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At least 19 recordsLinked to original sources
PubMed1978

Gonorrhea card test: an agglutination test for uncomplicated gonorrhea.

An antigen extracted and purified from Neisseria gonorrhoeae B370, type 4, was employed to sensitize charcoal particles for use in an agglutination assay of human sera for antibodies that indicate active gonorrheal infection. The screening card test is more sensitive than the fluorescent gonorrheal test-heated (FGT-H), especially in men. A simple one-step absorption improved the specificity without reducing the sensitivity of the test.

Agglutination Tests↗
PubMed1975

Screening and the detection of gonorrhea.

The purpose of a physician's screening for gonorrhea is the provision of comprehensive health care to patients who seek his care. Among sexually active young patients, gonorrhea is probably far more common than many other diseases a physician "screens" for during a routine physical examination. Since gonorrhea culture tests are too costly in time and money to be offered to every patient, guidelines can be used to select patients for screening who are most likely to have gonorrhea. The gonorrhea culture test should be carried out in the same spirit as a cervical cytology test, as a potential health benefit and without stigma.However, even more important than gonorrhea screening, from the standpoint of the patient, is (1) increased use of culture for diagnostic problem solving, particularly in women with dysuria, abnormal vaginal discharge, abnormal menstrual bleeding or lower abdominal pain, and (2) location and treatment of sex partners.

Cost-Benefit Analysis↗
PubMed1978

Gonorrhea in homosexual men.

Extragenital gonorrhea was seen in 65% of 54 cases of gonorrhea in 43 homosexual men attending a venereal diseases clinic between 1974 and 1977; in 21 cases the infection was extragenital only. This type of gonorrhea was often asymptomatic and was associated with a high rate of failure of initial treatment in 6 of the 50 cases in which the patient returned for follow-up assessment, and in 5 of the 6 the persistent infection was extragenital. Syphillis was seen concomitantly or had previously occurred in 6 of the 54 cases. Fifteen of 28 cases of primary, secondary or early latent syphilis seen in men during the same study period had occurred in homosexuals. Appropriate testing for extragenital gonorrhea and for syphilis is important in homosexual men who present for examination, and homosexuality with the possibility of extragenital gonorrhea should be considered in a man with syphilis of recent onset.

Gonorrhea↗
PubMed1978

Cohort study of venereal disease. I: the risk of gonorrhea transmission from infected women to men.

Reliable data on the risk of transmission of N. gonorrhoeae would enhance our understanding of the importance of host defenses against gonorrhea and would aid in the evaluation of prophylactic measures. This paper examines the risk of transmission of gonorrhea from infected female to male and the role that variables such as race, prophylaxis and amount of exposure play in the development of gonococcal urethritis. Volunteer crew members of a large naval vessel were followed prospectively as a cohort to study their risk of acquiring gonococcal infection during a four-day liberty period in the Far East. At the same time the prevalence of N. gonorrhoeae was determined in a population of females to whom the sailors were exposed. The calculated risk of transmission per exposure with an infected partner was .19 for whites and .53 for blacks. A statistically significant relationship was noted between the risk of transmission of gonorrhea and both the number of partners and the frequency of sexual intercourse. Further, the increasing infection rate with increasing numbers of exposures in men who had a single sex partner suggests that the majority of men are in fact susceptible to gonorrhea if the quantity of exposure is sufficient.

Adult↗
PubMedDate not supplied

A rational basis for the epidemiologic treatment of gonorrhea in a clinic for sexually transmitted diseases.

Epidemiologic treatment of gonorrhea refers to the administration of antibiotics when the diagnosis is considered likely, but before the results of confirmatory tests are available. Unfortunately, the risk of infection is seldom known. To place epidemiologic treatment on a more rational basis, infection rates were determined for groups of clinic patients defined by easily collected indexes of risk such as reason for attending the clinic, sex, race, and sexual preference, history of contact with gonorrhea, and history of a urethral or vaginal dischange. Infection rates ranged from 0.8% for men seeking marriage licenses to 65.1% for female contacts of men with "established" gonorrhea. By selectively employing gram-stained smears, it is possible to reduce further the need for epidemiologic treatment within the various defined groups of patients. Epidemiologic treatment policies should be determined by each large clinic and should be based on known infection rates for clearly defined groups of patients. Such rates are necessary for obtaining informed consent from patients and for evaluation of the cost-effectiveness of epidemiologic treatment in the overall effort to control gonorrhea.

Colorado↗
PubMed2026

Extragenital testing for gonorrhea and chlamydia in health department clinics in Virginia, 2018-2023.

