Urethra

Urethritis is usually caused by Neisseria gonorrhoeae or Chlamydia trachomatis. Gonococcal urethritis can be diagnosed with excellent specificity by Gram stain of the urethral exudate.

Occasionally samples are sent from elderly males labeled as “urethra”. These are commonly from chronically catheterized patients. In males greater than 60 years of age process as superficial wound specimen. See Wounds (Superficial) – Wound swabs / Abscess swabs / Drainage.

Setup

Direct examination

Gram stain

Culture

Media Incubation
Vancomycin-Colistin-Nystatin Agar (VCN) CO2, 35°C x 72 hours

Interpretation Examine VCN after 24, 48 and 72 hours incubation for colonies suspicious of GC.
Reporting

Negative Report

No Neisseria gonorrhoeae isolated.
If VCN plate is overgrown by swarming Proteus or yeast, report ONLY as “Unable to rule out Neisseria gonorrhoeae due to bacterial/yeast overgrowth.”

Positive Report

Neisseria gonorrhoeae” isolated (do not quantitate), beta lactamase negative or positive. “Report has been copied to Medical Officer of Health”.

Telephone all positive GC cultures to floor/ordering Physician.

For all positive GC cultures, a Communicable Disease Report is sent to the Medical Officer of Health and is recorded in the significant isolates log book.

References Izenberg H.D.. 2003. Genital Cultures, in Clinical Microbiology Procedures Handbook, 2nd ed. Vol.1 ASM Press, Washington, D.C.