Gonococcal Infections in Newborns and in Adolescents

  • Noni MacDonald
  • Tim Mailman
  • Shalini Desai
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 609)

Gonococcal (GC) genital tract infection was first recognized by Hippocrates in the fifth century BC and later given its name — “gonorrhea” meaning “flow of semen” — by Galen in second century AD (Woods 2005). Despite the passage of time, much research, the advent of sensitive and specific diagnostic tests and effective antimi-crobial therapy, gonorrhea remains one of the most prevalent bacterial sexually transmitted infections (STI), in both industrialized and developing countries. This chapter focuses on gonococcal infections in two groups — newborns who acquire infection from their mothers at the time of delivery, and adolescents: a group at the center of the ongoing worldwide STI epidemic.


Chlamydia Trachomatis Neisseria Gonorrhoeae Public Health Agency Sexual Network Partner Notification 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. American Academy of Pediatrics (2006). Gonococcal infections. In Pickering LK, Baker CJ, and McMillan JA (eds.), Red Book: 2006 Report of the Committee on Infectious Diseases 27th ed. American Academy of Pediatrics, Elk Grove Village, IL, pp. 301–309.Google Scholar
  2. Apea-Kubi KA, Yamaguchi S, Sakyi B, Kisimoto T, Ofori-Adjei D, and Hagiwara T. (2004). Neisseria gonorrhoea, Chlamydia trachomatis, and Treponema pallidum infection in antenatal and gynecological patients at Korle-Bu Teaching Hospital, Ghana. Jpn J Infect Dis, 57:253–256.PubMedGoogle Scholar
  3. Australian Government, Department of Health and Aging (2004). Australia’s notifiable diseases status, 2002. Annual report of National Notifiable Diseases Surveillance System-sexually transmissible diseases. Communicable Diseases Australia 28:1–14 http://www.health.gov.au/internet/wcms/Publishing.nsf/Content/cda-pubs-cdi-2004-cdi2801-htm-cdi2801b12.htm
  4. Bernstein KT, Zenilman J, Olthoff G, Marsiglia VC, and Erbelding EJ. (2006). Gonorrhea reinfection among sexually transmitted disease clinic attendees in Baltimore, Maryland. Sex Transm Dis, 33:80–86.PubMedCrossRefGoogle Scholar
  5. Bignell CJ. (2001). European guideline for the management of gonorrhoea. Int J STD AIDS, 12(Suppl 3):27–29.PubMedCrossRefGoogle Scholar
  6. Bozicevic I, Fenton KA, Martin IM, Rudd EA, Ison CA, Nanchahal K, and Wellings K. (2006). Epidemiology correlates of asymptomatic gonorrhea. Sex Transm Dis 33:289–295.PubMedCrossRefGoogle Scholar
  7. Brown AE, Sadler KE, Tompkins SE, McGarrigle CA, LaMontagne DS, Goldberg D, Tookey PA, Smyth B, Thomas D, Murphy G, Parry JV, Evans BG, Gill ON, Ncube F, and Fenton KA. (2004). Recent trends in HIV and other STIs in the United Kingdom: data to the end of 2002. Sex Transm Infect, 80:159–166.PubMedCrossRefGoogle Scholar
  8. Brown JD, L’Engle KL, Pardun CJ, Guo G, Kenneavy K, and Jackson C. (2006). Sexy media matter: exposure to sexual content in music, movies, television, and magazines predicts black and white adolescents’ sexual behavior. Pediatrics 117:1018–1027.PubMedCrossRefGoogle Scholar
  9. Centers for Disease Control and Prevention (2002). Screening tests to detect Chlamydia trachomatis and Neisseria gonorrhoea infections-2002. MMWR, 51:RR-15.Google Scholar
  10. Centers for Disease Control and Prevention (2005). Sexually transmitted disease surveillance 2004. Division of STD Prevention. September 2005.www.cdc.gov/std/stats/04pdf/2004surveillanceall.pdf)
  11. Centers for Disease Control and Prevention (2006a). Youth risk behaviour surveillance-United States, 2005. MMWR, 55:SS-5.www.cdc.gov/MMWR/PDF/SS/SS5505.pdf
