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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


The infection is caused by a bacterial pathogen that initially infect host tissue in the urethra, anus, or throat, through sexual contact. Once inside the urethra, the 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 of males and females. This may lead to complications in women that can affect the urethra, cervix and fallopian tubes. In men, 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.

 

Signs and symptoms

Stopping the spread of Neisseria gonorrhoeae can be a difficult task, and the asymptomatic nature of the infection poses an additional challenge. While there may be some signs to watch out for, regular STI screening is still advised to limit transmission.

Neisseria-Gonorrhoea-signs-and-symptoms-infographic

 

Unique and complex challenges


Up to 80% of women and approximately 10% of men with gonorrhoea
are asymptomatic.3

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.4


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.

Antibiotic resistance on the rise

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


Neisseria gonorrhoeae 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.5

Close-up-of-assays-in-instrument

 

Paving the way for optimized NG treatment

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


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.



References

  1. Rowley, J. et al. Bulletin of the World Health Organization. 2019;97:548–562P.
  2.  CDC. Gonorrhea - CDC Fact Sheet (Detailed Version). https://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea-detailed.htm. Accessed 16 March 2020.
  3.  Budkaew, et al. PLoS One. 2019;14(4):e0211682.
  4. Unemo M, Jensen, JS. Nature Reviews Urology. 2017;14(3):139-152.
  5.  Martin, et al. Canada Communicable Disease Report 2019;45(2-3):45–53.
  6. Eyre DW et al. Euro Surveill. 2019;24(10):pii=1900147.
  7. Harris SR et al., Lancet Infect Dis 2018; 18:758-68.
  8. Lahra M, et al. Commun Dis Intell. 2017;41(1):E60–E67.
  9.  Heffernan H et al. Antimicrobial resistance and molecular epidemiology of gonococci in NZ, 2014-5