Urethritis is usually caused by Neisseria gonorrhoeae or Chlamydia trachomatis. Gonococcal urethritis can be diagnosed with excellent specificity by Gram stain of the urethral exudate.
Occasionally samples are sent from elderly males labeled as “urethra”. These are commonly from chronically catheterized patients. In males greater than 60 years of age process as superficial wound specimen. See Wounds (Superficial) – Wound swabs / Abscess swabs / Drainage.
Direct examination
Gram stain
Culture
| Media | Incubation |
| Vancomycin-Colistin-Nystatin Agar (VCN) | CO2, 35°C x 72 hours |
Negative Report
No Neisseria gonorrhoeae isolated.
If VCN plate is overgrown by swarming Proteus or yeast, report ONLY as “Unable to rule out Neisseria gonorrhoeae due to bacterial/yeast overgrowth.”
Positive Report
“Neisseria gonorrhoeae” isolated (do not quantitate), beta lactamase negative or positive. “Report has been copied to Medical Officer of Health”.
Telephone all positive GC cultures to floor/ordering Physician.
For all positive GC cultures, a Communicable Disease Report is sent to the Medical Officer of Health and is recorded in the significant isolates log book.