  12. Centers for Disease Control and Prevention (2006b). Trends in the prevalence of sexual behaviours. National Youth Risk Behaviour Survey: 1991–2005.www.cdc.gov/healthyyouth/yrbs/pdf/trends/2005_YRBS_Sexual_Behaviors.pdf
  13. Centers for Disease Control and Prevention (2006c). Sexually transmitted diseases treatment guidelines, 2006. MMWR, 55(No. RR-11):1–94.Google Scholar
  14. Chen X-S, Yin Y-P, Chen L-P, Thuy NTT, Zhang G-Y, Shi M-Q, Hu L-H, and Yu Y-H. (2006). Sexually transmitted infections among pregnant women attending an antenatal clinic in Fuzhou, China. Sex Transm Dis, 33:296–301.PubMedCrossRefGoogle Scholar
  15. Christian P, Khatry SK, LeClerq SC, Roess AA, Wu L, Yuenger JD, and Zenilman JM. (2005). Prevalence and risk factors of chlamydia and gonorrhea among rural Nepali women. Sex Transm Infect, 81:254–258.PubMedCrossRefGoogle Scholar
  16. DiClemente RJ and Crosby RA. (2006). Preventing sexually transmitted infections among adolescents: ‘the glass is half full’. Curr Opin Infect Dis, 19:39–43.PubMedCrossRefGoogle Scholar
  17. Dillon JA, Ruben M, Li H, Borthagaray G, Marquez C, Fiorito S, Galarza P, Portilla JL, Leon L, Agudelo CI, Sanabria OM, Maldonado A, and Prabhakar P. (2006). Challenges in the control of gonorrhea in South America and the Caribbean: monitoring the development of resistance to antibiotics. Sex Transm Dis, 33:87–95.PubMedCrossRefGoogle Scholar
  18. Doherty IA, Padian NS, Marlow C, and Aral SO. (2005). Determinants and consequences of sexual networks as they affect the spread of sexually transmitted infections. J Infect Dis, 191(Suppl 1):S42–S54.PubMedCrossRefGoogle Scholar
  19. Ellison RT III, Curd JG, Kohler PF, Reller LB, and Judson FN. (1987). Underlying complement deficiency in patients with disseminated gonococcal infection. Sex Transm Dis, 14:201–204.PubMedGoogle Scholar
  20. Foster A and Klauss V. (1995). Ophthalmia neonatorum in developing countries. N Engl J Med, 332:600–6001.PubMedCrossRefGoogle Scholar
  21. Ford K, Sohn W, and Lepkowski J. (2002). American adolescents: sexual mixing patterns, bridge partners, and concurrency. Sex Transm Dis, 29:13–19.PubMedCrossRefGoogle Scholar
  22. Gaydos CA. (2005). Nucleic acid amplification tests for gonorrhea and chlamydia: practice and applications. Infect Dis Clin North Am, 19:367–386, ix.PubMedCrossRefGoogle Scholar
  23. Gaydos CA. (2006). Rapid tests for sexually transmitted diseases. Curr Infect Dis Rep, 8:115–124.PubMedCrossRefGoogle Scholar
  24. Ghanem KG, Giles JA, and Zenilman JM. (2005). Fluoroquinolone-resistant Neisseria gonorrhoeae: the inevitable epidemic. Infect Dis Clin North Am, 19:351–365.PubMedCrossRefGoogle Scholar
  25. Golden MR and Manhart LE. (2005). Innovative approaches to the prevention and control of bacterial sexually transmitted infections. Infect Dis Clin North Am, 19:513–540.PubMedCrossRefGoogle Scholar
  26. Hooper RR, Reynolds GH, Jones OG, Zaidi A, Wiesner PJ, Latimer KP, Lester A, Campbell AF, Harrison WO, Karney WW, and Holmes KK. (1978). Cohort study of venereal disease.1: the risk of gonorrhea transmission from infected women to men. Am J Epidemiol, 108:136–144.PubMedGoogle Scholar
  27. Holmes KK, Johnson DW, and Trostle HJ. (1970). An estimate of the risk of men acquiring gonorrhea by sexual contact with infected females. Am J Epidemiol, 91:170–174.PubMedGoogle Scholar
  28. Isenberg SJ, Apt L, and Wood M. (1995). A controlled trial of povidone-iodine as prophylaxis against ophthalmia neonatorum. N Engl J Med, 332:562–566.PubMedCrossRefGoogle Scholar
  29. Joesoef MR, Kahn RH, and Weinstock HS. (2006). Sexually transmitted infections in incarcerated adolescents. Curr Opin Infect Dis, 19(1):44–48.PubMedCrossRefGoogle Scholar
