gonokokken

Gonokokken, or gonococci, are Gram-negative diplococci of the species Neisseria gonorrhoeae, the bacteria that cause gonorrhea. They are primarily a human pathogen and belong to the Neisseria genus, which includes several related species. Infections with N. gonorrhoeae are classified as sexually transmitted infections (STIs).

Transmission occurs mainly through sexual contact – vaginal, anal, and oral. Neonatal transmission during birth can cause conjunctivitis in newborns, which can be prevented by eye prophylaxis. The highest incidence is among sexually active young adults, with transmission linked to multiple partners and inconsistent condom use.

Clinical presentation varies. In men, gonorrhea commonly causes urethral discharge and dysuria. In women, symptoms are often mild or nonspecific (cervicitis, dysuria, pelvic pain), and many infections are asymptomatic. If left untreated, infection may spread to the uterus and fallopian tubes (pelvic inflammatory disease) and can cause infertility or increased risk of ectopic pregnancy. Disseminated gonococcal infection can present with arthritis, dermatitis, and tenosynovitis.

Diagnosis relies on nucleic acid amplification tests (NAAT) of urine or swabs from affected sites. Culture on enriched media such as Thayer-Martin or chocolate agar is used for antibiotic susceptibility testing and in certain settings. Gram staining can reveal intracellular gram-negative diplococci in men with acute urethritis.

Treatment guidelines emphasize antibiotics with activity against N. gonorrhoeae and consideration of chlamydia co-infection. Because of rising resistance, regimens are region-specific and guided by current public health recommendations. Surveillance for resistance and prompt partner notification are essential components of management.

Prevention focuses on safer sex practices, regular screening in high-risk groups, and partner notification and treatment. There is currently no approved vaccine. The organism was first described by Albert Neisser in 1879; the name gonococcus derives from Greek for seed and berry.