Gonorrhea Causative Agent
Gonorrhea and its Causative Agent; a study of challenges of treating gonorrhea
By: Nader Hossaini
George Mason University
Word count: 2281
Gonorrhea and its Causative Agent
Abstract
In this study, gonorrhea which is a sexually transmitted disease that can be found in every parts of the world including in the United States was investigated; gonorrhea passes from one person to another mainly through unprotected sexual activity. The causative agent for the disease, Neisseria gonorrhoeae, is a gram-negative coffee bean-shaped diplococci bacteria occurring in the form of two joined cells. The manner the bacteria initiate the disease is that Neisseria gonorrhoeae attaches to the epithelial cells which are …show more content…
warm and moist, and the binding causes the epithelial cells to react by changing shape and by secreting pus. The best medication for this disease is the antibiotic penicillin; however, there are strains of Neisseria gonorrhoeae that have become resistant to penicillin. Other types of strong antibiotics are used that are effective against the causative agent of gonorrhea. The disease is prevented from spreading by abstinence, having monogamist relationships, and using condoms to reduce the risk of contracting gonorrhea. When it comes to the sexually transmitted disease of gonorrhea, one should be tested for the disease as sometimes gonorrhea does not show any obvious symptoms. As for the Neisseria gonorrhoeae, the causative agent for gonorrhea, being resistant to antibiotics indicates that the future treatment for this disease is going to become more challenging which necessitates searching for other methods of treatment. In the laboratory, the very fastidious Neisseria gonorrhoeae is isolated on Thayer-Martin agar, an agar plate containing three types of antibiotics and nutrients, facilitating the growth of Neisseria species while inhibiting the growth of other microorganisms such as gram-positive organisms. Finally, of the eleven species of Neisseria that colonize humans, only two cause harm and are considered pathogenic, one of which is Neisseria gonorrhoeae which is the causative agent of gonorrhea. Words: 292
Introduction
Worldwide, Gonorrhea is the second most occurring sexually transmitted disease (STD) and can be found in every country including in the United States1; the causative agent of this STD, Neisseria gonorrhoeae, is bacteria that passes from one person to another mainly by performing unprotected sex. Not all infected individuals display the common symptoms of gonorrhea, and this makes it virtually impossible for them to seek treatment and not to spread the disease. Those individuals are called non-symptomatic carriers and are contagious as well as the ones showing the symptoms. In men, the symptoms include a burning feeling during urination and a pus-like discharge from the penis1, in women, the symptoms include abdominal pain, vaginal discharge, as well as burning feeling while urinating1. In addition, women are more at risk of this STD because they often do not show the symptoms as they should or they display mild symptoms that feels like the usual female diseases such as yeast infection. It is widely known that individuals most at risk are patients with multiple sexual partners1. In this study, the method by which Neisseria gonorrhoeae causes the disease is examined, and the challenges of treating gonorrhea is investigated.
Methods
In this study, google scholar was utilized to search for references regarding the STD gonorrhea and its causative agent. Key words used for search include: gonorrhea, Neisseria gonorrhoeae, bacteria, STD, treatment, antibiotics, and penicillin.
Gonorrhea is caused by the bacteria Neisseria gonorrhoeae which is a gram-negative coffee bean-shaped diplococci bacteria, occurring in the form of two joined cells having a very thin peptidoglycan layer. Some strains may form unusually small colonies when cultivated. Cell surface components include capsule and pili that mediate initial attachment of gonococci to epithelial cells2. The way the aforementioned bacteria cause the disease is that using the pili on the surface, it attaches itself to the epithelial cells which are warm and moist2. That binding causes the epithelial cells to react by changing shape and by secreting pus. The attachment is taken place in two stages, first, the pili overcome the electrostatic barrier between the negatively charged surfaces of the bacterial and host cell, then specific cell receptor having high specificity for binding to the epithelial cells in the vigina, penis, or eyes2. The surface of the bacterial cells may also express proteins such as opa which is a major component of the cell surface, and functions to help the strong attachment of the gram-negative bacteria to the epithelial cells. The strong attachment of the bacteria Neisseria gonorrhoeae to the epithelial cells would cause the epithelial cells to change shape and express the symptoms of the STD gonorrhea as indicated2.
