17 (28): 497–500.
  3. ^ a b O'Donnell JA, Gelone SP (2009). "Bacterial Cause of PID: Gonorrhoeae". Pelvic Inflammatory Disease. Infobase Publishing. ISBN 978-1-4381-0159-0.
  4. ^ Inaba S, Aizawa Y, Kataoka S, Saitoh A (December 2023). "Purulent nasal discharge due to gonococcal nasopharyngitis in a neonate". Journal of Infection and Chemotherapy. 29 (12): 1164–1166. doi:10.1016/j.jiac.2023.08.005. PMID 37558089.
  5. ^ Mahapure K, Singh A (August 2023). "A Review of Recent Advances in Our Understanding of Neisseria gonorrhoeae". Cureus. 15 (8): e43464. doi:10.7759/cureus.43464. PMC 10498933. PMID 37711920.
  6. ^ a b Ryan KJ, Ray CG, eds. (2004). Sherris Medical Microbiology (4th ed.). McGraw Hill. ISBN 978-0-8385-8529-0.[page needed]
  7. ^ Cite error: The named reference www.cdc.gov_2017 was invoked but never defined (see the help page).
  8. ^ a b c Cite error: The named reference CDC was invoked but never defined (see the help page).
  9. ^ Cite error: The named reference Hill_2016 was invoked but never defined (see the help page).
  10. ^ "Final Recommendation Statement: Chlamydia and Gonorrhea: Screening". U.S. Preventive Services Task Force. Retrieved 7 December 2017.
  11. ^ Cite error: The named reference Lev13th2 was invoked but never defined (see the help page).
  12. ^ Ng LK, Martin IE (January 2005). "The laboratory diagnosis of Neisseria gonorrhoeae". The Canadian Journal of Infectious Diseases & Medical Microbiology. 16 (1): 15–25. doi:10.1155/2005/323082. PMC 2095009. PMID 18159523.
  13. ^ "Gonococcal Infections - 2015 STD Treatment Guidelines". 4 January 2018.
  14. ^ MacKenzie CR, Henrich B, eds. (2012). Diagnosis of sexually transmitted diseases: methods and protocols. Humana Press. ISBN 978-1-61779-936-5. OCLC 781681739.
  15. ^ Quillin SJ, Seifert HS (April 2018). "Neisseria gonorrhoeae host adaptation and pathogenesis". Nature Reviews. Microbiology. 16 (4): 226–240. doi:10.1038/nrmicro.2017.169. PMC 6329377. PMID 29430011.
  16. ^ Costa-Lourenço AP, Barros Dos Santos KT, Moreira BM, Fracalanzza SE, Bonelli RR (1 October 2017). "Antimicrobial resistance in Neisseria gonorrhoeae: history, molecular mechanisms and epidemiological aspects of an emerging global threat". Brazilian Journal of Microbiology. 48 (4): 617–628. doi:10.1016/j.bjm.2017.06.001. PMC 5628311. PMID 28754299.