GC (Neisseria gonorrhoeae) Culture Only

CPT: 87081
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Test Details

Synonyms

  • Neisseria gonorrhoeae Culture
  • Culture for Neisseria gonorrhoeae Only
  • Culture for GC Only
  • Genital Culture (GC) Only
  • Gonorrhea Culture
  • Jembec Culture

Test Includes

Culture; isolation and identification if culture results warrant (additional charges/CPT code[s] may apply). CPT coding for microbiology and virology procedures often cannot be determined before the culture is performed.

Use

Isolate and identify N gonorrhoeae; establish the diagnosis of gonorrhea

Limitations

Cultures are usually evaluated only for Neisseria gonorrhoeae. No other organisms are identified. Overgrowth by Proteus and yeast may make it impossible to rule out presence of N gonorrhoeae. The vancomycin in Thayer-Martin media may inhibit some strains of N gonorrhoeae. Nongonococcal urethritis may be caused by Ureaplasma urealyticum, Corynebacterium genitalium type 1, Trichomonas vaginalis, Chlamydia trachomatis, herpes simplex virus, and (rarely) Candida albicans.

Methodology

Culture on selective media; DNA probes for identification

Reference Interval

Negative

Additional Information

In a study of 1001 women consecutively seen at a venereal disease clinic, endocervical culture was positive in 88.4%, urine sediment 72%, and anal canal 22.8%. The prevalence of gonorrhea in the study population was 28.5%.1 A serologic test for syphilis (VDRL, RPR, or ART), HIV, and cervical/vaginal cytology should be considered in patients suspected of having gonorrhea. Throat culture for GC was found to have little contribution to the further recovery of N gonorrhoeae over culture of the urethra, cervix, and anus.2

Specimen Requirements

Specimen

Body fluid, discharge, pus, swab of genital lesions, or urethral discharge (best for men when available), anus, throat.

Volume

0.5 mL or one swab inoculated to Jembec plate or one swab in Amies gel bacterial transport

Container

Jembec (available from the laboratory) or Thayer-Martin plate (client-provided) are preferred. Prewarm plate before inoculation. Bacterial swab transport containing Amies gel is also acceptable.

Collection

Do not collect urethral specimens until at least one hour after urinating. Collection directly from male urethral discharge is desirable. Collect anorectal specimens from the crypts just inside the anal ring; anoscopy useful. Prostatic fluid yields fewer positives than does urethral culture.

Endocervix: Swab endocervical canal. Avoid contaminating swab with vaginal secretions. Cultures from the urethra or vagina are indicated from females when endocervical culture is not possible.

Urethra: Strip the urethra toward the orifice to express exudate. Use a sterile swab to obtain the specimen.

Vagina: Use a speculum, moistened only with warm water, not lubricant. Obtain a specimen from the posterior vaginal vault or from the vaginal orifice if the hymen is intact.

Swab samples should be rolled over the surface of the Jembec medium.

Storage Instructions

Inoculated Thayer-Martin plates should be placed in a CO2 incubator or candle jar within 15 minutes of collection. For Jembecs, remove a CO2-generating tablet from its foil wrapper and place in the specially-designed well in the plate. Place inoculated plates in the ziplock bag and seal the bag. Jembecs should be preincubated at 35°C, if possible, prior to shipment at room temperature.

Causes for Rejection

Inappropriate specimen received; unlabeled specimen or name discrepancy between specimen and request label; specimen received after prolonged delay (usually more than 72 hours); specimen received in expired transport container

Clinical Information

Footnotes

1. Chapel TA, Smeltzer M. Culture of urinary sediment for the diagnosis of gonorrhea in women. Br J Vener Dis. 1975 Feb; 51(1):25-27. 804957
2. Brown RT, Lossick JG, Mosure DJ, Smeltzer MP, Cromer BA. Pharyngeal gonorrhea screening in adolescents: Is It necessary? Pediatrics. 1989 Oct; 84(4):623-625. 2780123

References

Judson FN. Gonorrhea. Med Clin North Am. 1990 Nov; 74(6):1353-1366. 2123279
Rajasekariah GR, Edward S, Shapira D, et al. Direct detection of Neisseria gonorrhoeae with monoclonal antibodies characterized by serotyping reagents. J Clin Microbiol. 1989 Jul; 27(7):1700-1703. 2475525
Roongpisuthipong A, Lewis JS, Kraus SJ, Morse SA. Gonococcal urethritis diagnosed from enzyme immunoassay of urine sediment. Sex Transm Dis. 1988 Oct-Dec; 15(4):192-195. 3147523
Schoone GJ, Cornelissen WJ, Veenhuijsen PC, Schöneman CE, Terpstra WJ. Comparison of dot blot with in situ hybridization for the detection of Neisseria gonorrhoeae in urethral exudate. J Appl Bacteriol. 1989 May; 66(5):401-405. 2502529
Thomason JL, Gelbart SM, Sobieski VJ, Anderson RJ, Schulien MB, Hamilton PR. Effectiveness of gonozyme for detection of gonorrhea in low-risk pregnant and gynecologic populations. Sex Transm Dis. 1989 Jan-Mar; 16(1):28-31. 2502866
Young H, Moyes A. Utility of monoclonal antibody coagglutination to identify Neisseria gonorrhoeae.Genitourin Med. 1989 Jan; 65(1):8-13. 2493423

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
008128 GC Culture Only 698-1 008128 GC Culture Only 698-1
Reflex Table for GC Culture Only
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 080019 Result 080020 Result 1 6463-4
Reflex Table for GC Culture Only
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 080019 Result 080021 Result 2 6463-4
Reflex Table for GC Culture Only
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 080019 Result 080022 Result 3 6463-4
Reflex Table for GC Culture Only
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 080019 Result 080023 Result 4 6463-4
Reflex Table for GC Culture Only
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 080019 Result 080024 Antimicrobial Susceptibility 23658-8

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