The symptoms of severe gonorrhea are initiated by the irregular damage of the urethral mucosa with buildup of gonococci and polymorphs in the subepithelial connective tissues. During the three-to-five day asymptomatic interval that follows exposure, Neisseria gonorrhoeae seemingly become established on the urethral mucosa since they are not removed by frequent acts of micturition. An attachment of the gonococcus to the mucosal surface occurs before the invasion of deeper tissues while there is indication that the adhesion to epithelial cells is a factor that affects the distribution of bacteria in the mouth and gastrointestinal tract. Also, adherence to cells might be important in the pathogenesis of other mucosal infections. It is shown that mycoplasma pneumoniae attaches to and progressively damages the ciliated epithelium of the human trachea maintained in organ culture.
The best medication for this disease is the antibiotic penicillin; however, if the strains of Neisseria gonorrhoeae bacteria are resistant to penicillin, either a stronger dose of penicillin should be used or other types of strong antibiotics or an antibiotic mixture can be used that are proven effective against the causative agent of gonorrhea that are becoming more resisting to the antibiotic treatment, another antibiotic that is effective in treating gonorrhea is ceftriaxone3. The antibiotic dose is injected into the blood stream of the patient as soon as possible after the individual is infected with the causative agent. As it is known, the medicine acts to destroy the outer membrane of the bacteria in order to destroy it and cure the disease3. However, in recent years, there are studies that show some strains of Neisseria gonorrhoeae have become very resistant to some antibiotics which indicates that the future treatment for this disease is going to become more challenging. It is crucial to try to find other forms of treatments for this common disease and indeed for any other bacterial disease since until today the best agent effective in destroying illnesses caused by bacteria are various types of antibiotics since the bacteria are adapting to survive despite getting treated by antibiotics3. It is also clear that more antibiotics must be found that are effective in destroying bacteria.
The disease can be prevented from spreading from a person to another by abstinence, being monogamist, and using condoms as it is obviously risky to have multiple sexual partners and also having unprotected sex.
Since gonorrhea is one of the common sexually transmitted diseases, getting it depends on the behavior of the individual at risk4. Therefore, the preventive majors for this disease are virtually identical to protecting against any other sexually transmitted illness. When it comes to the sexually transmitted disease of gonorrhea, it is clear that one should be tested for the disease as sometimes gonorrhea does not show any obvious symptoms. Especially women who are at risk should often check with a physician to make sure they are disease free. Screening programs are extremely helpful in identifying individuals that are infected with Neisseria …show more content…
gonorrhoeae4.
In the laboratory, the very fastidious Neisseria gonorrhoeae can be isolated on Thayer-Martin agar, which is an agar plate containing three types of antibiotics and nutrients which facilitate the growth of Neisseria species while inhibiting the growth of other microorganisms such as gram-positive organisms and some bacilli and fungi. Neisseria gonorrhoeae that causes gonorrhea grows on a selective medium for pathogenic Neisseria species after 48 hours of cultivation. Neisseria gonorrhoeae are the most fastidious of the Neisseria species as they need complex growth media. The agar contains sheep blood while the agar medium is improved with vitamins such as vitamin B1, vitamin B12, and para-aminobenzoic acid, as well as coenzymes NAD, amino acids (glutamine, cysteine, cystine), nucleobases (adenine, guanine) and minerals essential for growth4. The growth media for Neisseria gonorrhoeae contain antimicrobials that inhibit the growth of organisms other than Neisseria gonorrhoeae, this is important since the bacteria of interest is only Neisseria gonorrhoeae. Gonococci are so sensitive that they cannot grow on a regular blood agar while the plates are always incubated in a CO2-enriched, humid atmosphere. Colonies of Neisseria gonorrhoeae differ in diameter from 1 to 4.0 mm after forty eight hours due to the formation of different colony types (designated T1, T2, T3, T4) while the colonies are smooth and non-pigmented4.
