Gonococci are bacteria whose medical importance lies in the fact that they can cause the sexually transmitted disease gonorrhea. Gonorrhea is transmitted through sexual intercourse and is typically manifested by a purulent discharge from the urethra in men or from the vagina in women. With antibiotic treatment, this gonococcal infection can be cured and late effects such as impending infertility can be prevented.
What are gonococci?
Neisseria gonorrhoeae, the scientifically exact name for gonococcus, is a spherical bacterium about one-thousandth of a millimeter in size that uses flagella to travel. Its preferred habitat is the mucous membranes of the urinary tract and reproductive organs. Since infection with gonococci, gonorrhea or colloquially called “gonorrhea”, is transmitted only by direct contact of bacteria-containing material with mucous membranes, it is one of the classic venereal diseases. The bacteria infect the urethra of the man and the cervix of the woman. In the course of oral or anal sexual practices, gonococci may also infect the oral mucosa or the mucosa of the rectum.
Significance and function
After an incubation period of a few days, counting from the time of infection with gonococcus, men experience itchy urethritis with pain during urination and purulent discharge. This discharge typically occurs in the morning after getting up and is therefore also known as “bonjour drops”. In women, purulent discharge from the vagina may also occur as part of an infection of the cervix. However, the disease can also proceed without pronounced symptoms. If left untreated, the symptoms usually subside after a few months. Gonorrhea usually responds well to antibiotic treatment. For a long time, the antibiotic of choice was penicillin, one of the first antibiotics available. However, gonococcal strains that are resistant to penicillin are now increasingly being found. Therefore, the preferred therapy today is the administration of other antibiotics, e.g. from the group of cephalosporins. In an uncomplicated course of the disease, treatment over a few days is sufficient. Complicated courses may also require a therapy period of up to one month. When a diagnosis is made, the patient should always be informed that his or her sexual partners should be examined and, if necessary, also treated. Since the introduction of the Infection Protection Act in 2000, the attending physician no longer has to report cases of illness to the public health department. Infection can be prevented by using condoms during sexual intercourse. Despite the propagation of “safer sex,” gonorrhea is still a significant sexually transmitted disease today, with about 15,000 cases per year in Germany. Other sexually transmitted pathogens, such as chlamydia, are often transmitted at the same time as gonococci.
Diseases
Gonococci are feared because of the complications that can occur in severe courses of gonorrhea. In men, the inflammation can spread to the epididymis and to the prostate, which is called epididymitis and prostatitis, respectively. In women, co-infection of the fallopian tubes (salpingitis) may develop. In both sexes, these complications can lead to infertility. The infection can also affect the eye if the hand that previously had contact with the genitals is used to rub the eye. In the worst case, this can lead to blindness in the affected eye if left untreated. There is also a risk to the eye of a newborn if the mother’s genital tract – and thus the birth canal – is infected. In the past, to prevent such a newborn infection with gonococci, called gonoblenorrhea, antibacterial eye drops were administered to all children immediately after birth. Since expectant mothers are now routinely screened for gonorrhea and treated if necessary, this so-called credé prophylaxis has largely been abandoned today. The most serious complication of a gonococcal infection is so-called gonococcal sepsis, in which the pathogenic infection is no longer locally limited to certain mucous membranes, but gonococci can be dispersed throughout the body via the bloodstream.The most feared consequences are life-threatening inflammation of the heart valves (gonococcal endocarditis) or the meninges (gonococcal meningitis).
