J Gen Microbiol, 1987 Dec, 133 ( Pt 12), 3393 - 401 Outer membrane protein III of Neisseria gonorrhoeae: variations in biological properties of antibodies directed against different epitopes; Virji M et al.; Monoclonal antibodies (mAbs) have been raised to gonococcal outer membranes . A panel of six mAbs was identified by several criteria as reacting with outer membrane protein III (P.III) . Competitive radioimmunoassays showed that the mAbs could be grouped into three pairs recognizing different epitopes on P.III . These epitopes are equally present on all pathogenic Neisseria . The mAbs demonstrated differing protective effects in model systems . Those directed against one epitope were particularly effective in protecting Chang conjunctiva epithelial cells against gonococcal challenge . mAbs against this epitope and another promoted complement-mediated bactericidal activity, while those directed against the third epitope were ineffective . Thus the biological effects of mAbs directed against P.III vary according to the epitope recognized. Br Med J (Clin Res Ed), 1987 Nov 28, 295(6610), 1377 - 9 Diagnosis of ophthalmia neonatorum; Winceslaus J et al.; Ninety consecutively seen babies with eye discharge in the first three weeks of life were examined . Four babies had "sticky eyes" with no evidence of ophthalmia and had uniformly negative cultures and test results for antichlamydial antibody; these babies were excluded . Of the 86 babies with ophthalmia neonatorum, Neisseria gonorrhoeae was isolated from eight, Chlamydia trachomatis from 44, other bacteria alone from 20, and 14 had negative cultures . Three babies with negative cultures had longstanding conjunctivitis and had been treated with chloramphenicol eye ointment; all had antichlamydial IgM antibodies, indicating that the conjunctivitis was chlamydial . Hence the total number of babies whose conjunctivitis was chlamydial was 47 . The result of the Gram stained conjunctival smear correlated well with that of culture and final assessment by the microimmunofluorescence test, enabling an immediate presumptive diagnosis to be made of gonococcal, chlamydial, or bacterial conjunctivitis . Prompt and effective treatment of babies was started . Explanation to the mother and contact tracing were carried out when the confirmatory cultures and antibody tests were completed . The Gram stained conjunctival smear is a highly sensitive, specific, and predictive test for the aetiological agent of ophthalmia neonatorum . By virtue of its simplicity and rapidity the test may be useful in developing countries. An Esp Pediatr, 1987 Nov, 27(5), 339 - 42 {Cortical evoked auditory evoked potentials in a series of patients who had bacterial meningitis during childhood}; Baselga Asensio C et al.; Cortical auditory evoked potentials (CAEP) were recorded from scalp electrodes in 47 patients, who survived to bacterial meningitis in their childhood . CAEP were obtained from 1 month to 8 years after recovering from acute disease . Neisseria meningitidis was the microorganism more frequently isolated from CSF (43.5%) . Exclusively abnormal values in amplitude of CAEP were registered in 15 cases (32%), mainly at the lower tones explored; 14 of them were subjected to conventional audiometric test, which demonstrated unilateral hearing loss only in 2 . No alterations in the latency of P2 wave were seen . We recommend to include CAEP in search of hearing disorders in younger children after recovering from meningitis, since they can detect lesions in cortical-subcortical auditory tracts, which otherwise could go unnoticed. Antimicrob Agents Chemother, 1987 Nov, 31(11), 1822 - 5 Cefodizime in serum and skin blister fluid after single intravenous and intramuscular doses in healthy volunteers; Korting HC et al.; In gonorrhea therapy, cephalosporins are conventionally administered by intramuscular (i.m.) injection, which rather frequently leads to local side effects . To investigate whether the well-tolerated intravenous (i.v.) injection of cephalosporins may be of comparable gonocidal effect, levels of cefodizime, a new broad-spectrum cephalosporin, in serum and tissue fluid (suction blister and cantharides blister fluid) were determined in six healthy men . Single doses of 1 g of cefodizime were injected i.v . and i.m . according to a randomized crossover design . On i.m . injection the drug was completely bioavailable, and the peak concentration in serum was 75 +/- 8 micrograms/ml . The terminal half-life of serum levels was 2.4 h . Cefodizime concentrations in the blister fluids increased for 1.5 to 3 h after the i.v . dose and for at least 3 h on i.m . administration . The concentrations