Gonorrhea can be diagnosed by healthcare professionals in several ways such as taking a sample of penile or vaginal discharge and place it on a glass slide, then adding a stain to the sample and examine it under a microscope, this test can be done by a laboratory technologist. In case the cells react to the stain, the specimen is probably gonorrhea while this is an easy method which is fairly quick and easy, but it doesn’t provide absolutely certainty5. A second method of checking for the agent causing this disease is taking a sample and placing it on a special dish, then incubating under ideal growth conditions for several days, and a colony of gonorrhea bacteria will grow if gonorrhea is present. An initial result may be ready within twenty four hours while a final result will take up to three days. The sample may be taken from the throat, anus, vagina, tip of the penis, blood, or joint fluid, or any other infected area. A laboratory technician could remove blood or joint fluid by inserting a needle and removing a small amount of fluid, and a cotton-tipped swab can obtain specimens from other sites. The methods used for testing for Neisseria gonorrhoeae are always being developed5.
Discussion
Gonorrhea is caused by the bacteria Neisseria gonorrhoeae which is gram-negative bacteria, occurring in the form of two joined cells having a very thin peptidoglycan layer.
The symptoms of severe gonorrhea are initiated by the irregular damage of the urethral mucosa with buildup of gonococci and polymorphs in the subepithelial connective tissues. During the three-to-five day asymptomatic interval that follows exposure, Neisseria gonorrhoeae seemingly become established on the urethral mucosa since they are not removed by frequent acts of micturition. An attachment of the gonococcus to the mucosal surface occurs before the invasion of deeper tissues while there is indication that the adhesion to epithelial cells is a factor that affects the distribution of bacteria in the mouth and gastrointestinal tract. Also, adherence to cells might be important in the pathogenesis of other mucosal infections. The best medication for this disease is the antibiotic penicillin; however, if the strains of Neisseria gonorrhoeae bacteria are resistant to penicillin, either a stronger dose of penicillin should be used or other types of strong antibiotics or an antibiotic mixture can be used that are proven effective against the causative agent of gonorrhea that are becoming more resisting to the antibiotic treatment, another antibiotic that is effective in treating gonorrhea is ceftriaxone3. Some strains of Neisseria gonorrhoeae have become very resistant to some antibiotics which indicate that
the future treatment for this disease is going to become more challenging. It is crucial to try to find other forms of treatments for this common disease and indeed for any other bacterial disease since until today the best agent effective in destroying illnesses caused by bacteria are various types of antibiotics since the bacteria are adapting to survive despite getting treated by antibiotics. It is clear that more antibiotics must be found that are effective in destroying bacteria.
References:
1. Handsfield HH, Dalu ZA, Martin DH, et al. Multicenter trial of single-dose azithromycin vs. ceftriaxone in the treatment of uncomplicated gonorrhea. Sexually Transmitted Diseases. 1994; 21: 107-111. This reference indicates that gonorrhea is spread worldwide, and that both azithromycin and ceftriaxone are equally effective in the treatment of uncomplicated gonorrhea.
2. Ward ME, Watt PJ. Adherence of Neisseria gonorrhoeae to Urethral Muscosal Cells: An electron-microscopic study of human gonorrhea. The Journal of Infectious diseases. 1972; 126: 601-605. This journal indicates that selective attachment to epithelial cells is a critical determinant that affects the distribution of the bacteria Neisseria gonorrhoeae in the mouth and gastrointestinal tract, and that adherence to cells might be important in the pathogenesis of other mucosal infections.
3. Ohnishi M, Golparian D, Shimuta K, et al. Is Neisseria gonorrhoeae initiating a future era of untreatable gonorrhea? Detailed characterization of the first strain with high-level resistance to ceftriaxone. Antimicrobial Agents and Chemotherapy. 2011; 55: 3538-3545. Treatment options for gonorrhea have diminished rapidly because of the emergence and worldwide spread of antimicrobial resistance to all drugs previously used or considered first line, i. e., penicillin, narrow-spectrum cephalosporin, tetracyclines, macrolides, and fluoroquinolones.
4. Yorke JA, Hethcote HW, Nold A. Dynamics and control of the transmission of gonorrhea. The American Venereal Disease Association. 1978; 5: 51-56. This article indicates that screening programs are very effective in identifying individuals infected with gonorrhea, and only the sexually active individuals in a community who could be infected by their contacts need be considered.
5. Golden MR, Whittington WLH, Handsfield HH, et al. Effect of expedited treatment of sex partners on recurrent or persistent gonorrhea or chlamydial infection. The New England Journal of Medicine. 2005; 352: 676-683. This study conducts experiments on women and men to try and determine methods that are most effective in treating gonorrhea.
