How are men and women tested for gonorrhea? preparation and decoding. How to choose the right analysis for gonorrhea What analysis is given for gonorrhea

Gonorrhea, or gonorrhea, is considered one of the most common sexually transmitted diseases. Against the background of active antibiotic therapy, the frequency of complications has recently decreased significantly. But at the same time, improper treatment of the disease, lack of examination before therapy leads to a large number of atypical and asymptomatic forms, so laboratory diagnosis of gonorrhea is very important.

Laboratory diagnosis of gonorrhea uses the following methods by which pathology can be determined.

• express test (they detect the pathogen by the method of counter electrophoresis);
• bacterial (bakposev is carried out by growing a culture of the pathogen);
• microscopic analysis of the microbes contained in the smear;
• immune fluorescence reaction;
• linked immunosorbent assay;
• calculus binding reaction;
• polymerase chain reaction;
• provocation in gonorrhea is used to identify a chronic variant of the course.

Each of these methods has its own advantages and disadvantages.

Is it advisable to do a rapid test

This diagnostic examination is very simple and can be done at home. Outwardly, such an analysis for gonorrhea is similar to a pregnancy test. In the same way, the decoding of the analysis for gonorrhea occurs: if there is one strip, then this indicates a negative result - the absence of gonococcus. The presence of two strips indicates that the test for gonorrhea is positive.

Is it advisable to do such an analysis for gonorrhea in women? Their reliability is quite high, and they should not be neglected. Diagnosis is simple: in the presence of an antigen-antibody complex, the second strip is stained.

It is not worth relying completely on the results of such testing. The fact is that a similar complex of antigen and antibody can also be formed in the presence of other types of microorganisms, and the decoding of such a test will be incorrect. There are cases when the resulting antigen-antibody complex is not enough to stain the strip. Therefore, patients need to take other types of tests.

What is smear microscopy

In order to take a smear, it is necessary to collect secreted from the urethra, vagina, cervix and rectum. This diagnosis will be reliable if the patient adheres to the following recommendations:

• approximately 4-5 days before the analysis, stop taking antibacterial drugs;
• for at least three hours before taking a smear, refrain from urinating.

The optimal time for taking a smear for women is the initial days of the menstrual cycle.

The smear is taken twice. The first is stained with methylene blue (or a brilliant green solution - it gives a more intense color). The other smear is stained using the Gram method. Deciphering the analysis after the Gram stain gives more accurate data, because this way it will be possible to determine the infection with gonococci.

The disadvantage of this technique is that its sensitivity varies greatly. The reliability of determining the disease with gonorrhea using Gram stain reaches 92 percent.

Features of the bacterial method

Tank culture for gonorrhea is currently the gold standard in the detection of infectious pathologies, including gonorrhea. The essence of the analysis on the flora is that the discharge from the genitourinary organs is placed in a nutrient medium. There are favorable conditions for the formation of a colony of microorganisms. With the help of a survey on the flora, you can reliably detect the presence of gonococcus. These are the conditions:

• increased concentration of carbon dioxide;
• high temperature - 37 degrees;
• nutrient content.

If a smear on the flora showed that the number of bacteria has increased significantly, this indicates that there is an infection in the body. The advantage of the flora analysis is that it gives almost a hundred percent correct result. False-positive test results can be very pronounced.

Today, bacteriological examination for flora is the most common among many diagnostic centers.

Advantages and disadvantages of RIF

The enzyme immunoassay method is not widely used today. During the course of the diagnosis, the presence or absence of antibodies is detected. Such an analysis can also detect dead pathogens of gonorrhea. This is the disadvantage of this method of diagnosing gonorrhea - it shows a positive result if the immune system has overcome the causative agents of this disease.

The advantages of RIF are that it detects a very high sensitivity and almost complete specificity. Despite the advantages, RIF is currently used by a limited number of clinics and diagnostic centers.

Significance of PCR in the detection of gonorrhea

PCR for gonorrhea is an accurate and highly informative way to diagnose this sexually transmitted disease. When diagnosing, the DNA of the gonococcus is determined. Just like a smear on the flora, it is very informative. If a patient is suspected of having gonorrhea, DNA will be detected within a few days.

The method is associated with some inconveniences. First of all, the high cost of such an examination should be mentioned. Research is also difficult to access for residents of small towns.

Blood analysis

A blood test for gonorrhea is more likely to rule out the disease. Gonococcus forms antigens of different classes in the blood. Their presence in the serum is detected a week after infection. The peak value of antigens is observed in the second week from the onset of pathology. Then the titer gradually decreases.