of non-protein-bound cefodizime in blister fluid already exceeded the MIC for 90% of Neisseria gonorrhoeae strains 10 min after i.v . injection and 20 to 30 min after the i.m . dose . At 6 h after each dose, active concentrations were still present in serum . The results suggest that cefodizime administered i.v . and i.m . has equivalent high cure rates in uncomplicated gonorrhea . This hypothesis should be tested further by a controlled clinical trial . If equivalent, i.v . administration excels because it is better tolerated locally. Antimicrob Agents Chemother, 1987 Nov, 31(11), 1744 - 9 Effects of different media and methods of inoculum preparation on results of antimicrobial susceptibility testing of Neisseria gonorrhoeae by agar dilution; Dillon JA et al.; The effects of two methods of inoculum preparation (the opacity standard method and a template method) and three different types of media on the penicillin, tetracycline, spectinomycin, and erythromycin MICs for 191 non-penicillinase-producing, 49 penicillinase-producing, and 5 tetracycline-resistant isolates of Neisseria gonorrhoeae were evaluated . Three World Health Organization reference strains (III, V, and VII) were similarly evaluated . Inoculum preparation method did not significantly alter the MIC (i.e., within a twofold dilution) of either susceptible or chromosomally resistant non-penicillinase-producing isolates; MICs achieved by the template method were slightly higher, but these differences were not significant . However, with penicillinase-producing and tetracycline-resistant isolates, the template method, which delivered 10(4) CFU, produced unequivocal MICs (denoting clinical resistance) which were significantly higher than MICs observed with the opacity standard method (inoculum, 10(3) CFU) . With penicillin-, spectinomycin-, and erythromycin-containing medium, addition of hemoglobin to the medium produced lower, though not significantly different, MICs with all isolates as compared with MICs on medium without hemoglobin . Media supplemented with hemoglobin produced higher tetracycline MICs with all isolates, which were significantly different (greater than twofold) from MICs on the same hemoglobin-free media . Changes in auxotype did not alter overall observations concerning the effects of different media and inocula on MICs. J Infect, 1987 Nov, 15(3), 243 - 5 Septicaemia due to Neisseria lactamica--initial confusion with Neisseria meningitidis; Brown NM et al.; Neisseria lactamica, isolated from a baby with septicaemia, was at first thought to be Neisseria meningitidis, possibly acquired in hospital . Extensive investigation of contacts was made until the O-nitrophenyl-D-galactopyranoside reaction proved positive . Distinction between the two species, easily made in this way, is important both in individual patients and in population surveys. Am J Obstet Gynecol, 1987 Nov, 157(5), 1122 - 5 Preliminary observations on lactoferrin secretion in human vaginal mucus: variation during the menstrual cycle, evidence of hormonal regulation, and implications for infection with Neisseria gonorrhoeae; Cohen MS et al.; The concentration of the iron-binding protein lactoferrin was measured in vaginal mucus of women throughout the menstrual cycle . Lactoferrin is proposed to limit growth of mucosal pathogens such as Neisseria gonorrhoeae . Lactoferrin concentration in mucus was highest just after menses (62.9 to 218 micrograms/mg of protein) and lowest (3.8 to 11.4 micrograms/mg of protein) just before menses . Overall concentration of mucus protein showed no variation with menstrual cycle, and little lactoferrin was detectable in cell debris . Plasma lactoferrin did not show the variation seen in vaginal mucus . Because of the suggestion of hormonal influence on vaginal lactoferrin, its concentration was determined in women receiving oral contraceptive therapy . Mean lactoferrin concentration in women taking oral contraceptives was significantly lower than in the control group (never exceeding 19.8 micrograms/mg of protein) and showed no monthly variation . Vaginal lactoferrin appears to be under hormonal control . Variation in vaginal lactoferrin concentration may result in alterations in susceptibility to bacterial pathogens such as Neisseriae gonorrhoeae. Infect Immun, 1987 Nov, 55(11), 2844 - 9 Expression of a cloned lipopolysaccharide antigen from Neisseria gonorrhoeae on the surface of Escherichia coli K-12; Palermo DA et al.; A gonococcal gene bank maintained in Escherichia coli K-12 was screened by colony immunoblotting, and a transformant expressing a surface antigen reactive to anti-gonococcal outer membrane antiserum was isolated . The isolate carried a recombinant plasmid, pTME6, consisting of approximately 9 kilobases of Neisseria gonorrhoeae DNA inserted into the BamHI site of pBR322 . Surface labeling of E . coli HB101(pTME6) confirmed that the antigen was expressed on the E . coli cell surface . The antigenic material was resistant to proteinase K digestion and sensitive to periodate oxidation, indicating that the material was carbohydrate . Purified lipopolysaccharide (LPS) from HB101(pTME6) produced a unique band on silver-stained polyacrylamide gels that contained immunoreactive material as seen on Western blots of LPS samples . Only two of three E . coli LPS mutant strains carrying pTME6 reacted with the antigonococcal antiserum, suggesting that a certain E . coli core structure is necessary for antigen expression . We conclude that pTME6 contains one or more gonococcal genes encoding an LPS core biosynthetic enzyme(s) which can modify E . coli core LPS to produce a gonococcuslike epitope(s). Infect Immun, 1987 Nov, 55(11), 2579 - 84 Degradation of gonococcal peptidoglycan by granule extract from human neutrophils: demonstration of N-acetylglucosaminidase activity that utilizes peptidoglycan substrates; Striker R et al.; The degradation of purified Neisseria gonorrhoeae peptidoglycan (PG) by granule extract derived from normal human polymorphonuclear leukocytes was examined . Hen egg lysozyme-resistant, extensively O-acetylated {3H}PG (O-PG) from strain FA19 and lysozyme-sensitive, non-O-acetylated {14C}PG (non-O-PG) from strain RD5 (each containing label in both glucosamine and muramic acid) were mixed and incubated with granule extract at pHs 4.5, 5.5, and 6.5 . The rate of degradation of O-PG was uniformly slower than that of non-O-PG in the same tube, but ultimately, even the O-PG was rendered completely soluble . Molecular-sieve high-performance liquid chromatography revealed that both PGs were degraded by granule extract at the pH values tested to disaccharide peptide monomers and peptide-cross-linked oligomers, reflecting the action of human lysozyme . Of particular interest was the appearance of a peak containing free N-acetylglucosamine which was quite prominent in reaction mixtures at pH 4.5, less prominent at pH 5.5, and not detectable at pH 6.5 . Free N-acetylglucosamine was not released from control PG samples at any pH in the absence of granule extract . Treatment of purified gonococcal PG monomers with granule extract at pH 4.5 yielded exclusively free N-acetylglucosamine and muramyl peptides with no N-acetylglucosamine . These data suggest that granule extract contains a previously undescribed pH-dependent N-acetylglucosaminidase with specificity for PG as well as an N-acetylmuramidase activity that degrades O-PG less efficiently than it does non-O-PG. Surv Ophthalmol, 1987 Nov-Dec, 32(3), 199 - 208 Gonococcal keratoconjunctivitis; Ullman S et al.; Gonococcal keratoconjunctivitis is a potentially devastating infection, because Neisseria gonorrhoeae can cause a rapid, severe, ulcerative keratitis resulting in visual loss . The therapeutic decision making process is complicated by the necessity for prompt, effective parenteral therapy, frequent coinfection with other sexually transmitted diseases, and emergence of antibiotic resistance . Because of the evolving problem of antibiotic resistance and the need for cost containment, the current recommendations of hospitalization for intravenous penicillin may need to be modified . The third generation cephalosporin, ceftriaxone, has properties that suggest it may be the best available antimicrobial agent as a single-dose treatment of gonococcal conjunctivitis . Spectinomycin may be a useful alternative in the penicillin-allergic adult patient. Biomed Environ Mass Spectrom, 1987 Nov, 14(11), 591 - 8 Structural determination of lipid A from gram negative bacteria using laser desorption mass spectrometry; Cotter RJ et al.; Laser desorption mass spectrometry has been employed for the structural determination of lipid A components derived from the lipopolysaccharides (LPS) of gram-negative bacteria . Mass spectra were obtained for methylated monophosphoryl lipid A from Neisseria gonorrhoeae and Rhodopseudomonas sphaeroides, for diphosphoryl lipid A from Escherichia coli and for the intact LPS from the Re Mutant of E . coli consisting of triphosphoryl lipid A and two KDO (2-keto-3-deoxyoctonate) units . Fragmentation of the phosphate (or pyrophosphate) on the reducing glucosamine is followed by fragmentation of acyl-linked fatty acids . Also observed are fragment ions which correspond to the distal portion of the molecule. Genetics, 1987 Nov, 117(3), 391 - 8 Effects of