By: Nader Hossaini
George Mason University
Word count: 2281
Gonorrhea and its Causative Agent
Abstract
In this study, gonorrhea which is a sexually transmitted disease that can be found in every parts of the world including in the United States was investigated; gonorrhea passes from one person to another mainly through unprotected sexual activity. The causative agent for the disease, Neisseria gonorrhoeae, is a gram-negative coffee bean-shaped diplococci bacteria occurring in the form of two joined cells. The manner the bacteria initiate the disease is that Neisseria gonorrhoeae attaches to the epithelial cells which are …show more content…
warm and moist, and the binding causes the epithelial cells to react by changing shape and by secreting pus. The best medication for this disease is the antibiotic penicillin; however, there are strains of Neisseria gonorrhoeae that have become resistant to penicillin. Other types of strong antibiotics are used that are effective against the causative agent of gonorrhea. The disease is prevented from spreading by abstinence, having monogamist relationships, and using condoms to reduce the risk of contracting gonorrhea. When it comes to the sexually transmitted disease of gonorrhea, one should be tested for the disease as sometimes gonorrhea does not show any obvious symptoms. As for the Neisseria gonorrhoeae, the causative agent for gonorrhea, being resistant to antibiotics indicates that the future treatment for this disease is going to become more challenging which necessitates searching for other methods of treatment. In the laboratory, the very fastidious Neisseria gonorrhoeae is isolated on Thayer-Martin agar, an agar plate containing three types of antibiotics and nutrients, facilitating the growth of Neisseria species while inhibiting the growth of other microorganisms such as gram-positive organisms. Finally, of the eleven species of Neisseria that colonize humans, only two cause harm and are considered pathogenic, one of which is Neisseria gonorrhoeae which is the causative agent of gonorrhea. Words: 292
Introduction
Worldwide, Gonorrhea is the second most occurring sexually transmitted disease (STD) and can be found in every country including in the United States1; the causative agent of this STD, Neisseria gonorrhoeae, is bacteria that passes from one person to another mainly by performing unprotected sex. Not all infected individuals display the common symptoms of gonorrhea, and this makes it virtually impossible for them to seek treatment and not to spread the disease. Those individuals are called non-symptomatic carriers and are contagious as well as the ones showing the symptoms. In men, the symptoms include a burning feeling during urination and a pus-like discharge from the penis1, in women, the symptoms include abdominal pain, vaginal discharge, as well as burning feeling while urinating1. In addition, women are more at risk of this STD because they often do not show the symptoms as they should or they display mild symptoms that feels like the usual female diseases such as yeast infection. It is widely known that individuals most at risk are patients with multiple sexual partners1. In this study, the method by which Neisseria gonorrhoeae causes the disease is examined, and the challenges of treating gonorrhea is investigated.
Methods
In this study, google scholar was utilized to search for references regarding the STD gonorrhea and its causative agent. Key words used for search include: gonorrhea, Neisseria gonorrhoeae, bacteria, STD, treatment, antibiotics, and penicillin.
Gonorrhea is caused by the bacteria Neisseria gonorrhoeae which is a gram-negative coffee bean-shaped diplococci bacteria, occurring in the form of two joined cells having a very thin peptidoglycan layer. Some strains may form unusually small colonies when cultivated. Cell surface components include capsule and pili that mediate initial attachment of gonococci to epithelial cells2. The way the aforementioned bacteria cause the disease is that using the pili on the surface, it attaches itself to the epithelial cells which are warm and moist2. That binding causes the epithelial cells to react by changing shape and by secreting pus. The attachment is taken place in two stages, first, the pili overcome the electrostatic barrier between the negatively charged surfaces of the bacterial and host cell, then specific cell receptor having high specificity for binding to the epithelial cells in the vigina, penis, or eyes2. The surface of the bacterial cells may also express proteins such as opa which is a major component of the cell surface, and functions to help the strong attachment of the gram-negative bacteria to the epithelial cells. The strong attachment of the bacteria Neisseria gonorrhoeae to the epithelial cells would cause the epithelial cells to change shape and express the symptoms of the STD gonorrhea as indicated2.
