Two groups not on all fours.
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Biomedical subjects
Publications and source records attributed to Hugh Young.
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In 2003, a national surveillance of demographic, behavioural, clinical and laboratory data on gonorrhoea at genitourinary (GU) medicine clinics in Scotland was undertaken. The data-set represented 77% of all gonorrhoea cases. Findings were compared with data reported from England and Wales. Young women (16-19 years) and young men (20-24. years) represented the greatest proportion of heterosexual infections in Scotland (36 and 30%, respectively) and in England and Wales (37 and 32%, respectively). In Scotland (relative to England and Wales), men who have sex with men (MSM) accounted for more of the total gonorrhoea; there were more heterosexuals aged 45+ years; fewer belonged to ethnic minorities; fewer had had gonorrhoea previously; more heterosexual men had a sexual partner abroad; ciprofloxacin resistance was higher. During the year, first-line therapy changed from ciprofloxacin to a third-generation cephalosporin. Extended surveillance for gonorrhoea is vital in guiding appropriately targeted interventions as the epidemiology of gonorrhoea may differ in neighbouring countries.
Auditing the sensitivity of microscopic diagnosis of gonorrhoea is recommended by the current guidelines. A retrospective study was performed of 596 cases of positive cultures for Neisseria gonorrhoeae in modified New York City culture (MNYC) media diagnosed from 1995 to 1999. The sensitivity of the cervical slides in women was 51% while in men who have sex with men (MSM) the sensitivity of urethral and rectal slides were 89% and 54% respectively. The sensitivity of urethral slides in heterosexual men was 84%. Neisseria serovar 1B02 among MSM and serovar 1B31 among women were mostly undiagnosed with microscopy. Serovars 1A05, 1A21, B08 among heterosexual men were exclusively associated with negative microscopy. Microscopy is important in the rapid detection and treatment of gonorrhoea. Infections with certain serovars are less likely to be detected by microscopy; making them more likely to spread within the community. Culture from different ano-genital sites is essential to maximize detection of gonorrhoea in all patients.