Blood for gonorrhea should be donated in cases where acute symptoms of pathology are observed: pain and pain during urination and an increase in overall body temperature. The presence of sepsis is also an unconditional indication for such a diagnosis.

But with chronic gonorrhea, there is no need to conduct a blood test. It still won't show anything. It is possible to determine the presence of such a pathogen by a blood test if the doctor uses the ELISA method.

Features of analyzes in men

An analysis for gonorrhea in men is performed using a urological smear. The indications for such an examination are as follows:

• the presence of secretions;
• sharp pain during and after urination;
• the appearance of swelling of the genitals;
• the presence of rashes on the skin and mucous membranes;
• frequent urge to urinate, especially when the amount of urine excreted is small;
• inflammation of the prostate, seminal vesicles;
• partner has an infection.

More accurate is the definition of the pathogen using the polymerase chain reaction. In this case, the infection can be accurately determined in the asymptomatic variant of the pathology.

Before taking a smear, a man should refrain from intimate contact for one or two days. In the evening you have to take a shower. In the morning, you should refrain from going to the toilet for several hours. Before taking a smear, it is necessary to toilet the genitals: remove plaque from the head of the penis.

To take a smear, a urological instrument is inserted into the urethra to a depth of several centimeters. In this case, you can take a sufficient amount of biological material for its study.

Analysis during pregnancy

Gonorrhea during pregnancy is a serious but treatable infection. Its danger is as follows:

• there is a high probability of miscarriage;
• there is a risk of premature birth;
• during pregnancy, infection of the amniotic fluid is possible;
• possible intrauterine infection of the child.

If gonorrhea is not treated during pregnancy, then the female body becomes extremely vulnerable to other infectious pathologies.

The doctor decides how to determine a dangerous disease based on the patient's complaints and anamnesis analysis. Examination for gonococcal infection during pregnancy is prescribed for all women who first applied to the antenatal clinic. The ideal option is to pass the necessary tests even before planning a child. For analysis, the doctor takes a smear from the urethra and cervix. During pregnancy, this procedure is safe for the woman and the fetus. In some cases, a urine test is performed instead of a smear.

If the results of the diagnosis are positive, then the woman will certainly be prescribed treatment. Please note that the choice of drugs for the treatment of gonococcal infection is limited. But with a timely visit to the doctor and the implementation of all his recommendations, a complete recovery is possible.

You should not be afraid of tests for a dangerous sexually transmitted disease, which is gonorrhea. Timely access to a doctor and the start of treatment can prevent the development of dangerous complications. Timely and complete analysis during pregnancy is especially important. You should not be afraid of disclosing the analyzes, because they are strictly confidential.

Gonorrhea is still a fairly common disease. So according to the main statistics at the moment, about 200 million adults suffer from this disease.

“What is gonorrhea? How does it manifest itself? What tests for gonorrhea exist? These are the questions that will be discussed in this article.

Gonorrhea and the main features of its incidence

Gonorrhea is an infectious disease belonging to the group of venereal pathology, which is transmitted sexually and is accompanied by damage to the structures of the genitourinary system.

The causative agent of gonorrhea is the diplococcus Neisseria gonorrhoeae, which has a specific bean-shaped shape and is located inside the cells. The source of infection is a sick person or a carrier. Transfer is carried out using three ways:

1. sexual, when during sexual contact the infection is transmitted from an infected partner to a healthy one, while gonococcus can be infected with absolutely all types of sexual contact;
2. household, when infection occurs when using common hygiene and household items: towels, underwear and bed linen, washcloths;
3. vertical - this is the path of infection from an infected pregnant mother to the fetus, which can lead to the development of gonoblenorrhea, followed by the formation of blindness.

Description of the clinical picture of gonorrhea

When infected with gonococcus, inflammatory processes develop in the mucous membranes of the organs of the genitourinary system, rectum, oropharynx, conjunctiva of the eyes. Gonorrhea in men can occur with a clinical picture of urethritis, prostatitis, orchitis, epididymitis. In females, this infection is most often manifested by cervicitis, urethritis, cystitis.

The first signs of infection develop within 3-7 days from the moment of penetration of the pathogen. Then there is the development of a complete clinical picture, the manifestations of which do not go away within 3-4 weeks. After this period, either a complete cure occurs, or recovery with the presence of residual effects, or the infection acquires a chronic course.

In the clinical picture of gonorrhea, there is a triad of symptoms that are always present in such patients:

• burning and itching, aggravated during the process of urination;
• a feeling of pain that occurs when urinating;
• the presence of purulent secretions of a dirty yellow color.

