Neisseria gonorrhoeae – Culture, Reference Identification and Susceptibility

Specimen Collection and Handling

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

GC kit / Neisseria gonorrhoeae culture kit order # 390051

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

GC kit / Neisseria gonorrhoeae culture kit order # 390051

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

1

The PHO GC, Neisseria gonorrhoeae culture charcoal kits are the optimal collection kit.  A bacteriological transport kit without charcoal is also acceptable.

2

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.

3

Do not use expired kits.

Limitations

Preparation Prior to 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.T ransport 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.

Requisitions and Kit Ordering

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.

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.

Test Methods

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.

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)

Test of Cure for Chlamydia trachomatis/Neisseria gonorrhoeae is not routinely indicated.  Repeat testing is recommended in the following scenarios:

  1. when compliance is difficult to ensure (e.g. failure to take or finish medication),
  2. if an alternative treatment has been used,
  3. in all pre-pubertal children,
  4. in all pregnant women, and
  5. in all cases of pharyngeal gonorrhea.

The optimal specimen for test of cure is culture and should be performed at 1-2 weeks after completion of treatment. If culture is not available, test of cure by NAAT will also be accepted. Test of cure for GC should be performed 2-3 weeks after completion of treatment.

contact lab

Contact Laboratory Customer Service

Laboratory Services

customerservicecentre@oahpp.ca

Updated 4 Jan 2019