Definition
Gonorrhea is a sexually transmitted infection (STI) caused by the bacterium
Neisseria gonorrhoeae. It can present as urethritis in men, cervicitis or urethritis in women, and in extragenital sites such as the pharynx, rectum, conjunctiva, and rarely, systemically in both sexes
Epidemiology
- Global incidence: The estimated global annual incidence of gonorrhea is 86.9 million adults
- United States incidence: In 2016, the incidence of Neisseria gonorrhoeae infection in the United States was 100 per 100,000 person-years
- China incidence: In 2022, China reported 96,313 cases of gonorrhea, making it the fourth most common notifiable infectious disease in the country
Pathophysiology
The pathophysiology of gonorrhea involves
Neisseria gonorrhoeae invading the urethral epithelium, adhering to epithelial cells, multiplying, and initiating an inflammatory response. The infection is transmitted by direct inoculation of infected secretions from one mucosal surface to another. Antibiotic resistance is associated with specific gene mutations, including
penA,
penB, and
mtrR for penicillin resistance;
rpsJ,
penB, and
mtrR for tetracycline resistance; and
gyrA and
parC for fluoroquinolone resistance
Prognosis
The prognosis of gonorrhea is generally good with appropriate antibiotic treatment. However, untreated cases can lead to complications such as epididymitis, prostatitis, and disseminated gonococcal infection. The rise in prevalence of antimicrobial-resistant strains, particularly the international spread of ceftriaxone-resistant clones, poses a formidable challenge to gonorrhea control
In conclusion, gonorrhea is a common STI with a significant global incidence. It is caused by
Neisseria gonorrhoeae, which invades the urethral epithelium and initiates an inflammatory response. The prognosis is generally good with appropriate treatment, but the rise in antimicrobial-resistant strains poses a significant challenge to disease control.