BACKGROUND: Extragenital testing for chlamydia and gonorrhea infections is now routine in many settings. We assessed temporal and demographic trends in extragenital testing and positivity in public health department clinics in Virginia. METHODS: We analyzed urogenital and extragenital chlamydia/gonorrhea laboratory results for clients aged 15 years or older who attended 116 health department clinics from 2018 to 2023. Test volume and positivity was stratified by anatomic site, year, sex, and age. RESULTS: There were 181,471 client visits with valid test results. The proportion of visits with any extragenital testing increased from 19% to 46% during this time. Male clients were twice as likely as females to receive pharyngeal testing (46% vs. 22%) and five times as likely to be tested rectally (15% vs. 3%). Rectal specimen positivity surpassed urogenital positivity for chlamydia (females and males) and gonorrhea (males only). Overall, one-quarter of clients diagnosed with gonorrhea infections were identified exclusively through extragenital testing, as were 9% of clients with positive chlamydia tests. These proportions increased over time and were greater for younger clients and for males relative to females. Two-thirds of extragenital infections would have been missed by urogenital testing alone, including 40% and 49% of females and 86% and 73% of males with extragenital chlamydia and gonorrhea infections respectively. CONCLUSIONS: The proportion of clients who received extragenital chlamydia/gonorrhea testing increased over time, extragenital test positivity was high, and it identified infections that would have been missed otherwise. The impact on sexually transmitted infection sequelae and transmission remains unclear.

NAAT↗
PubMed1977

Auxotypes and penicillin susceptibilities of Neisseria gonorrhoeae isolated from patients with gonorrhea involving two or more sites.

A system of auxotyping described in 1973 is based on the differing nutritional requirement patterns of Neisseria gonorrhoeae strains. Our ongoing evaluation of the reliability of auxotyping has involved a study of the constancy of characteristics of gonococci isolated at one time from two or more sites of a given subject. The auxotypes and minimal inhibitory concentration (MIC) of penicillin G were determined for 181 isolates obtained from 84 patients with uncomplicated gonorrhea, for 16 isolates from 8 couples with uncomplicated gonorrhea, and for 21 isolates from 12 other patients, 9 with disseminated gonococcal infection and three consorts. The penicillin MIC served to distinguish between many members of auxotypes 1, 2, and 3, which are commonly involved in uncomplicated gonorrhea. Thus, for proline-requiring gonococci (auxotype 2) the MIC ranged from 0.01 to 1.2 IU of penicillin per ml. The profile of gonococcal responses to seven other antibacterial drugs provided useful additional information where the extent of phenotypic similarity was in doubt. In all but seven instances, the gonococci isolated from different sites of the same patient, or from a consort, had the same nutritional requirements and penicillin MIC. The gonococci isolated from one patient with disseminated gonococcal infection and from one of her two sexual contacts had nutritional requirements for arginine, hypoxanthine, uracil, and thiamine pyrophosphate, whereas the strain isolated from her second contact differed in having no requirement for thiamine pyrophosphate. The paired cervical and rectal isolates from one patient with uncomplicated gonorrhea differed only with respect to a requirement for hypoxanthine. Pairs of isolates from three patients differed slightly in degree of susceptibility to penicillin. In the remaining two instances, however, numerous differences between the isolates from the endocervix and the anal canal of a given patient indicated the presence of concomitant infections with different strains of N. gonorrhoeae.

Culture Media↗
PubMed1979

[Ampicillin treatment trial in gonorrhea recurrences].

The results of using ampicillin in treatment of 54 gonorrhea patients (41 males and 13 females) previously treated with other antibiotics without success are presented. Ampicillin was used in a daily dose of 500 mg administered 5 times a day at equal intervals and an 8-hour interval during the night time. The course dose was 6--10 g. Patients with chronic and fresh gonorrhea with insignificantly pronounced symptoms were subjected to immunotherapy before the treatment with ampicillin. Pure gonococcal strains sensitive to ampicillin were isolated from 16 patients before the ampicillin use. Clinical improvement after the treatment with ampicillin in most of the patients was observed by the end of the 1st day and was evident from elimination of the urethral discharges, absence of urination colics and urea clarification. Etiological recovery was recorded in all the gonorrhea patients due to the treatment with ampicillin. All the patients were crossed off the register. The clinical and laboratory investigations showed high efficiency of ampicillin in treatment of gonorrhea relapses. The antibiotic is rapidly absorbed into the blood. Its therapeutic blood levels are maintained during 24 hours. It is well tolerated by the patients.

Ampicillin↗
PubMedDate not supplied

Gonorrhea screening in family planning clinics when should it become selctive?

