The antibiotic susceptibility, serovars and auxotypes were investigated in gonococcal strains isolated from all patients with gonorrhoea during one year in Stockholm, Sweden. The results were correlated to geographical origin of the infection. A total of 394 gonococcal strains were isolated from 392 patients, 135 (34%) women and 257 (66%) men. Beta-lactamase-producing gonococcal strains (PPNG) were isolated from 5% of the women and 16% of the men. Men had acquired their infection abroad more often than women (54% vs 33%) (P < 0.001). The majority (81%) of the PPNG infections were imported. Some serovars and auxotypes were more common among imported strains than among indigenous ones. All strains were sensitive to spectinomycin and 2 strains had decreased susceptibility to norfloxacin and ciprofloxacin. Decreased susceptibility to benzylpenicillin, ampicillin, doxycycline and cefuroxime was related to the geographical origin of the strains with strains imported from regions other than Europe being the most resistant.
PilC is a phase-variable protein associated with pilus-mediated adherence of pathogenic Neisseria to target cells. In this study, 24 strains of Neisseria gonorrhoeae with known epidemiological data were examined for expression of PiIC. All strains produced PilC independently of serovar and site of isolation. To investigate whether the PilC protein is conserved or variable among gonococcal strains, the complete nucleotide sequence of pilC in four strains, isolated from either rectum, throat or blood, was determined. The deduced amino acid sequence in these strains differed from each other and from the two PilC proteins of N. gonorrhoeae MS11. These data demonstrate that PilC is commonly expressed, but the PilC sequence may vary among gonococcal strains.
A commercial EIA (Chlamydiazyme) for detection of Chlamydia trachomatis was evaluated in comparison to culture using genital specimens from 472 men and 279 women. The sensitivity of the EIA compared with culture was 66.0% in men and 71.4% in women, while the specificity was 99.7% and 95.9% respectively. The EIA failed more often to detect chlamydial antigen when the number of inclusion bodies found in the corresponding cultures was less than or equal to 100/well. A direct test (MicroTrak) was performed on the EIA samples which showed discordant results compared to corresponding cultures. One of 17 EIA positive samples, and 12 of 36 EIA negative samples were positive in the direct test (p less than 0.05). A cut-off absorbance value of 0.1 is recommended by the manufacturer in the EIA. However, 84.2% of the EIA negative samples in the negative absorbance interval 0.05-0.099 corresponded with a positive culture. In view of variations in the sensitivity of the culture technique between laboratories and the low sensitivity of the EIA found in this study, it is recommended that each laboratory using the EIA compare it to culture. It is also recommended that an equivocal zone around the cut-off value be used in the EIA, the zone to be established by each laboratory using the test.
The performance of a commercial EIA (Chlamydiazyme) for detection of Chlamydia trachomatis in urine specimens was compared with that of culture of urethral samples from men with urethritis. The incidence of chlamydial infection on the basis of culture results was 34% (56/167). The sensitivity, specificity, positive and negative predictive values for the EIA were 55% (31/56), 98% (109/111), 94% (31/33) and 81% (109/134), respectively, compared with culture. Although this EIA has a high specificity, the low sensitivity makes it valueless as a clinical tool for demonstrating chlamydial antigen in urine from men with urethritis.
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