- "For the microbiologic diagnosis
of gonorrhea, culture is necessary for
anti-microbial susceptibility testing, due to the
large numbers of resistant strains.
- In males, the diagnosis is based upon
Gram staining of a urethral exudate.
- The
presence of intracellular Gram-negative
diplococci is diagnostic of gonorrhea.
- In females,
the normal flora of the vagina confounds direct
diagnosis by Gram stain.
- Culture is required.
- Due to the fact that N. gonorrheae is
rapidly killed by drying, the culture plate must
be streaked in the examination room.
- A Thayer-Martin (or
equivalent) bi-plate is normally used.
- The left side of the plate contains
chocolate agar, whereas the right side of the
plate contains chocolate agar plus antibiotics.
- This inhibits normal flora and
allows primarily the gonococcus to grow.
- Occasional strains of gonococcus
will be resistant to the antibiotics in the agar,
so both sides must be streaked."
- Some institutions have recombinant DNA
test for the gonococcus that eliminates the need
for Thayer-Martin plates, but you may still have
to use this culture method in many hospitals or
clinics.
- Ó
1999 KUMC Pathology and the University of Kansas,
used with permission; courtesy of Dr. James
Fishback, Department of Pathology, University of
Kansas Medical Center.
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