  30. Joyner JL, Douglas JM, Jr., Ragsdale S, Foster M, and Judson FN. (2000). Comparative prevalence of infection with Trichomonas vaginalis among men attending a sexually transmitted diseases clinic. Sex Transm Dis, 27:236–240.PubMedCrossRefGoogle Scholar
  31. Kahn JA, Rosenthal SL, Succop PA, Ho GYF, and Burk RD. (2002). Mediators of the association between age at first sexual intercourse and subsequent human papillomavirus infection. Pediatrics, 109(1):E5. http://pediatrics.aappublications.org/cgi/content/full/109/1/e5
  32. Khan A, Fortenberry JD, Juliar BE, Tu W, Orr DP, and Batteiger BE. (2005). The prevalence of chlamydia, gonorrhea, and trichomonas in sexual partnerships: implications for partner notification and treatment. Sex Transm Dis, 32:260–264.PubMedCrossRefGoogle Scholar
  33. Laga M, Meheus A, and Piot P. (1989). Epidemiology and control of gonococcal ophthalmia neonatorum. Bull World Health Organ, 67:471–477.PubMedGoogle Scholar
  34. Lofy KH, Hofmann J, Mosure DJ, Fine DN, and Marrazzo JM. (2006). Chlamydial infections among female adolescents screened in juvenile detention centers in Washington State, 1998–2002. Sex Transm Dis, 33:63–67.PubMedCrossRefGoogle Scholar
  35. MacDonald NE, Wells GA, Fisher WA, Warren WK, King MA, Doherty JA, and Bowie WR. (1990). High-risk STD/HIV behavior among college students. JAMA, 263:3155–3159.PubMedCrossRefGoogle Scholar
  36. MacDonald NE, Fisher WA, Wells GA, Doherty JA, and Bowie WR. (1994). Canadian street youth: correlates of sexual risk-taking activity. Pediatr Infect Dis J, 13:690–697.PubMedCrossRefGoogle Scholar
  37. Manhart LE and Holmes KK. (2005). Randomized controlled trials of individual-level, population-level, and multilevel interventions for preventing sexually transmitted infections: what has worked?. J Infect Dis, 191(Suppl 1):S7–S24.PubMedCrossRefGoogle Scholar
  38. Mann J, Kropp R, Wong T, Venne S, and Romanowski B. (2004). Gonorrhea treatment guidelines in Canada: 2004 update. CMAJ, 171:1345–1346.PubMedGoogle Scholar
  39. May RM and Anderson RM. (1987). Transmission dynamics of HIV infection. Nature, 326:137–142.PubMedCrossRefGoogle Scholar
  40. Miller WC, Ford CA, Morris M, Handcock MS, Schmitz JL, Hobbs MM, Cohen MS, Harris KM, and Udry JR. (2004). Prevalence of chlamydial and gonococcal infections among young adults in the United States. JAMA, 291:2229–2236.PubMedCrossRefGoogle Scholar
  41. Public Health Agency of Canada (2005). 2002 Canadian sexually transmitted infections surveillance report. CCDR, 31S2:1–39.Google Scholar
  42. Public Health Agency of Canada. (2006a). Gonococcal infections. In Canadian Guidelines on Sexually Transmitted Infections 2006 edition. Public Health Agency of Canada. http://www.phac-aspc.gc.ca/std-mts/sti_2006/pdf_2006_e.html
  43. Public Health Agency of Canada. (2006b). Primary care and sexually transmitted infections. In Canadian Guidelines on Sexually Transmitted Infections 2006 edition. Public Health Agency of Canada. http://www.phac-aspc.gc.ca/std-mts/sti_2006/pdf_2006_e.html
  44. Public Health Agency of Canada. (2006c). Street youth in Canada. Findings from enhanced surveillance of Canadian street youth, 1999–2003. http://www.phac-aspc.gc.ca/std-mts/reports_06/youth_e.html
  45. Public Health Agency of Canada STD (2002). Self-directed learning module. Slide gallery: http://www.phac-aspc.gc.ca/slm-maa/slides/other/index.html, gram stain: http://www.phac-aspc.gc.ca/slm-maa/slides/other/pages/u206,.html urethritis: http://www.phac-aspc.gc.ca/slm-maa/slides/other/pages/u203.html mucopurulent cervicitis: http://www.phac-aspc.gc.ca/slm-maa/slides/other/pages/stdx003.html skin lesions in disseminated gonococcal infection http://www.phac-aspc.gc.ca/slm-maa/slides/other/pages/r909.html polyarticular arthritis in Disseminated Gonococcal Infection http://www.phac-aspc.gc.ca/slm-maa/slides/other/pages/8r931.html