The symptoms of severe gonorrhea are initiated by the irregular damage of the urethral mucosa with buildup of gonococci and polymorphs in the subepithelial connective tissues. During the three-to-five day asymptomatic interval that follows exposure, Neisseria gonorrhoeae seemingly become established on the urethral mucosa since they are not removed by frequent acts of micturition. An attachment of the gonococcus to the mucosal surface occurs before the invasion of deeper tissues while there is indication that the adhesion to epithelial cells is a factor that affects the distribution of bacteria in the mouth and gastrointestinal tract. Also, adherence to cells might be important in the pathogenesis of other mucosal infections. It is shown that mycoplasma pneumoniae attaches to and progressively damages the ciliated epithelium of the human trachea maintained in organ culture.
The best medication for this disease is the antibiotic penicillin; however, if the strains of Neisseria gonorrhoeae bacteria are resistant to penicillin, either a stronger dose of penicillin should be used or other types of strong antibiotics or an antibiotic mixture can be used that are proven effective against the causative agent of gonorrhea that are becoming more resisting to the antibiotic treatment, another antibiotic that is effective in treating gonorrhea is ceftriaxone3. The antibiotic dose is injected into the blood stream of the patient as soon as possible after the individual is infected with the causative agent. As it is known, the medicine acts to destroy the outer membrane of the bacteria in order to destroy it and cure the disease3. However, in recent years, there are studies that show some strains of Neisseria gonorrhoeae have become very resistant to some antibiotics which indicates that the future treatment for this disease is going to become more challenging. It is crucial to try to find other forms of treatments for this common disease and indeed for any other bacterial disease since until today the best agent effective in destroying illnesses caused by bacteria are various types of antibiotics since the bacteria are adapting to survive despite getting treated by antibiotics3. It is also clear that more antibiotics must be found that are effective in destroying bacteria.
The disease can be prevented from spreading from a person to another by abstinence, being monogamist, and using condoms as it is obviously risky to have multiple sexual partners and also having unprotected sex.
Since gonorrhea is one of the common sexually transmitted diseases, getting it depends on the behavior of the individual at risk4. Therefore, the preventive majors for this disease are virtually identical to protecting against any other sexually transmitted illness. When it comes to the sexually transmitted disease of gonorrhea, it is clear that one should be tested for the disease as sometimes gonorrhea does not show any obvious symptoms. Especially women who are at risk should often check with a physician to make sure they are disease free. Screening programs are extremely helpful in identifying individuals that are infected with Neisseria …show more content…
gonorrhoeae4.
In the laboratory, the very fastidious Neisseria gonorrhoeae can be isolated on Thayer-Martin agar, which is an agar plate containing three types of antibiotics and nutrients which facilitate the growth of Neisseria species while inhibiting the growth of other microorganisms such as gram-positive organisms and some bacilli and fungi. Neisseria gonorrhoeae that causes gonorrhea grows on a selective medium for pathogenic Neisseria species after 48 hours of cultivation. Neisseria gonorrhoeae are the most fastidious of the Neisseria species as they need complex growth media. The agar contains sheep blood while the agar medium is improved with vitamins such as vitamin B1, vitamin B12, and para-aminobenzoic acid, as well as coenzymes NAD, amino acids (glutamine, cysteine, cystine), nucleobases (adenine, guanine) and minerals essential for growth4. The growth media for Neisseria gonorrhoeae contain antimicrobials that inhibit the growth of organisms other than Neisseria gonorrhoeae, this is important since the bacteria of interest is only Neisseria gonorrhoeae. Gonococci are so sensitive that they cannot grow on a regular blood agar while the plates are always incubated in a CO2-enriched, humid atmosphere. Colonies of Neisseria gonorrhoeae differ in diameter from 1 to 4.0 mm after forty eight hours due to the formation of different colony types (designated T1, T2, T3, T4) while the colonies are smooth and non-pigmented4.
