Neisseria gonorrhoeae, NAA

The Neisseria gonorrhoeae, NAA test (gonococcus DNA PCR) amplifies organism-specific nucleic acid to confirm infection in patients with compatible symptoms or exposures and in those without symptoms undergoing targeted screening. It is suitable for evaluating urethritis, cervicitis, and related genital or anorectal syndromes, and may be used to assess therapeutic clearance when clinically indicated. Because nucleic acid amplification testing offers high analytical sensitivity and specificity, this method is preferred for direct pathogen detection over culture or serologic approaches in most routine diagnostic and screening settings.

Neisseria gonorrhoeae is a gram-negative diplococcus transmitted predominantly through sexual contact and can be passed perinatally during delivery. In women, infection is often silent; when present, manifestations include mucopurulent cervicitis, dysuria, intermenstrual or postcoital bleeding, and vulvovaginal irritation. Men typically develop symptoms within several days, such as purulent urethral discharge and dysuria, and may show meatal erythema and edema; proctitis may occur with receptive anal exposure. Without treatment, infection may ascend the genitourinary or reproductive tract. Reported complications include prostatitis and epididymo-orchitis in men, and endometritis, salpingitis, and oophoritis in women; dissemination to joints or the eye can also occur. Risk is increased with multiple sexual partners, unprotected vaginal, anal, or oral intercourse, and contact with partners who have sexually transmitted infections. Diagnostic options include microbiologic culture, serologic testing, and molecular assays. Nucleic acid amplification tests provide the greatest analytical sensitivity and specificity for organism detection. Effective antibiotic regimens are available.