The presence of these three symptoms, even without any research, helps to suspect a gonorrhea infection!

Diagnostic search for gonorrhea

The diagnosis of "gonorrhea" is made on the basis of the patient's complaints specific to this disease, information about the anamnesis of life and disease, and the results of an instrumental examination. Moreover, tests for gonorrhea in men are not fundamentally different from tests for gonorrhea in women.

So, to establish this ailment, the following studies are used:

• a general urine test and a blood test for gonorrhea, in which there will be changes indicating the presence of an inflammatory process in the body (an increase in the number of leukocytes and especially the neutrophil fraction, an increase in ESR). It should be remembered that blood for gonorrhea should be taken on an empty stomach and preferably in the morning!
• blood chemistry;
• smear microscopy is the most widely used method, with a specificity of 90%. For this study, you need to take a smear of discharge from the urethra in men, and in women - from the vagina, cervical and urethra. Taking a smear in men has some difference in comparison with taking material from female representatives due to the peculiarities of the anatomical structure. The sampling of material from the faces of the strong half is carried out using a special probe, which is inserted into the urethra. This procedure is quite painful and unpleasant. After preparing the smear, they are stained according to Gram and microscopy. When examining the resulting preparation with magnifying instruments, one can see bean-shaped diplococci, painted blue against a background of bluish cytoplasm;
• cultural method or carrying out bacteriological crops on special nutrient media, which reveals the growth of a bacterial culture on a particular medium and determines sensitivity to various types of antibiotics;
• enzyme immunoassay, which detects antigens and antibodies to gonococci, which allows you to determine the stage of the disease;
• PCR - diagnostics - the most accurate and fastest method for determining the causative agent of gonorrhea, based on the detection of gonococcal DNA in the studied materials. The reliability of the method is 95%!

Analysis of the results

The absence of gonorrhea can be said if the antigens and DNA of the gonococcus are not detected, the sowing did not give any growth of the culture, and the causative agent was not detected in the smear during microscopy.

In the case of the detection of antigens, DNA elements and the gonococci themselves in the smear, as well as with the growth of the culture on nutrient media, one can safely make the diagnosis of gonorrhea.

Diagnosis of gonorrhea is not difficult, but this disease is better to prevent than to treat later!

Questions about how a smear is taken for gonorrhea in women and men are of concern to patients suffering from pelvic inflammatory disease. Consider what types of tests are used to determine the infection and how to prepare for the delivery of biological material.

There are several methods to detect infection. The most accurate of these is the PCR method. Which tests to choose for diagnosis, the attending physician decides. To confirm the complete disposal of gonorrhea, various types of tests for gonococci will have to be taken several times.

How to prepare for the analysis

In order for urine analysis to show only those pathogenic organisms that are inside the urinary system, it is necessary to carry out procedures to maintain hygiene of the external genital organs before collecting it. When urinating, men should pull the skin fold on the penis to free the external opening of the urethra.

Women are advised to insert a tampon into the vagina after washing. Then the pathogenic microflora from the internal genital organs will not enter the urine, and after receiving the result it will become clear whether the bladder is affected by the infection or it has not yet had time to populate the urinary system. During menstruation, urine cannot be collected.

Analyzes at the end of treatment are given after provocation. This is the name of the action that stimulates the release of gonococci on the walls of those mucous tissues, from where the pathogen is detected bacterioscopically or culturally when taking biomaterials. Provocation can be carried out in several ways. Your doctor may give you an injection of inactivated gonococcal vaccine a few days in advance. Men are advised to drink alcohol and eat salted fish before the analysis.

How is PCR performed?

In order to identify a sluggish infection and carry out the necessary treatment in adults, a laboratory test is performed to determine DNA in a scraping of epithelial cells of the urogenital tract. This is a new type of research that requires special equipment. The analysis is carried out using a sensitive analyzer.

For laboratory research, men take:

• urogenital smear with prostate secretion;
• the first portion of morning urine;
• ejaculate;
• rectal smear.

They should not urinate for 3 hours before the test, so that pathogenic microflora accumulates in the urine.

Determine gonococci in a smear from women taken from the walls:

• vagina;
• anus.

The sampling procedure is painless, and patients may experience only psychological discomfort. Women need to take a smear for gonococci before menstruation or 2 days after it ends.

To identify the pathogen, a real-time polymerase chain reaction is used:

An indication as a result of the analysis of the presence of a pathogenic agent that causes gonorrhea in the DNA material under study indicates infection. Deciphering the results of research should be done by a doctor of the appropriate specialty.

