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Neisseria gonorrhoeae is gram-negative bacteria that causes infections in the urethra, cervix, vagina, or anus. It is one of the two most common STDs in the United States along with chlamydia. If left untreated, gonorrhea infections can spread in the reproductive tract, causing prostatitis and epididymitis in men, or pelvic inflammatory disease (PID) in women.
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The World Health Organization (WHO) estimates that there are 88 million new cases of gonorrhea each year. It is common for infected individuals to be asymptomatic and unknowingly spread the disease. Asymptotic infections along with the emergence of multidrug-resistant N. gonorrhoeae, present a significant challenge in controlling the disease. If left untreated, gonorrhea may last for weeks or months with a high risk of complications such as infertility in both men and women, infection in the joints and other areas of the body, and an increased risk for HIV/AIDS.
Women with gonorrhea infections before or during pregnancy are also at increased risk for pregnancy complications such as stillbirth and premature birth. In addition, babies can become infected with gonorrhea during the birth process, leading to eye and joint infections and possible life-threatening blood infections. Men who have had a gonorrhea infection have a significantly increased risk of having prostate cancer.
Traditionally, gonorrhea is diagnosed with gram stain and culture as they have 100% specificity; however, newer tests including NAAT and rapid antigen detection assays are gaining popularity. Significant disadvantages of culture include variable sensitivity, complex logistics, and slow turnaround times and new tests need to have improved sensitivity, ease of handling, and rapid processing. All gonorrhea tests use urine sample or a swab from the site of potential infection, often the urethra, cervix, mouth, or rectum.
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