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RUNNING HEAD: GONORRHEA
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Gonorrhea
Kelsey Hackett, Lydia Stutzman, Nicole Warren,
Rachael Lenaeus, Abbigail Garreans & Schyler Pauba
Dr. Harsha Sharma
Microbiology
Nebraska Methodist College
March 13, 2008
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I. Introduction
II. What are microorganisms?
A. History
1. Ask class what they know about microorganisms.
2. Spontaneous Generation- Greeks
3. Robert Hooke: first to observe a microorganism in 1665
4.Oldest form of life on Earth – 3.5 billion years
B. Many diverse organisms
1. Prokaryotes: single celled, no membrane bound nucleus or organelles
a) Bacteria: cell walls made of peptidoglycan, multiply by binary fission
(grow quickly!)
b) Archaea: live in extreme environments
2. Eukaryotes: can be single or multi cellular, membrane bound nucleus and
organelles= more complex than prokaryotes
a) Algae: photosynthetic organisms often found in salt or fresh water
b) Protozoa: microscopic, yet very complex organisms found in both land
and water environments
c) Fungi: molds, yeasts or mushrooms that feed on organic compounds
d) Helminths:
3. Infectious Agents: Because they are not made of cells, these are termed
obligate intracellular parasites- they rely on living host cells for growth.
a) Viruses:
b) Viroids:
c) Prions: responsible for neurodegenerative disease in humans and
animals and are ALWAYS fatal
III. How are microorganisms BENEFICIAL to human beings?
A. (Ask class to think of some examples)
B. Without microorganisms, humans could not exist on earth
C. Help protect against diseases
D. The entire surface of our body contains bacteria
E. The study of microorganisms advances medical and scientific research
1. Easy to study, yield quick results.
2. “What is true of an elephant is also true of bacteria” – Dr. Jacques Monod.
IV. How are microorganisms HARMFUL to human beings?
A. Microorganisms and infectious agents are responsible for more human deaths than any
war
1. From 1918-1919 more Americans died from Influenza than the amount killed
in WWI, WWII, the Korean War and the Vietnam War combined
2. Plague resulted in 25 million European deaths between 1346-1350
3. Smallpox has caused 10 million deaths over past 4,000 years
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V. What is Gonorrhea?
A. The word Gonorrhea comes from two Latin words.
1. gonos- meaning seed
2. rhoe- meaning flow
B. It is a sexually transmitted bacterial infection
1. It attacks mucous membranes of the body
a) Examples: mouth, ears, nostrils, eyes, genitalia, and anus
2. The bacteria reside in warm moist body cavities
a) In both men and women
C. Gonorrhea causes most female infertility
1. Also called “the clap” or “the drip”
VI. History of Gonorrhea
A. Discovery
1. Gonorrhea was described in early writings from Egypt, China, and Japan;
Warnings against "unclean discharge from the body" appear in the Bible
2. The gram-negative bacteria that causes gonorrhea was discovered in 1879 by
Albert Neisser
3. German immunologist Paul Ehrlich named the bacterium gonococcus
4. Since then, five types of the gonococcus organism have been identified
B. Background
1. The history of gonorrhea is long and dates back many decades and even
centuries
2. Some of the earliest cases of sexually transmitted diseases related to
gonorrhea date back to France in 1250’s, but at that time it was not
officially named gonorrhea
3. Gonorrhea is not a new problem; it was common among WWI recruits;
More than 1 million cases per year were reported during the late 1970's,
now down to an average around 342,250 per year
C. Today's concerns
1. Its continued prevalence and its slowly increasing resistance to antibacterial
treatment
2. First successful treatment of Gonorrhea was in the beginning of the twentieth
century; used penicillin (most common form of antibiotic to treat) until
Gonorrhea started showing resistance (1970)
D. Other forms of treatment used in past
1. Mercury was used as a treatment for gonorrhea
2. Silver nitrate was one of the commonly used drugs in the 19th century, later
replaced by Protargol
VII. Pathophysiology
A. Plasmids carry antibiotic-resistance genes, called penicillinase
B. Genes are then transmitted between different subtypes
1. Subtypes are able to evade serum immune responses
C. By transmitting the genes, the surface protein genes results in high host susceptibility
to reaction
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D. The high susceptibility makes the genes resistant to beta-lactam antibiotics for 20
