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The present article describes the laboratory diagnosis of Neisseria gonorrhoeae by culturing of the organism from different types of clinical specimens followed by confirmatory tests. The success of culture methods requires good quality collection and transport of clinical specimens. The present guide describes the media requirements and cultural conditions for N gonorrhoeae growth and the characteristics for a presumptive identification of N gonorrhoeae. Confirmatory tests include biochemical tests, chromogenic enzyme substrate tests, immunoassays and nucleic acid methods. Nucleic acid detection methods include either amplification-based methods or nonamplification tests, and are increasingly used in clinical laboratories where a viable culture is not possible to obtain. Nucleic acid methods can also be used to detect the presence of low numbers in a specimen. Nucleic acid detection methods need confirmation with another amplification method or gene target. Controls must be included to ensure true positive and negative results, and to rule out nucleic acid contamination. Monitoring of antimicrobial susceptibilities of N gonorrhoeae is important to investigate treatment failure and to evaluate the efficacy of currently recommended therapies. Many methods for the characterization of N gonorrhoeae require cultures. The useful typing methods for determining strain relatedness include auxotyping, serotyping, plasmid profile analysis, DNA sequencing of the porB gene and pulsed-field gel electrophoresis. Quality assurance programs for diagnostic testing and antimicrobial susceptibility testing is reviewed.

Real-time PCR will be the most sensitive diagnostic method.

Please take a look at this useful RG link.

Article Specific and Sensitive Detection of Neisseria gonorrhoeae in...

Algorithm for culture and identification of Niesseria gonorrheae

Article The Laboratory Diagnosis of Neisseria gonorrhoeae

Early diagnosis of Neisseria gonorrhoeae infections is important with regard to patients' health and infectivity. We report the development of a specific and sensitive TaqMan assay for the detection of N. gonorrhoeae in clinical samples.

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https://www.researchgate.net/publication/7494719_Specific_and_Sensitive_Detection_of_Neisseria_gonorrhoeae_in_Clinical_Specimens_by_Real-Time_PCR

For Nonculture, the detection of N. gonorrhoeae by a nonculture assay, such as antigen detection, nonamplified DNA probe, or nucleic acid amplification tests (NAATs). Both amplified and nonamplified tests are suitable for screening, but amplified methods are more sensitive. NAATs are commonly used by high volume laboratories.

For Culture, Positive Oxidase, and Demonstration of Typical Morphology

The growth of GNDC from a urethral or endocervical specimen on selective media, such as modified Thayer-Martin (MTM), that demonstrates positive oxidase reaction, typical colony morphology and typical Gram stain morphology .

It is a Gram-negative, non-spore forming, non-motile, encapsulated, and non acid-fast bacteria, which appear in kidney bean shape under the microscope

Identification should be achieved by a combination of test procedures which both identify the organism and exclude other Neisseria species. N.gonorrhoeae is usually isolated from high risk patients, where it is only necessary to perform presumptive identification followed by a single confirmatory test. However, in low risk patients and in child and sexual abuse (medicolegal) cases it is necessary to use more than one confirmatory test. Detection of N. gonorrhoeae can be achieved by NAATs or culture. A culture should be taken in all cases of N. gonorrhoeae diagnosed by NAATs.

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