Traditional diagnostic methods

In medical practice, other types of research are carried out aimed at identifying and determining the type of infectious agent. They have been successfully used in the diagnosis of sexually transmitted diseases for a long time. These are microbiological methods that are divided into bacterioscopic and cultural methods:

If the culture result is positive, the specialist will find out which antibiotics the gonococcus is sensitive to. This will make it easier for the doctor to select a drug that will completely cure the patient. Bacterial culture is often given one month after the end of treatment for prophylaxis.

other methods

An analysis of blood serum will help determine the presence in the human body of antibodies to the causative agent of gonorrhea. This method has a number of disadvantages and is prescribed when the test smear does not contain gonococci, but there is a persistent inflammatory process of the appendages in the body.

You can determine the gonococcal infection yourself using a special test strip. If a woman suffers from purulent discharge, she can purchase an express test for the presence of gonococcus in the urine at a pharmacy and carry it out following the instructions. Upon receipt of a positive result, you need to contact a venereologist to confirm the diagnosis and prescribe treatment.

The disease revealed by any analysis must be cured, because it becomes the cause of infertility.

Unfortunately, many after "accidental" sexual relationships show signs of sexually transmitted diseases. Gonorrhea is one of the most common diseases today. According to statistics, about a hundred million people fall ill every year.

This is a disease that is provoked by a gonococcal infection. Infection occurs through unprotected intercourse. It is common for gonorrhea to affect the mucous membrane of the genital organs and urinary tract. There are even cases of damage to the mucous membranes of the oral cavity and rectum. This is possible after orogenital contacts. The pelvic organs may be affected, rarely the mucous membrane of the eye.

In most cases, infection occurs through direct contact (traditional sex, anal and oral) with a sick sexual partner. There are rare cases of human transmission of infection through the use of personal hygiene items, underwear or bed linen. Infection through "household" things account for 1% of all cases. Because, gonococcus almost immediately dies in the open air. During childbirth, the baby can be infected if the woman in labor is sick.

Often, cases of asymptomatic forms, or with little symptoms and untreated forms of gonorrhea, began to be recorded. As a result, the respiratory tract, nervous and cardiovascular systems can be affected. In the most neglected forms, joint damage occurs and blood poisoning occurs.

Gonorrhea develops in a latent form from three to fifteen days. This period is called the incubation period. Depending on how long a person has had gonorrhea, the disease is divided into a chronic form (from two months from the moment of infection) and fresh (up to 2 months).

gonorrhea symptoms

In men, the incubation period lasts from 1 to 7 days from the moment of infection. In women, this period lasts from 5 to 10 days. After this time, the disease manifests itself. In the acute form, pus appears, mucus is released, there is a sensation of tickling and burning, pain. The pain can even be at the time of urination.

In men, swelling and redness of the penis may appear, pus comes out of the urethra. Sometimes the general temperature rises. With a sluggish course of the disease, sexual dysfunction manifests itself over time (weak erection, premature ejaculation). In women, the labia swells and painful sensations appear in them. There is inflammation of the lymph nodes, eczema appears.

When gonorrhea affects the mouth area, small ulcers appear, strong salivation begins, and sore throat. When the rectum is affected, the anus itches and specific discharges appear. When the disease flows into a chronic form, infertility occurs, and internal organs are affected.

Diagnosis and treatment

An analysis for gonorrhea will help to make an accurate diagnosis. Based on the results of the analysis, the doctor prescribes treatment on an individual basis, which, as a rule, consists of taking antibiotics. To achieve the best effect, immunotherapy and physiotherapy are prescribed. Before the patient begins to take medication, the doctor checks him for tolerability of the drug. If an allergic reaction is observed, then alternative drugs are prescribed.

Difficulties in the financial situation or fear of publicity can push the patient to self-treatment. This is a highly undesirable path. You can find out for sure whether there is an infection through an analysis for gonorrhea. Otherwise, an infected person does not know for sure what exactly he is sick with and whether the infection is pure.

Gonorrhea occurs not only by itself, but also in mixed infections, such as gonorrheal-chlamydial infection. Incorrect prescription of the drug can lead to the emergence of new strains of the disease, which will be more aggressive and insensitive to drugs. Further, the infection can turn into a chronic latent form, and the body will be already imperceptibly affected.

Research methods

Due to the fact that pain and discharge from the genital organs in both men and women can occur due to a large number of diseases, laboratory methods for examining the material for gonorrhea are needed.

