Neisseria gonorrhoeae Antimicrobial Susceptibility Testing

Laboratory Fee Schedule
Procedure #: N/A

Synonym(s):	GC AST
Requisition Form	G-2B
Test Description	Antimicrobial susceptibility testing by ETest gradient strip for azithromycin, cefixime, ceftriaxone, and ciprofloxacin for suspected drug-resistant Neisseria gonorrhoeae.
Pre-Approval Needed	N/A
Supplemental Information Required	Provide summary of treatment/testing. Provide most recent international or interstate travel within one month prior to specimen collection. Attach additional documentation to submission form or write summaries on reverse side of submission form.
Supplemental Form(s)	N/A
Performed on Specimens from (sources)	Urethra, throat, oropharynx, rectum, vagina, cervix, conjunctiva
Sample/Specimen Type for Testing	Pure isolate Clinical specimen
Minimum Volume/Size Required	Pure Isolate: At least one viable colony Clinical: At least one viable colony on transport media, such as Copan ESwab
Storage/Preservation Prior to Shipping	Pure Isolate: Isolates should be grown on a non-selective medium (Chocolate II or GC base + 1% growth supplements) and incubated for 16–18 hours at 35°C –37°C in a 4%–6% CO₂-enriched atmosphere. Pure isolate alternative: Bacterial culture should be resuspended (≥4 McFarland) in trypticase soy broth (TSB) with 15%–20% glycerol and frozen immediately at -70°C. Clinical specimens: Store ESwabs in transport media at room temperature.
Transport Medium	Copan ESwab Transport kits for clinical specimens available from DSHS upon request. Acceptable transport media: Copan ESwab, InTray GC, Jembec plates, Transgrow bottle.
Specimen Labeling	At least two patient identifiers are required on specimen (e.g., patient full name, date of birth, medical record number). Three patient identifiers are preferred. Patient identifiers on specimen label must exactly match identifiers on submission form. (e.g., abbreviated name on label and full name on form is not acceptable.) Additional DSHS Laboratory specimen labeling guidelines available online here.
Shipping and Specimen Handling Requirements	Ship according to Dangerous Goods Regulations, IATA, and/or CFR 49. Category B Biological Substance, UN3373 shipping requirements apply. Handle as infectious agent using universal precautions. Submitters are responsible for packaging and shipping specimens according to regulatory requirements. Clinical specimens must be received by the Laboratory within 24 hours of collection. Ship isolates and clinical specimens overnight at ambient temperatures. Ship isolates in TSB with glycerol frozen at -70°C on dry ice overnight. Ship specimens Monday–Thursday to avoid weekend deliveries. Dry ice shippers and dry ice are not provided by DSHS. Additional DSHS Laboratory specimen shipping guidelines online here.
Method	ETest Gradient strip AST
Turn-around Time	10 days
Interferences/Limitations	Specimen must be viable for testing.
Common Causes for Rejection	Insufficient quantity Unacceptable specimen type or source Improper shipping conditions Expired media or collection container Discrepancies between specimen label and submission form Incomplete or missing submission form Specimens not suspected of treatment failure
Additional Information	To order the test choose “Neisseria gonorrhoeae (GC) AST” in Section 4.1 of G-2B submission form. Identification confirmation and beta-lactamase testing will also be performed.