recA mutations on pilus antigenic variation and phase transitions in Neisseria gonorrhoeae; Koomey M et al.; Intragenic recombination between the single complete pilin gene (expression locus) and multiple, distinct, partial pilin gene copies (silent, storage loci) is thought to account for the generation of pilus antigenic diversity and piliation phase (on-off) changes exhibited by Neisseria gonorrhoeae . The mechanisms operating in the genomic rearrangements associated with these forms of pilus variation were investigated through the study of isogenic strains of gonococci bearing either wild-type or altered recA alleles . Examination of the rates of pilus phase variation and the genetic basis for changes in piliation status displayed by these strains show that recA mediated homologous recombination is required for these high frequency events and confirm that the nonpiliated state results from mutations in the expressed pilin gene . In a strain that is deficient in recA mediated homologous recombination, pilus phase variation occurs at a 100-1000-fold reduced rate and results predominantly from one class of spontaneous frameshift mutations within the pilin structural gene. J Clin Pathol, 1987 Nov, 40(11), 1369 - 73 Characterisation of Branhamella catarrhalis and differentiation from Neisseria species in a diagnostic laboratory; Ahmad F et al.; To distinguish Branhamella catarrhalis from Neisseria species a study of 140 strains was made on simple laboratory media, with particular reference to deoxyribonuclease (DNase) production, superoxol reaction, and growth characteristics . All 97 clinical isolates of B catarrhalis (58 of which were beta-lactamase positive) and eight strains of B catarrhalis from the National Collection of Type Cultures were DNase positive and superoxol positive . None grew on modified New York City medium, modified Thayer Martin medium, MacConkey agar, crystal violet blood agar, nor under anaerobic conditions . Of the 16 different non-pathogenic Neisseria species tested, all were DNase negative, eight (50%) were superoxol reaction negative, and 13 (81%) grew on crystal violet blood agar . Using simple laboratory media, DNase, and superoxol tests, it was possible to identify B catarrhalis and to distingish it from pathogenic and non-pathogenic Neisseria species. Proc Natl Acad Sci U S A, 1987 Nov, 84(22), 8135 - 9 Porin protein of Neisseria gonorrhoeae: cloning and gene structure; Gotschlich EC et al.; The outer membrane porin molecule of Neisseria gonorrhoeae is known as protein I (PI) . Among different strains of gonococci there is variability of PI, and two main classes, PIA and PIB, have been recognized . A lambda gt11 bank of gonococcal DNA was screened using monoclonal antibodies directed to a PIB-type porin molecule of N . gonorrhoeae, and three immunoreactive clones were isolated . DNA sequence analysis indicated that each contained only portions of the PI structural gene, but that together they contained the complete gene, and its structure was determined . The DNA sequence predicts a protein of 348 amino acids with a typical 19 amino acid signal peptide . The PI protein resembles Escherichia coli porins in size, lack of long hydrophobic sequences, and absence of cysteine residues . Sequence homologies between PI and the E . coli porins were found, particularly in the 100 N-terminal and the 110 C-terminal amino acids . In addition to the coding sequence of PI, the complementary strand contains a large open reading frame . At the 3' end of the PI gene, immediately following an inverted repeat (probably the transcription terminator), the clone contains an unusual sequence consisting of 31 perfect repeats of the heptamer CTGTTTT . Hybridization analysis suggests that there is a single structural gene for PI and that it is homologous to the gene found in a PIA-bearing strain of gonococcus. J Immunol Methods, 1987 Oct 23, 103(1), 1 - 7 The effect of pH on the aggregation of biotinylated antibodies and on the signal-to-noise observed in immunoassays utilizing biotinylated antibodies; Wadsley JJ et al.; During the development of immunoassays to detect gram-negative bacteria, an effect of pH on the aggregation of some murine monoclonal antibodies directed to Neisseria gonorrhoeae was observed . By reacting positively charged primary amines on these antibodies with the neutral NHS-biotin (N-hydroxy-succinimidobiotin), the surface charge on the antibodies was altered and a concomitant change in the solubility of these antibodies noted . This derivatization produced not only a pH-dependent change in the solubility properties of the antibodies, but also affected the response of immunoassays