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Gonorrhea: rapid diagnosis of gonorrhea in urethral secretions
Medical expert of the article
Last reviewed: 05.07.2025
Gonococci cause purulent inflammation of the genital tract - gonorrhea. The difficulty of their detection lies in their weak viability, which does not allow for the widespread use of the bacteriological method (it gives positive results in 20-30% of cases). The Gram staining method of smears taken from the cervical canal in women before the start of antibacterial therapy has a sensitivity of 45-65%, for smears from the urethra - 16%, with a specificity of more than 90%. Staining smears from the urethra in men has a sensitivity and specificity of more than 95% in the presence of clinical manifestations of the disease, without clinical manifestations - 69% and 86%, respectively.
In recent years, serological diagnostic methods have become widespread. They give positive results not only in acute forms of the disease, but also (most importantly) in protracted and chronic processes, as well as in complicated gonorrhea.
The method is based on the detection of Neisseria antigens in scrapings from the urethra, cervical canal and conjunctiva using the ELISA method with visual assessment of the result. This method, based on the presence of a genus-specific lipopolysaccharide antigen in Neisseria, allows for rapid screening of the pathogen. The results of the study are a positive or negative answer. To obtain satisfactory results, it is necessary to follow certain rules: the material must be correctly taken (scraping) and delivered to the laboratory in a timely manner (within 2 hours). The method has high sensitivity (more than 80%) and specificity (more than 97%).
The test allows diagnosing gonococcal infection in urethritis, prostatitis, vaginitis, cervicitis, adnexitis.
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