Neisseria Gonorrhea Agent Information Sheet

Boston University
Research Occupational Health Program (ROHP)
617-358-7647

Agent

Neisseria gonorrhoeae is an aerobic gram-negative, non-spore forming, non-motile, encapsulated, and non-acid-fast bacteria, which appear in kidney bean shape under the microscope.

Disease/Infection

Conjunctivitis and cutaneous disease are possible from a lab exposure. Theoretically, disseminated disease is also possible. Non lab related diseases may include genital gonorrhea, pelvic inflammatory disease and disseminated disease.

Pathogenicity

Five reported cases of laboratory acquired infection. One case was a cutaneous infection and 4 were gonococcal conjunctivitis.

• Special Populations at Risk
  Immunocompromised

Biosafety Information

Risk Group/BSL
Risk Group 2
Biosafety Level 2 Practices

Modes of Transmission
Infection of skin can be caused by unprotected exposure to the bacteria. Contaminated surfaces also pose risk of infection. Inhalational anthrax results from inhalation of spores of the bacteria. Intestinal anthrax occurs by ingestion of organism. Transmission from person to person is very rare.

Host Range/Reservoir
It is an obligate human pathogen with no other known host.

Symptoms
Clinical manifestations vary depending on the infection. Laboratory acquired gonorrhoeae would produce localized symptoms and only those are highlighted here. Gonococcal conjunctivitis is usually painful, with prominent photophobia and copious, purulent exudate and corneal ulceration can supervene rapidly in the absence of prompt antibiotic therapy. Cutaneous disease can present as local abscess.

Disseminated gonococcal infections occur due to the spread of the bacteria. Patients with disseminated infection may present with dermatitis, arthritis, and rarely, meningitis or endocarditis.

Incubation Period
2-7 days for gonococcal conjunctivitis

Viability
N. gonorrhoeae is sensitive to most disinfectants. Disinfectants used against most vegetative bacteria include 1% sodium hypochlorite, 70% ethanol, phenolics, 2% glutaraldehyde, formaldehyde, and peracetic acid. N. gonorrhoeae is sensitive to desiccation. Most vegetative bacteria can also be inactivated by moist heat and dry heat.

Survival Outside Host
Research should be conducted using Biosafety Level 2 practices, equipment, and facility design. Gloves and gowns should be worn when handling infected laboratory animals and when there is the likelihood of direct skin contact with infectious materials. BSL-2 practices, containment equipment, and facilities are recommended foe activities using clinical materials and diagnostic quantities of infectious cultures.

Information for Lab Workers

Laboratory PPE

Lab coat, gloves and eye protection when direct skin contact with infected materials or animals is unavoidable. Eye protection must be used where there is a known or potential risk of exposure to splashes.

Containment

BSL-2 practices, containment equipment, and facilities are recommended for activities using clinical materials and diagnostic quantities of infectious cultures.

In Case of Exposure/Disease

• For injuries in the lab which are major medical emergencies (heart attacks, seizures, etc…):
  • Medical Campus: call or have a coworker call the Control Center at 617-414–4144.
  • Charles River Campus: call or have a coworker call campus security at 617-353-2121.
    You will be referred to or transported to the appropriate health care location by the emergency response team.
• For lab exposures (needle sticks, bite, cut, scratch, splash, etc…) involving animals or infectious agents, or for unexplained symptoms or illness call the ROHP 24/7 hour number (1-617-358-ROHP (7647); or, 8-ROHP (7647) if calling from an on-campus location) to be connected with the BU Research Occupational Health Program (ROHP) medical officer. ROHP will refer you to the appropriate health care location.
• Under any of these scenarios, always inform the physician of your work in the laboratory and the agent(s) that you work with.
• Provide the wallet-size agent ID card to the physician.

Vaccination

No vaccine is currently available

Information for First Responders/Medical Personnel

Public Health Issues

Neisseria gonorrhea is a reportable disease in the United States

Diagnosis/Surveillance

Several laboratory tests are available to diagnose gonorrhea, and include culture and gram stain and PCR based tests on clinical specimen.

First Aid/Post Exposure Prophylaxis

Perform one of the following actions:

Treatment

Although treatment of gonococcal infections depends upon the site and type of infection, most infections are treated with third generation cephalosporins such as Ceftriaxone or Cefixime. Post laboratory exposure consideration of use of third generation cephalosporins would be made.

References

Biosafety in Microbiological and Biomedical Laboratories; Deborah E. Wilson, DrPH, CBSP Director Division of Occupational Health and Safety National Institutes of Health Bethesda, Maryland L. Casey Chosewood, M.D. Director Office of Health and Safety Centers for Disease Control and Prevention Atlanta, Georgia; US Government Printing Office, Washington DC. 5th Edition; 2007

Control of Communicable Diseases Manual. David L. Heymann. Washington DC, USA:

American Public Health Association Press, 19th edition 2008

Gonorrhea – CDC Fact Sheet; http://www.cdc.gov/std/gonorrhea/STDFact-gonorrhea.htm

Characteristics of N. gonorrhoeae and Related Species of Human Origin; https://www.cdc.gov/std/laboratory/2014labrec/table1.htm

Centers for Disease Control and Prevention. Update to CDC’s Sexually Transmitted Diseases Treatment Guidelines, 2006: Fluoroquinolones No Longer Recommended for Treatment of Gonococcal Infections.  Morbidity Mortality Weekly Review; 2007; 56: 332.

Revised: 2/4/21