1 Microbiological. Methods allow to identify and determine the type of infection. They are divided into two methods: cultural and bacterioscopic. The study in the first case is carried out by growing bacteria (material taken from the affected organs) on special media. Microorganisms are determined by the fact that it “grows”. The method is relatively inexpensive, but takes time (about seven days). Allows you to test the sensitivity to drugs. In the second case, a stained smear (material from the affected organ) is studied under a microscope for the presence of gonococcus. It is a fast, cheap and reliable method. 2 Molecular-genetic. These include PCR (polymerase chain reaction) and LCR (ligase chain reaction). The methods are highly sensitive and quickly performed. But expensive, and not all laboratories can carry them out. 3 Serological. This is the Bordet-Gangu reaction. Serum is used. The method is based on finding antibodies to the causative agent of gonorrhea in the bloodstream. It is used mainly in the course of the disease in a chronic form. 4 "Provocation". It happens biological, thermal, chemical. A provocation is used when a latent course of the disease is suspected, and gonorrhea has not been detected by laboratory methods. Through provocation, the gonococcus is excreted from the walls of the genitourinary tract into the lumen of the organs, after which it can be detected by laboratory methods. 5 Other analyses. It is necessary to pass a general analysis of urine and blood. These methods do not detect gonorrhea, but show the course of inflammatory processes in the body.

It is important not to delay contacting a qualified doctor. With timely treatment, treatment usually takes two weeks. During the course of treatment, it is mandatory to refrain from sexual intercourse. A gentle lifestyle is desirable. Try to exclude sports, stress and swimming in the pool for this time. Perform water procedures on time and monitor hygiene in general.

After you have completed your prescribed course of antibiotic treatment, a second blood test for gonorrhea (Borde-Gangu reaction) is needed. This procedure is needed to confirm that the treatment was successful and the gonorrhea is cured. Or to identify its "undertreatment" and, on the basis of this, prescribe additional treatment.

Tests for gonorrhea (clapper) are carried out by detecting the pathogen in those places where the causative agent of gonorrhea (gonorrhea) can live - gonococcus.

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Places for taking an analysis for gonorrhea (gonorrhea) in the human body can be:

• Genitourinary organs of men and women
• Anus (anus)
• Oropharynx (throat)
• mucous membrane of the eye

The sampling for gonorrhea (gonorrhea) in our clinic "Polyclinic +1" is carried out only by a venereologist, because the staff of most laboratories often take material only from the genitals, which is fundamentally wrong.

The possibility of testing for gonorrhea (clap) from the blood

Unfortunately, it is still not possible to test for gonorrhea (gonorrhea) from the blood. Neither the pathogen itself nor the antibodies to it are determined by a blood test.

Test methods for gonorrhea (clapper):

• microscopic examination
• PCR (polymerase chain reaction)
• Analysis for gonorrhea (clapper) by the method of sowing discharge

Microscopic examination of the analysis for gonorrhea (clapper)

Microscopic examination of the analysis for gonorrhea (clapper) occurs after staining the discharge with special dyes (methylene blue, according to Gram). When examining a smear, a high content of leukocytes (pus) is detected in combination with the presence of round binuclear bacteria - gonococcus.

In the Polyclinic +1 clinic, you can perform a microscopic analysis for gonorrhea (gonorrhea) within 20-30 minutes and immediately, without waiting for rapidly developing complications, begin treatment with a venereologist of our clinic.

PCR analysis for gonorrhea (clapper) is performed in the laboratory within 1 day, as a rule, they are simultaneously examined for other sexually transmitted diseases (chlamydia, mycoplasma, trichomoniasis, and others). This must be done due to infection with several venereal diseases at once. PCR analysis for gonorrhea (clapper) is performed in the laboratory both in the form of a “detected-not found” response, and with the determination of the concentration of gonococcus, which is important for effective treatment.

Analysis for gonorrhea (clapper) by culture

An analysis for gonorrhea (clapper) by the method of sowing discharge is carried out with:

• The absence of one of the partners of gonococcus, and the detection of another
• Treatment failure
• For chronic gonorrhea (gonorrhea)
• In the presence of complications of gonorrhea (inflammation of the testicles, prostatitis)

The term of production of crops for gonorrhea is 5-9 days. In addition to the presence of gonococcus, the analysis for gonorrhea (clapper) by the sowing method also determines the concentration of the pathogen, and most importantly, sensitivity to antibiotics.

In the Polyclinic +1 clinic, you can take any test for gonorrhea (gonorrhea), as well as undergo treatment for both gonorrhea (gonorrhea) and any other sexually transmitted disease.

The cost of admission is 900 rubles.

We are waiting for you in our clinic.