Gonococci, or Neisseria gonorrhoeae, is the bacterium that causes gonorrhea, a common sexually transmitted infection (STI). This Gram-negative diplococcus appears as pairs of round bacteria under a microscope and does not retain a specific stain used in laboratory tests.
How Gonococci Spread
Gonococci primarily spread through sexual contact, including vaginal, anal, and oral sex. The bacteria colonize mucosal linings. Transmission requires direct intimate contact because the bacteria are sensitive to environmental changes. Neisseria gonorrhoeae can also be transmitted from a pregnant individual to their baby during childbirth. Pregnant individuals are often advised to be tested for gonococcal infection before birth, given the high rate of asymptomatic infections.
Signs and Symptoms of Infection
Many individuals, especially women, experience no symptoms. When symptoms appear, they can be mild and mistaken for other conditions, like bladder or vaginal infections. This asymptomatic nature makes regular testing important.
Symptoms vary depending on the infected area. In men, these include burning urination, penile discharge (white, yellow, or green), and painful or swollen testicles. Women may experience burning urination, increased vaginal discharge, and bleeding between periods.
Rectal infections can cause discharge, anal itching, soreness, bleeding, or painful bowel movements. Oral infections may present as a sore throat, and eye infections can cause redness, itching, and discharge.
Diagnosis and Treatment Approaches
Diagnosis involves specific laboratory tests. Common methods include nucleic acid amplification techniques (NAATs), which detect the bacteria’s genetic material from urine samples or swabs taken from affected areas (e.g., urethra, cervix, rectum, throat). While culture methods are used, NAATs are preferred for speed and sensitivity. A Gram stain of urethral exudate showing Gram-negative diplococci can also diagnose gonococcal urethritis.
Treatment primarily involves antibiotics. The Centers for Disease Control and Prevention (CDC) provides guidelines, often recommending combination therapy with two antimicrobial agents (e.g., ceftriaxone by injection and azithromycin by mouth). Sexual partners of infected individuals should also receive treatment to prevent reinfection and further spread. A challenge in treating gonococcal infections is the development of antibiotic resistance by Neisseria gonorrhoeae, requiring adherence to current treatment guidelines.
Preventing Gonococcal Infection
Prevention involves several measures. Consistent condom use during sexual activity reduces transmission risk. Condoms act as a barrier, preventing the exchange of bodily fluids.
Regular STI testing is important, especially for sexually active individuals or those with new or multiple partners. Since many infections are asymptomatic, testing helps identify and treat infections early, preventing further spread. Open communication with sexual partners about sexual health also contributes to prevention.
Complications of Untreated Infection
Untreated gonococcal infection can lead to serious health consequences. In women, untreated infection can ascend to the uterus and fallopian tubes, causing pelvic inflammatory disease (PID). PID can result in chronic pelvic pain, ectopic pregnancy, and infertility.
For men, untreated infection can lead to epididymitis, an inflammation of the coiled tube at the back of the testicle, which may cause infertility. Untreated gonococcal infection can also increase an individual’s susceptibility to acquiring or transmitting HIV. In rare cases, the bacteria can spread through the bloodstream, leading to disseminated gonococcal infection (DGI), which causes symptoms like rash, fever, joint pain, and more severe conditions like septic arthritis or endocarditis.