Clinics and Departments

Laboratory Services

Lab Dept:

Microbiology/Virology

Test Name:

GC CULTURE (NEISSERIA GONORRHOEAE ONLY)

General Information

Lab Order Codes:

GC

Synonyms:

Culture, Neisseria gonorrhoeae; Culture, GC Only; Gonorrhoeae Culture

CPT Codes:

87081 - Culture, presumptive, pathogenic organisms, screening only

The following testing may be added if appropriate based on findings for organism identification (multiple additions are possible if more than one organism is identified).

87077 – Aerobic isolate, additional methods required for definitive identification, each isolate (if appropriate)
87206 – Smear, fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types

Test Includes:

Culture and identification of Neisseria gonorrhoeae only. Gram stain is not included and must be ordered separately. Refer to listing for Gram Stain.

Logistics

Lab Testing Sections:

Microbiology

Phone Numbers:

MIN Lab: 612-813-5866

STP Lab: 651-220-6555

Test Availability:

Daily, 24 hours

Turnaround Time:

Results are reported within 3 days.

Special Instructions:

Specimen site and date/time of collection are required for specimen processing.

Specimen

Specimen Type:

Swab of vagina, cervix, urethra, rectum, throat, endocervix, joint fluid, newborn eye, first few drops of voided urine

Container:

● Swab transport medium
● Direct inoculation: Obtain GC kit from Microbiology (JEMBEC system and/or Chocolate agar). See Special Processing.
● Sterile container

Collection:

Cervix:

1. Remove mucus and secretions from the cervix with a swab and discard.
2.
With a new sterile swab, firmly sample the endocervical canal.
3.
Place in swab culturette or directly inoculate plates.

Joint Fluid:

1. Disinfect overlying skin with 2% tincture of iodine
2.
Collect 0.5-1 mL of specimen via percutaneous needle aspiration or surgery.
3.
Transport to laboratory in sterile container <15 minutes.

Newborn Eye:

1. Swab: Pass moistened swab two times over lower conjunctiva. Avoid eyelid border and lashes.
2.
Place in swab culturette.

Rectal Swab:

1. Insert swab approximately 1 inch into anal canal.
2.
Gently move the swab from side to side to sample the anal crypts.
3.
If fecal contamination occurs, discard swab and use another to obtain specimen.
4.
Place swab in culturette.

Throat Swab:

1. Depress tongue with tongue depressor.
2.
Sample the posterior pharynx, tonsils, and inflamed areas with a sterile swab.
3.
Place swab in culturette.

Urethra (Males):

1. Insert a urethrogenital swab 2 to 4 cm into the urethral lumen, rotate swab.
2.
Leave in place for at least 2 seconds to facilitate absorption.
3.
Place swab in culturette or directly inoculate plates.

Vaginal:

1. Wipe away excessive amount of secretion or discharge.
2.
Obtain secretions from mucosal membrane of the vaginal vault with a sterile swab.
3.
If smear is also requested, use a second swab.
4.
Place swab in culturette.

Special Processing:

Direct Inoculation Procedure

1. Warm Chocolate and JEMBEC plate to room temperature before inoculation. Neisseria gonorrhoeae is very susceptible to extreme conditions such as drying and cold temperatures that will decrease the recovery rate.
2.
Collect two swabs.
3.
With first swab, inoculate the plate(s) by gently rolling the swab to touch all surfaces.
4.
Label plate(s) with the proper patient information.
5.
Activate CO2 generating tablet in JEMBEC plate as follows:

a) Remove CO2 tablet from foil wrapper with sterile forceps.

b) Place tablet in well in plate. Do not add water.

c) Place inoculated plate in plastic bag provided (one plate per bag).

d) Seal bag by pressing down on the “zipper” at the end of the bag with fingers and slide along to the opposite end.

e) Submit plates along with second swab.

Transport/Storage:

Onsite collections: Transport to the Microbiology Laboratory immediately. Do not refrigerate. Refrigeration may prevent the recovery of Neisseria gonorrhoeae.

Offsite collections:
Do not refrigerate, store at room temperature. Specimens must be promptly transported to the laboratory, with the next available courier, not to exceed 24 hours from the time of collection. However, delayed transport causes a delay of results.

Sample Rejection:

Improperly labeled specimen; specimens with prolonged transit time (see Transport/Storage for requirements); specimen not submitted in appropriate transport container; insufficient volume; external contamination. If an unacceptable specimen is received, the physician or nursing station will be notified and another specimen will be requested before the specimen is discarded.

Interpretive

Reference Range:

No Neisseria gonorrhoeae isolated.

Alert Value:

If Neisseria gonorrhoeae is isolated, results will be called to the physician or patient’s nurse.

Limitations:

Herpes simplex virus, Chlamydia, and Ureaplasma urealyticum are not recovered by this procedure. Refer to separate listings.

Methodology:

Aerobic culture with selective (Thayer - Martin) and nonselective media.

References:

Cook, JH, and M Pezzlo (1992). Specimen receipt and accessioning. Section 1. Aerobic bacteriology, 1.2.1-4. In HD Isenberg (ed) Clinical Microbiology Procedures Handbook. American Society for Microbiology, Washington DC

Miller, J Michael (1999) A Guide To Specimen Management in Clinical Microbiology, American Society for Microbiology, Washington DC

Miller, J Michael, and HT Holmes (1999) Specimen Collection, Transport, and Storage In PR Murray et al, (ed), Manual of Clinical Microbiology, 7th edition, American Society for Microbiology, Washington DC, pp 33-104

Updates:

3/23/2010: CPT Updates
4/25/2012: Addition of Alert Value.
11/20/2014: Offsite collection information added.



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