  46. Rice PA. (2005). Gonococcal arthritis (disseminated gonococcal infection). Infect Dis Clin North Am, 19:853–861.PubMedCrossRefGoogle Scholar
  47. Risser WL, Bortot AT, Benjamins LJ, Feldmann JM, Barratt MS, Eissa MA, and Risser JM. (2005). The epidemiology of sexually transmitted infections in adolescents. Semin Pediatr Infect Dis, 16:160–167.PubMedCrossRefGoogle Scholar
  48. Robertson AA, Thomas CB, St Lawrence JS, and Pack R. (2005). Predictors of infection with chlamydia or gonorrhea in incarcerated adolescents. Sex Transm Dis, 32:115–122.PubMedCrossRefGoogle Scholar
  49. Rosey AL, Abachin E, Quesnes G, Cadilhac C, Pejin Z, Glorion C, Berche P, and Ferroni A. (2006). Development of a broad-range 16S rDNA real-time PCR for the diagnosis of septic arthritis in children. J Microbiol Methods, 68(1):88–93.PubMedCrossRefGoogle Scholar
  50. Santelli J, Ott MA, Lyon M, Rogers J, and Summers D. (2006). Abstinence-only education policies and program: a position paper of the Society for Adolescent Medicine. J Adolesc Health, 38:83–87.PubMedCrossRefGoogle Scholar
  51. Schaller UC and Klauss V. (2001). Is Crede’s prophylaxis for ophthalmia neonatorum still valid?. Bull World Health Organ, 79:262–263.PubMedGoogle Scholar
  52. Shafii T and Burstein GR. (2004). An overview of sexually transmitted infections in adolescents. Adolesc medicine clinics. 15(2):201–214.CrossRefGoogle Scholar
  53. Steiner MJ and Cates W, Jr. (2006). Condoms and sexually-transmitted infections. N Engl J Med, 354:2642–2643.PubMedCrossRefGoogle Scholar
  54. Taelman HTM, Tyndall MW, Gichangi P, Omollo DO, Omar S, Ombete J, Mohamedali FY, Ndinya-Achola J, and Temmerman M. (1996). Acute urethritis among men in Nairobi, Kenya: etiologic diagnosis, syndromic treatment & association with HIV-1. Int Conf Aids, 7–12; 11:219 (abstract no Th.B.112).Google Scholar
  55. Vogel U and Frosch M. (1999). Mechanisms of neisserial serum resistance. Mol Microbiol, 32:1133–1139.PubMedCrossRefGoogle Scholar
  56. Ward H and Robinson AJ. (2006). Still waiting: poor access to sexual health services in the UK. Sex Transm Infect, 82:3.PubMedCrossRefGoogle Scholar
  57. Warner L, Stone KM, Macaluso M, Buehler JW, and Austin HD. (2006). Condom use and risk of gonorrhea and Chlamydia: a systematic review of design and measurement factors assessed in epidemiologic studies. Sex Transm Dis, 33:36–51.PubMedCrossRefGoogle Scholar
  58. Whitcher JP, Srinvasan M, and Upadhyay MP. (2001). Corneal blindness: a global perspective. Bull World Health Organ, 79:214–221.PubMedGoogle Scholar
  59. Woods CR. (2005). Gonococcal infections in neonates and young children. Semin Pediatr Infect Dis, 16:258–270.PubMedCrossRefGoogle Scholar
  60. World Health Organization (2001). Maternal Morbidity and Mortality. Training course on using data for decision making in maternal and perinatal health.www.emro.who.int/rhrn/Presentations/Decision/Maternal%20Morbidity%20and%20Mortality%20%20Training%20Course%20on%20Using%20Data%20for%20Decision%20Making%20in%20Maternal%20and%20Perinatal%20Health.pdf
  61. Wylie JL and Jolly A. (2001). Patterns of chlamydia and gonorrhea infection in sexual networks in Manitoba, Canada. Sex Transm Dis, 28:14–24.PubMedCrossRefGoogle Scholar

Copyright information

© Springer 2008

Authors and Affiliations

  • Noni MacDonald
    • 1
  • Tim Mailman
  • Shalini Desai
  1. 1.Division Pediatric Infectious Diseases, IWK Health CenterProfessor of Pediatrics, Dalhousie UniversityHalifax, Nova ScotiaCanada

Personalised recommendations