What Are the Examination Items for Gonorrhea?

There are many types of sexually transmitted diseases (STDs), and gonorrhea is a common one. Once infected with gonorrhea, not only will the body's immunity decline, but it can also lead to damage to adjacent organs. Early detection and treatment of gonorrhea are crucial. Before treating gonorrhea, relevant tests need to be conducted to determine the severity of the disease. Based on the patient's physical condition and the severity of the illness, targeted treatment can then be administered.

1) Smear Examination: A urethral secretion sample is taken from the patient and stained with Gram's stain. Gram-negative diplococci are searched for within polymorphonuclear leukocytes. The positive rate for smear examination is around 90% for patients with uncomplicated gonorrhea who have a large amount of purulent secretion. However, for patients with chronic gonorrhea with less secretion, the positive rate is lower. Therefore, prostatic massage fluid may need to be taken to improve the detection rate.

2) Culture Examination: Gonococcal culture is an important adjunct to diagnosis. Culture is a sensitive method for both asymptomatic and symptomatic male and female patients, and a positive culture can confirm the diagnosis. Before the advent of genetic diagnosis, culture was the only method recommended by the World Health Organization for screening for gonorrhea.

3) Antigen Detection: There are two types of antigen detection methods. One is the solid-phase enzyme immunoassay, which can be used to detect gonococcal antigens in clinical specimens. The other is the direct immunofluorescence test, which detects monoclonal antibodies against the outer membrane protein I of gonococci. The former can be used to diagnose gonococcal infection in women, while the latter is not yet recommended.

4) Antibiotic Sensitivity Test: After a positive culture, a drug sensitivity test is further conducted. The disk diffusion method is used for sensitivity testing, or the agar plate dilution method is used to determine the minimum inhibitory concentration (MIC), which can guide the selection of antibiotics.

5) PPNG Detection: β-lactamase can be detected using the paper acidity quantitation method. The Whatman I filter paper is used, and PP-NG strains can change its color from blue to yellow. A positive result indicates PPNG, while a negative result indicates N-PPNG.

For patients with gonorrhea, there are many aspects that need to be paid attention to in daily life, such as diet and the characteristics of gonorrhea itself. It is essential for patients with gonorrhea to have a certain understanding of these aspects, which can play a significant role in treatment or preventing recurrent relapses.