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Neisseria gonorrhoeae (NG)

Taking action to prevent silent transmission

Neisseria gonorrhoeae (NG), also known as gonococcus or GC, is among the most common sexually transmitted infections (STIs), with 87 million new cases annually.1

This bacterial pathogen most commonly causes infection of the throat, anus or urogenital tract, and is acquired through sexual contact. Bacteria invade and attach to host tissue, causing an inflammatory response often leading to a visible discharge.

These bacteria then have the potential to spread upwards through the urogenital tract. This may lead to complications in females that can affect the urethra, cervix, and fallopian tubes. In males, the prostate can be affected. Moreover, these infections may cause infertility for both sexes, along with urogenital symptoms, sores, redness or lesions in the mouth, discomfort, bleeding, or discharge from the anus.

However, the majority of patients do not experience any symptoms at all.

Unique and complex challenges

Urogenital infection is asymptomatic in up to 80% of females and 10 to 15% of males. Pharyngeal and rectal infections are most commonly asymptomatic or have very mild symptoms.2

The asymptomatic nature of NG adds to the complexity of treatment and infection control, as carriers may transmit the bacteria unknowingly. If left untreated, possible complications include pelvic inflammatory disease (PID), adverse pregnancy outcomes, and infertility.3

Clinical microbiology labs play a major role in solidifying infection control. Effective screening of both asymptomatic and symptomatic populations using diagnostic tools can help to contain the silent disease transmission, reduce prevalence, and further improve the understanding of this infection.

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Antibiotic resistance on the rise

The overuse of antibiotics has led to extensively drug-resistant NG strains that are extremely difficult to treat.

NG has shown decreased susceptibility to “last line” treatment options, including oral and injectable cephalosporins. Together with known resistances to penicillin, sulphonamides, tetracyclines, quinolones, and macrolides, NG can be considered a multidrug-resistant organism.4

Preserving last-line antibiotics through diagnostics

There is a need for new molecular diagnostic methods that will allow clinicians to detect and monitor antimicrobial resistance in these multidrug-resistant organisms, enabling better treatment strategies.

International guidelines recommend that the sensitivity data of an infection be known prior to treatment, in order to ensure the most appropriate antibiotic is used for front-line therapy. The susceptibility rates of previously used antibiotics are commonly over 50% and the determination of susceptibility prior to treatment can redirect antibiotic choice and preserve last-line antibiotics for future use.

susceptibility rate for NG
Paving the way for optimized NG treatment

Roche has continued to improve NG testing through advances in automation and accuracy. Roche instruments and assays make it easier to deliver faster, more reliable, and more accurate results.

Advances in molecular diagnostic test design can now provide information on antibiotic susceptibility or resistance. These results support decision-making that drive Resistance Guided Therapy, helping to ensure that the appropriate treatment plan is created.

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    References

    1. Rowley, J. et al. Bulletin of the World Health Organization. 2019;97:548–562P.
    2. Australasian Sexual and Reproductive Health Alliance. Australian STI Management Guidelines. Gonorrhoea. http://www.sti.guidelines.org.au/sexually-transmissible-infections/gonorrhoea#clinical-presentation
    3. Unemo M, Jensen, JS. Nature Reviews Urology. 2017;14(3):139-152.
    4.  Martin, et al. Canada Communicable Disease Report 2019;45(2-3):45–53.