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Subspecialties Microbiology and immunology, Guidelines and recommendations, Clinical care, Point of care testing

Gonorrhea: A Rising Resistance

What are the main issues with Neisseria gonorrhoeae diagnosis?

SS: The best diagnostic assays are molecular tests, but they don’t give us information on antimicrobial sensitivity. Patients often present without symptoms, so physicians don’t take samples for culture – and N. gonorrhoeae is also less likely to culture when the organism load is low. This means that many patients lack sensitivity information. Molecular assays to determine treatment resistance could help, because they are quicker and more sensitive than culture.

TS: Sensitivity and specificity can be a challenge when diagnosing gonorrhea. Microscopy is poorly sensitive in determining the presence of infection, except for perhaps when it occurs in the urethra in men. Specificity can be a problem for molecular tests in extragenital infections due to the presence of other Neiseria species, and confirmatory testing is usually required.

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About the Authors

Suneeta Soni

HIV and Sexual Health Consultant and co-author of the British Association for Sexual Health and HIV National Guidelines for the Management of Infection with Neisseria gonorrhea.


Tariq Sadiq

Consultant Physician in Sexual Health and HIV Medicine and co-author of the British Association for Sexual Health and HIV National Guidelines for the Management of Infection with Neisseria gonorrhea.

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