Gonorrhea can be diagnosed by healthcare professionals in several ways such as taking a sample of penile or vaginal discharge and place it on a glass slide, then adding a stain to the sample and examine it under a microscope, this test can be done by a laboratory technologist. In case the cells react to the stain, the specimen is probably gonorrhea while this is an easy method which is fairly quick and easy, but it doesn’t provide absolutely certainty5. A second method of checking for the agent causing this disease is taking a sample and placing it on a special dish, then incubating under ideal growth conditions for several days, and a colony of gonorrhea bacteria will grow if gonorrhea is present. An initial result may be ready within twenty four hours while a final result will take up to three days. The sample may be taken from the throat, anus, vagina, tip of the penis, blood, or joint fluid, or any other infected area. A laboratory technician could remove blood or joint fluid by inserting a needle and removing a small amount of fluid, and a cotton-tipped swab can obtain specimens from other sites. The methods used for testing for Neisseria gonorrhoeae are always being developed5.
Discussion
Gonorrhea is caused by the bacteria Neisseria gonorrhoeae which is gram-negative bacteria, occurring in the form of two joined cells having a very thin peptidoglycan layer.
The symptoms of severe gonorrhea are initiated by the irregular damage of the urethral mucosa with buildup of gonococci and polymorphs in the subepithelial connective tissues. During the three-to-five day asymptomatic interval that follows exposure, Neisseria gonorrhoeae seemingly become established on the urethral mucosa since they are not removed by frequent acts of micturition. An attachment of the gonococcus to the mucosal surface occurs before the invasion of deeper tissues while there is indication that the adhesion to epithelial cells is a factor that affects the distribution of bacteria in the mouth and gastrointestinal tract. Also, adherence to cells might be important in the pathogenesis of other mucosal infections. The best medication for this disease is the antibiotic penicillin; however, if the strains of Neisseria gonorrhoeae bacteria are resistant to penicillin, either a stronger dose of penicillin should be used or other types of strong antibiotics or an antibiotic mixture can be used that are proven effective against the causative agent of gonorrhea that are becoming more resisting to the antibiotic treatment, another antibiotic that is effective in treating gonorrhea is ceftriaxone3. Some strains of Neisseria gonorrhoeae have become very resistant to some antibiotics which indicate that
the future treatment for this disease is going to become more challenging. It is crucial to try to find other forms of treatments for this common disease and indeed for any other bacterial disease since until today the best agent effective in destroying illnesses caused by bacteria are various types of antibiotics since the bacteria are adapting to survive despite getting treated by antibiotics. It is clear that more antibiotics must be found that are effective in destroying bacteria.
References:
1. Handsfield HH, Dalu ZA, Martin DH, et al. Multicenter trial of single-dose azithromycin vs. ceftriaxone in the treatment of uncomplicated gonorrhea. Sexually Transmitted Diseases. 1994; 21: 107-111. This reference indicates that gonorrhea is spread worldwide, and that both azithromycin and ceftriaxone are equally effective in the treatment of uncomplicated gonorrhea.
2. Ward ME, Watt PJ. Adherence of Neisseria gonorrhoeae to Urethral Muscosal Cells: An electron-microscopic study of human gonorrhea. The Journal of Infectious diseases. 1972; 126: 601-605. This journal indicates that selective attachment to epithelial cells is a critical determinant that affects the distribution of the bacteria Neisseria gonorrhoeae in the mouth and gastrointestinal tract, and that adherence to cells might be important in the pathogenesis of other mucosal infections.
3. Ohnishi M, Golparian D, Shimuta K, et al. Is Neisseria gonorrhoeae initiating a future era of untreatable gonorrhea? Detailed characterization of the first strain with high-level resistance to ceftriaxone. Antimicrobial Agents and Chemotherapy. 2011; 55: 3538-3545. Treatment options for gonorrhea have diminished rapidly because of the emergence and worldwide spread of antimicrobial resistance to all drugs previously used or considered first line, i. e., penicillin, narrow-spectrum cephalosporin, tetracyclines, macrolides, and fluoroquinolones.
4. Yorke JA, Hethcote HW, Nold A. Dynamics and control of the transmission of gonorrhea. The American Venereal Disease Association. 1978; 5: 51-56. This article indicates that screening programs are very effective in identifying individuals infected with gonorrhea, and only the sexually active individuals in a community who could be infected by their contacts need be considered.
5. Golden MR, Whittington WLH, Handsfield HH, et al. Effect of expedited treatment of sex partners on recurrent or persistent gonorrhea or chlamydial infection. The New England Journal of Medicine. 2005; 352: 676-683. This study conducts experiments on women and men to try and determine methods that are most effective in treating gonorrhea.