Neisseria gonorrhoeae – Culture, Reference Identification and Susceptibility
Consistent with O. Reg. 671/92 of the French Language Services Act, laboratory testing information on this page is only available in English because it is scientific or technical in nature and is for use only by qualified health care providers and not by members of the public.
Specimen Requirements
| Test Requested | Required Requisition(s) | Specimen Type | Minimum Volume | Collection Kit |
Neisseria gonorrhoeae / GC culture |
Genital, non-genital swabs (rectal, throat/ pharyngeal, conjunctival scrapings/swabs) |
Swab |
||
Neisseria gonorrhoeae / GC culture |
Sexual abuse and/or sexual assault cases in peri-pubertal and pre-pubertal children, including rectal, throat/pharyngeal vaginal, and urethral swabs |
Swab |
||
Neisseria gonorrhoeae / GC culture |
Joint fluids/aspirates |
1.0 mL of fluid |
Sterile container |
|
Neisseria gonorrhoeae identification and/or confirmation, antimicrobial susceptibility |
Pure subculture of suspected organism |
Swab |
Submit a pure subculture of the organism on the appropriate selective media agar (e.g. chocolate agar) plate or in the GC kit / Neisseria gonorrhoeae culture kit order # 390051 |
Submission and Collection Notes
The PHO GC, Neisseria gonorrhoeae culture charcoal kits are the optimal collection kit. A bacteriological transport kit without charcoal is also acceptable.
Unsuitable specimens: Urine and seminal fluid are not acceptable specimen sites for Neisseria gonorrhoeae culture. Dry swabs and multi-organism transport kits are not acceptable collection kits for Neisseria gonorrhoeae culture and testing will not be performed.
Do not use expired kits.
Limitations
Storage and Transport
Label the specimen container with the patient’s full name, date of collection, and one other unique identifier such as the patient’s date of birth or Health Card Number. Failure to provide this information may result in rejection or testing delay.
Special Instructions
Specimens should be stored at room temperature or incubated at 35-37°C after collection and shipped at room temperature. Transport to the laboratory as soon as possible. Culture specimens must be received at the testing laboratory within 72 hours of collection. Presumptive growth on plated media should be sent in as is, as soon as possible, to conserve organism integrity.
Follow the instructions found in the Neisseria gonorrhoeae culture Kit Instruction Sheet.
Test Frequency and Turnaround Time (TAT)
Neisseria gonorrhoeae culture is performed daily, Monday to Saturday.
Turnaround time is up to 5 days from receipt by PHO laboratory.
Specimens are tested by routine bacterial culture methods.
Confirmation and susceptibility testing is done on all Neisseria gonorrhoeae positive specimens.
Algorithm
Routine culture reports are provided at 48 hours post incubation. A further report will follow if the organism is isolated after 72 hours incubation.
Interpretation
Routine culture results may be interpreted as isolated or not isolated.
Reference identification results will be reported as Neisseria gonorrhoeae or Not Neisseria gonorrhoeae after confirmation testing is done.
Reporting
Results are reported to the ordering physician or health care provider as indicated on the requisition.
Critical positive reports (results from body fluids/aspirates, tissues, CSF or specimens from pregnant patients, infants, pre-pubertal children, i.e. ≤ 12 years and medico-legal specimens, i.e. pre-pubertal children, sexual abuse in peri-pubertal and pre-pubertal children, sexual assault and legal cases) are phoned and faxed if the client is registered for auto fax.
All other positive reports are phoned or faxed to the ordering physician if the client if registered for auto fax.
Specimens that are positive for Neisseria gonorrhoeae are reported to the Medical Officer of Health as per the Ontario Health Protection and Promotion Act.
Additional Information
Medico-legal specimens
Culture is the specimen of choice for all potentially medico-legal specimens, i.e. pre-pubertal children, sexual abuse in peri-pubertal and pre-pubertal children, sexual assault and legal cases. Legal specimens should be transported to the laboratory under legal seal; contact the Medical Microbiologist prior to specimen collection.
Test of Cure (TOC)
General guidelines for Neisseria gonorrhoeae Test of Cure (TOC) are described below. Refer to the PHAC Canadian Guidelines on Sexually Transmitted Infections for detailed information.
TOC is recommended for all positive cases of gonorrhea regardless of the specimen collection site.
Culture is the preferred method for test of cure and should be performed 3-7 days after completion of treatment. If culture is not available, test of cure by NAAT will also be accepted and should be performed 2-3 weeks after completion of treatment. Repeat screening is recommended 6 months post-treatment for all individuals with Neisseria gonorrhoeae infection.
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