Routine screening of females for gonococcal infection has become common in many clinic settings, particularly in public family planning clinics. The results of such routine screening in one large family planning program operated by the Seattle-King County Department of Public Health was examined. From 1973 to 1975 a trend toward decreasing rates of positivity for gonorrhea was observed. Use of computer information on the population being served by the program and a review of individual patient's charts enabled identification of certain high-yield subpopulations, including blacks, welfare recipients, new patients over age 19, and new patients who were not using any contraception when first screened. The cost of detecting a case of gonorrhea through screening was related to the positivity rate with the demonstration of a very high cost per case found when the positivity rate is less than 1 percent. Consideration should be given to identifying high and low-yield subpopulations for gonorrhea screening in large family planning programs so that, as cost considerations demand, funds now used for routine gonorrhea screening may be used instead for selective screening and provision of family planning services to high-yield groups.

Cost-Benefit Analysis↗
PubMed1976

Asymptomatic gonorrhea.

The results of our studies showed that: 1. Asymptomatic gonorrhea occurred in about 70% of infected women, and in 10 to 15% of infected men; 2. Asymptomatic rectal gonorrhea occurred in 15% of those women with positive cervical cultures, and in 20% of infected women was the sole site of a positive culture; 3. The rectal site should be examined for N. gonorrhoeae both in diagnosis and in testing for cure; 4. Pharyngeal gonorrhea occurred in 22% of patients who were named as gonorrhea contacts and practiced fellatio. In 13% of this group (four cases) the pharynx was the only site of a positive culture.

Female↗
PubMed1977

Asymptomatic gonorrhea: prevalence in a population of urban adolescents.

During a 12-month period, 2,672 sexually active youths, 12 to 16 years of age, had genital bacteriologic cultures for Neisseria gonorrhoeae. Anterior urethral cultures were obtained from 2,098 males of whom 2,064 had no symptoms or signs of genitourinary disease. Forty cultures (1.9%) were positive for gonorrhea. Of 574 females, 374 were asymptomatic and 26 (7.0%) had positive gonorrhea cultures from the cervix. Since adolescent boys are more likely to be sexual adventurers, the 1.9% carrier rate represents an important reservoir of gonorrhea and equal in importance to that found in the asymptomatic adolescent girl.

Adolescent↗
PubMed1977

Spectinomycin versus tetracycline for the treatment of gonorrhea.

Spectinomycin and tetracycline are alternative drugs to penicillin in the treatment of gonorrhea. To compare the efficacy of these agents and their propensity to select resistant gonococci, we treated 4043 patients randomly with either 2 or 4 g of spectinomycin once or 9 g of oral tetracycline for four days. Minimum cure rate for anogenital gonorrhea was 94 per cent with either drug. Oropharyngeal infection responded poorly to spectinomycin in men, with failure of therapy in six of 11. Postgonococcal urethritis in men was less common after tetracycline than after spectinomycin (P less than 0.005). Spectinomycin failure was not related to drug resistance. Tetracycline failure correlated with resistance (P less than 0.0002); one fifth of the isolates resistant to 1.0 mug per milliter of tetracycline were not eradicated. For several reasons, including the appearance of beta-lactamase-producing gonococci, it is no longer clear that penicillin G is the "drug of choice" for gonorrhea. Spectinomycin and tetracycline are equally acceptable alternatives, each with distinct advantages and disadvantages.

Administration, Oral↗
PubMed1978

Repeated gonorrhea: an analysis of importance and risk factors.

This study was designed to assess the epidemiological importance of repeated infections due to Neisseria gonorrhoeae and to analyze variables potentially associated with repeated gonorrhea. The retrospective analysis was of 7,347 patients seen during one year, and the prospective study was of a stratified randomly selected sample of 429 patients. The 492 retrospectively identified repeaters constituted 0.06% of the county population and 6.7% of the clinic population. The 492 repeaters had 21.6% of the cases of gonorrhea reported from the county and 29.4% of the cases reported from the clinic. The repeaters tended to be younger than those without repeated infection (P less than 0.001), male (62%), black (81.7%), and residents of areas of lower socioeconomic status than those who were not repeaters (P less than 0.001). Most repeaters (73.5%) had not graduated from high school. Repeaters did not have significantly greater numbers of sex partners (P greater than 0.05) or greater exposure to prostitutes or clients than those who did not have repeated infections and less frequently had sexual contact while symptomatic. Intensive follow-up of the small number of high-risk repeaters and their contacts could result in a major reduction in the number of reported cases of gonorrhea.

Adolescent↗