GM TestGonorrhea - Smears (Neisseria gonorrhoeae)

Submission only by Local Health Departments Gram stain smears of the cervix and/or urethra are recommended when patients have signs and symptoms of urethral or cervical infection or are contacts to known cases of N. gonorrhoeae. Female smears should be collected in conjunction with a culture.

When a Gram stain cannot be performed on site, a slide of exudate material and/or a slide from an oxidase positive colony may be sent to the OSPHL to aid in a "presumptive" diagnosis of N. gonorrhoea. Sites other than cervix or urethra require confirmation testing.

Collection Instructions

1. Direct Patient Smear

a. Male Urethra - Use of a sterile calcium alginate swab (nasopharyngeal swab) is preferred when obtaining a specimen from the anterior urethra. Allow a few seconds for absorption of the organisms.

A sterile bacteriologic wire loop may be used as an alternative by gently scraping the anterior mucosa. Carefully roll the swab on the slide so as not to disrupt cells. Air dry. Prepare two slides and package as instructed below. A culture is indicated:

1. when a Gram stain of urethral exudate is negative,
2. in tests of cure, or
3. as a test for asymptomatic urethral infections.

b. Female Cervix (Endocervical Canal) - Insert speculum which has been moistened only with warm water. Remove excess cervical mucus with a sterile cotton swab, cotton ball or gauze. Insert another sterile cotton-tipped swab into endocervical canal; move swab from side to side allowing 10-30 seconds for absorption of organisms. Carefully roll the swab on the slide so as not to disrupt cells. Air dry and package as instructed below.

2. Culture Smear

Carefully select one oxidase positive colony resembling N. gonorrhoeae and remove it from the culture plate either with a sterile wire loop or sterile swab. Place a small drop of saline or distilled water on a slide and carefully disperse the organisms. Air dry. Package as instructed below.

Place slides in a plastic slide holder. Wrap the completed request form around the holder and secure form lengthwise with a rubber band. Place slide holder and form into the mailing container provided. Affix proper postage and mail promptly.


Reports

Smears are read the day of or the day following receipt of the specimen in the OSPHL, Monday through Friday. The Smear Report aids a presumptive positive diagnosis. If definitive testing is needed, submit a culture for confirmation.

References

1. Belsey R. E., Skeels M. R., Baer, D. M. and Koneman, E. W.: Basic Office Microbiology. Oradell, N. J.: Medical Economics Books, 1990: pp. 193-200.

2. Centers for Disease Control and Prevention. 1993 Sexually Transmitted Diseases Guidelines. MMWR 1993; 42 (No.RR-14): pp. 56-60.

3. U. S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention. May, 1991: pp. II - 3, 4, III - 13.