Neisseria gonorrhoeae Infections

The Neisseria gonorrhoeae is the etiologic agent of gonorrhea and is a human pathogen, which is transmitted during sexual intercourse or by contact with infected biological fluids (e.g., genital secretions or saliva). The most common gonococcal infections in males affect the urethral mucosa, but rectal, pharyngeal and conjunctival epithelia can also be involved. In women, N. gonorrhoeae affects primarily the cervical epithelium but also vaginal tissue can be colonized. The urethral infection in males, or gonorrhea, is also known colloquially as the clap or chaude pisse (terms that underlined the characteristic burning during urination) in the French language. In men, urogenital infection is generally symptomatic, with the appearance of urethritis in 80% of cases. On the other hand, in women, when the infection affects the cervix, it causes vaginal symptoms, such as discharge, burning sensations, and discomfort. However, in over 50% of women, the infection can persist with unspecific or mild symptoms or be asymptomatic. In both genders, rectal and pharyngeal infections are asymptomatic in 90% of cases. The incubation period of urethral infection has been reported to range from 2 to 4 days after exposure. The brief incubation period of gonorrhea is an effective, hard biological proxy of a very recent sexual behavior at risk, and gonorrhea rates are commonly used as an outcome of effectiveness of preventive behavioral interventions. Since the introduction of antibiotic therapy, N. gonorrhoeae has shown a great ability to modify its genome, creating different defense mechanisms against antimicrobial therapies. Some of these are not exclusively based on mechanisms of antimicrobial resistance, but also on an increase in adaptability.