Manual of Clinical Microbiology



Last Updated:2023

According to the second edition of Bergey's Manual of Systematic Bacteriology, the genus Neisseria belongs to the family Neisseriaceae in the order Neisseriales

Description of the Genus Neisseria

Most members of the genus Neisseria are cocci with a diameter up to 2 μm, presenting as single bacteria or in pairs. The species Neisseria elongata, N. weaveri, N. bacilliformis

Epidemiology and Transmission

N. gonorrhoeae causes gonorrhea, the second most commonly reported notifiable disease in the United States (14). N. gonorrhoeae is always considered pathogenic, and humans are the only hosts…

Clinical Significance

Members of the genus Neisseria have a high affinity for mucosal membranes. A wide variety of species can be isolated from humans, including N. gonorrhoeae, N. cinerea, N. elongata

Collection, Transport, and Storage of Specimens

The selection of specimens for culture‐based diagnosis of gonorrhea depends on sex, the level of sexual maturity, and the anatomical sites exposed. The anterior portion of the male urethra is…

Direct Examination

If possible, a direct smear for Gram staining should be prepared with a different swab than that used for the collection of a culture specimen in cases of male urethritis.…

Isolation Procedures

Cultivation of N. gonorrhoeae is best performed on chocolate agar, which supports the growth of many other commensal bacteria. To isolate N. gonorrhoeae from mucosal and other nonsterile body sites,…


After 48 h of growth on chocolate agar, colonies of N. gonorrhoeae are up to 1 mm in diameter, opaque, grayish white, glistening, and convex. Morphology can include the presence…

Molecular Typing

DNA‐based methods used for typing of N. gonorrhoeae include gel‐based methods such as opa typing and restriction fragment length polymorphism analysis by pulsed‐field gel electrophoresis (150). DNA sequence‐based…

Serologic Tests

Serologic tests are used for the determination of protection against IMD after vaccination or for seroepidemiological studies. They do not contribute to the ascertainment of invasive disease, since asymptomatic carriage…

Antimicrobial Susceptibilities

Antibiotic susceptibility testing of N. gonorrhoeae and N. meningitidis can currently be performed only using culture‐based methods. Recommended methods, breakpoints, and terminology differ among standardizing bodies, thus limiting direct comparison…

Evaluation, Interpretation, and Reporting of Results

Due to the imperfect specificity of many diagnostic methods used for identification of N. gonorrhoeae, results must be interpreted in the context of local disease prevalence, which considerably influences any…

Section Editor: Patricia Simner

Volume Editor: Robin Patel

Editors in Chief: Karen C. Carroll and Michael A. Pfaller

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