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Register NowNeisseria gonorrhoeae, Genital Culture (GC) Only
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CPT Code:
87081
Overview:
Isolate and identify N gonorrhoeae; establish the diagnosis of gonorrhea.
Cultures are usually evaluated only for Neisseria gonorrhoeae. No other organisms are identified. Overgrowth by Proteus and yeast may make it impossible to rule out presence of N gonorrhoeae. The vancomycin in Thayer-Martin media may inhibit some strains of N gonorrhoeae. Nongonococcal urethritis may be caused by Ureaplasma urealyticum, Corynebacterium genitalium type 1, Trichomonas vaginalis, Chlamydia trachomatis, herpes simplex virus, and (rarely) Candida albicans.
In a study of 1001 women consecutively seen at a venereal disease clinic, endocervical culture was positive in 88.4%, urine sediment 72%, and anal canal 22.8%. The prevalence of gonorrhea in the study population was 28.5%.1 A serologic test for syphilis (VDRL, RPR, or ART), HIV, and cervical/vaginal cytology should be considered in patients suspected of having gonorrhea. Throat culture for GC was found to have little contribution to the further recovery of N gonorrhoeae over culture of the urethra, cervix, and anus.2
1. Chapel TA, Smeltzer M. Culture of urinary sediment for the diagnosis of gonorrhea in women. Br J Vener Dis. 1975 Feb; 51(1):25-27. PubMed 804957
2. Brown RT, Lossick JG, Mosure DJ, Smeltzer MP, Cromer BA. Pharyngeal gonorrhea screening in adolescents: Is It necessary? Pediatrics. 1989 Oct; 84(4):623-625. PubMed 2780123
Judson FN. Gonorrhea. Med Clin North Am. 1990 Nov; 74(6):1353-1366. PubMed 2123279
Rajasekariah GR, Edward S, Shapira D, et al. Direct detection of Neisseria gonorrhoeae with monoclonal antibodies characterized by serotyping reagents. J Clin Microbiol. 1989 Jul; 27(7):1700-1703. PubMed 2475525
Roongpisuthipong A, Lewis JS, Kraus SJ, Morse SA. Gonococcal urethritis diagnosed from enzyme immunoassay of urine sediment. Sex Transm Dis. 1988 Oct-Dec; 15(4):192-195. PubMed 3147523
Schoone GJ, Cornelissen WJ, Veenhuijsen PC, Schöneman CE, Terpstra WJ. Comparison of dot blot with in situ hybridization for the detection of Neisseria gonorrhoeae in urethral exudate. J Appl Bacteriol. 1989 May; 66(5):401-405. PubMed 2502529
Thomason JL, Gelbart SM, Sobieski VJ, Anderson RJ, Schulien MB, Hamilton PR. Effectiveness of gonozyme for detection of gonorrhea in low-risk pregnant and gynecologic populations. Sex Transm Dis. 1989 Jan-Mar; 16(1):28-31. PubMed 2502866
Young H, Moyes A. Utility of monoclonal antibody coagglutination to identify Neisseria gonorrhoeae.Genitourin Med. 1989 Jan; 65(1):8-13. PubMed 2493423
Collection Details:
Collection Instructions:
Jembec (available from the laboratory) or Thayer-Martin plate (client-provided) are preferred. Prewarm plate before inoculation. Bacterial swab transport containing Amies gel is also acceptable.
Do not collect urethral specimens until at least one hour after urinating. Collection directly from male urethral discharge is desirable. Collect anorectal specimens from the crypts just inside the anal ring; anoscopy useful. Prostatic fluid yields fewer positives than does urethral culture.
Endocervix: Swab endocervical canal. Avoid contaminating swab with vaginal secretions. Cultures from the urethra or vagina are indicated from females when endocervical culture is not possible.
Urethra: Strip the urethra toward the orifice to express exudate. Use a sterile swab to obtain the specimen.
Vagina: Use a speculum, moistened only with warm water, not lubricant. Obtain a specimen from the posterior vaginal vault or from the vaginal orifice if the hymen is intact.
Swab samples should be rolled over the surface of the Jembec medium.
Inoculated Thayer-Martin plates should be placed in a CO2 incubator or candle jar within 15 minutes of collection. For Jembecs, remove a CO2-generating tablet from its foil wrapper and place in the specially-designed well in the plate. Place inoculated plates in the ziplock bag and seal the bag. Jembecs should be preincubated at 35°C, if possible, prior to shipment at room temperature.