years
1. Beta-lactam is an antibiotic
E. Infections that produced from this sort of pathophysiology show signs in the lower
genital tract, the pharynx, rectum, and male and female urethra
VIII. Symptoms of Gonorrhea
A. Silent Symptoms
1. You may have it and not know it.
2. Symptoms may be so mild you don’t notice.
B. Symptoms in men
1. Unusual discharge from penis
a) Discoloration
b) Pus-like
2. Itching
3. Urination
a) Painful
b) Frequent
c) May contain blood
4. Pain and swelling
a) Testicles
b) Glands of the groin
C. Symptoms in women
1. Painful urination
2. Fever
3. Unusual vaginal discharge
4. Bleeding between periods
5. Vomiting
6. Belly pain
D. Mild/ non-specific symptoms
1. Could be mistaken for:
a) Bladder infection
b) Vaginal infection
c) Urinary Tract Infection (UTI)
E. Rectal Infection
1. Discharge
2. Anal itching
3. Soreness
4. Bleeding
IX. How to Test for Gonorrhea
A. a sample of body fluid or urine
1. used to screen for or confirm a gonorrhea infection
B. types of tests used to detect (most tests use a sample of body fluid from the affected
area)
1. Nucleic acid amplification tests (NAAT)
2. Nucleic acid hybridization test (DNA probe test, molecular probe test)
3. Gonorrhea culture
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4. Gram stain
5. Enzyme-linked immunosorbent assay (ELISA, EIA)
X. Treatment of Gonorrhea
A. It has been said that historically, gonorrhea was treated with an injection of mercury.
While its efficacy is unknown, the first truly successful treatment was introduced in the twentieth
century. Antibiotic treatment by Penicillin proved successful until resistance occurred in the
1970s.
B. When bacteria replicate and multiply, the DNA splits into two, a process that results
in mutations. Sometimes these mutations can be helpful and offer a survival benefit for the
bacteria.
C. While it was once considered a relatively easy STD to cure, these antimicrobialresistant strains have recently created a large obstacle in the control of gonorrhea.
D. In fact, it has become so resistant to multiple, common antibiotics that the Center for
Disease Control has recently added gonorrhea to its list of super bugs. The CDC defines warns
that these bugs are “infections that can't be successfully treated with commonly prescribed
antibiotics and often involve longer illnesses, extended hospital stays or severe side effects from
last resort drugs. They often lead to higher treatment costs. For young children, the elderly and
the immuno-compromised, a progressive antibiotic-resistant infection can be fatal.”
E. A new strain of Neisseria Gonorrhea is immune to an antibiotic called
fluoroquinolone that has been prescribed in the form of a pill for over a decade. Due to this
resistant strain, the only guaranteed treatment for all cases is a shot of the cephalosporin
antibiotic.
F. Antibiotic treatment is dependent on the strain and its severity as well as geographical
location (since different areas of the world experience different resistant cases).
G. It may be necessary to take combinations of antibiotic treatments to cure the
infection. It is important to finish an entire course of the medication because inconsistency
encourages bacteria resistance and survival. Regular doses will kill the bacteria rapidly and
efficiently. When the bacteria are undertreated, some of them may have enough time to replicate
and make changes in their DNA. Then, as they continue to multiply, new forms of the bacteria
do not respond to the antibiotics.
H. Gonorrhea testing is not usually included in routine STD testing, so make sure to ask
your healthcare provider if you think you may be at risk of infection. If treated early in its course,
gonorrhea should not cause any long-term problems. However, if left untreated, advanced
complications can arise.
XI. Prevention of Gonorrhea
A. Abstinence: only 100% sure way of not contracting Gonorrhea or any STD is to
refrain completely from having sexual intercourse
B. Practice safe sex
1. Talk to your partner about STD’s first before getting involved in a sexual
relationship
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2. Have you and your partner get tested for any STD’s before getting involved in
a sexual relationship
a. Get tested immediately if there is any discharge, burning during urination,
unusual sore or rash
b. Stop having sex immediately and see a doctor
3. Don’t have more than one sexual relationship at a time (increased risk)
4. If you or your partner have had several sex partners within the past year, or
you are a man who has unprotected sex with men, get tested for STD’s even if
you have no symptoms
C. Contraception
1. Condom use reduces your risk of contracting an STD, but not 100%
a. Latex or polyurethane condoms
b. Latex condoms are proven to be over 99% effective when used
consistently and correctly
2. Condom must be in place before sexual activity begins (apply condom
correctly)
3. Male and females condoms available
D. Remember, everyone who is not in a monogamous long-term relationship needs
to protect themselves by practicing safe sex routinely
XII. Conclusion
References
What is gonorrhea? What causes gonorrhea? (2009). Retrieved on March 2, 2010, from Medical News
Today, http://www.medicalnewstoday.com/articles/155653.php
http://www.webmd.com/sexual-conditions/gonorrhea-test
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Resources
http://helpinggonorrhea.com/history%20of%20gonorrhea.494.htm
http://www.healthandnutritiontips.net/history_of_gonorrhea/history_of_gonorrhea.html
http://www.whatisgonorrhea.com/history-gonorrhea.php
http://www.faqs.org/health/topics/38/Gonorrhea.html
http://www.webmd.com/sexual-conditions/tc/gonorrhea-prevention