in which these antibodies were used . Data presented suggests that the signal-to-noise (S/N) observed in these assays is maximized under conditions where the biotinylated antibody is introduced into the assay at a pH at least 2 U above its pI . Our hypothesis is that as the pH of the solution approaches the biotinylated antibodies' isoelectric point, they become 'stickier', perhaps by aggregation (which we have directly measured), leading to high non-specific binding and hence a lower S/N. JAMA, 1987 Oct 9, 258(14), 1932 - 4 Dipstick leukocyte esterase activity in first-catch urine specimens . A useful screening test for detecting sexually transmitted disease in the adolescent male; Sadof MD et al.; Although sexually active female adolescents are often routinely screened for sexually transmitted diseases, indications for culturing adolescent males for sexually transmitted urethral infections are controversial . A study of 54 sexually active males (14 to 22 years old) was undertaken to assess the reliability of using dipstick leukocyte esterase activity in first-catch urine specimens to detect urethritis caused by Neisseria gonorrhoeae and Chlamydia trachomatis . Eighteen males had sexually transmitted diseases: N gonorrhoeae (nine patients), C trachomatis (eight patients), and N gonorrhoeae and C trachomatis (one patient) . First-catch urine specimens with a 1+ (mild) or 2+ (moderate) reaction on dipstick testing had a leukocyte (WBC) count of 10 WBCs per high-power field or greater on microscopic analysis, with an 83% sensitivity, 100% specificity, a 100% positive predictive value, and a 92% negative predictive value for the presence of N gonorrhoeae, C trachomatis, or both . Clinical criteria for screening (urethral discharge, dysuria, or exposure to a sexually transmitted infection) plus a dipstick-positive first-catch urine specimen had a 94% sensitivity, 89% specificity, an 81% positive predictive value, and a 97% negative predictive value. J Biol Chem, 1987 Oct 5, 262(28), 13404 - 8 Bacteria form intracellular free radicals in response to paraquat and streptonigrin . Demonstration of the potency of hydroxyl radical; Hassett DJ et al.; The generation of oxygen reduction products by Neisseria gonorrhoeae FA1090 upon exposure to streptonigrin (SNG) and paraquat (PQ2+) and their toxicity was examined . N . gonorrhoeae exhibited maximal cyanide-insensitive respiration, which was employed as an indicator of superoxide (O2-) formation, in the presence of 0.064 mM streptonigrin and 90 mM PQ2+, respectively . Using the concentrations of SNG and PQ2+ described above, complete lethality (greater than 10(8) cells/ml) was observed among cells exposed to SNG, whereas PQ2+ reduced viability by only 3 logs . In an attempt to determine the oxygen radical species generated by gonococci when exposed to SNG, dimethyl sulfoxide, Fe3+, KCN, and the spin trap 5,5-dimethyl-1-pyrroline-N-oxide (DMPO), we were able to detect .OH manifested as the methyl adduct (DMPO-CH3) . The production of the latter species was not inhibited by catalase, suggesting intracellular .OH generation . When PQ2+ was substituted for SNG, only low levels of DMPO-CH3 were observed, the production of which ceased within 8 min . SNG and PQ2+, added to a O2(-)- generating system in the presence of Fe3+, promoted increased .OH generation . The iron chelator diethyl-enetriaminepentaacetic acid enhanced the generation of spin-trapped .OH and O2- in the presence of PQ2+ . The addition of catalase to this system, however, eliminated the DMPO-CH3 signal, showing that the .OH in this system was extracellular . PQ2+-mediated generation of extracellular .OH in the presence of Fe3+-diethylenetriaminepentaacetic acid EDTA did not enhance the killing of gonococci by PQ2+ . These data show that the lethality of SNG relative to PQ2+ is due to the inherent ability of SNG to catalyze the formation of critical levels of intracellular .OH, detectable through the use of spin trapping techniques. Microbiologica, 1987 Oct, 10(4), 363 - 70 Production of bacteriocin-like substances by human oral streptococci; Fabio U et al.; A sample of human streptococci (mainly Streptococcus mutans species) from dental plaques was examined in order to evaluate the production frequency and activity spectrum of bacteriocin-like substances (mutacins) . 89% of the 55 Streptococcus mutans strains produced substances with a wide spectrum of antibacterial activity . The bacteriocins produced showed a marked inhibitory activity against Gram-positive bacteria . Among the Gram-negative species tested, only Neisseria sicca was inhibited by 25% of Streptococcus mutans strains . Also, 16 strains belonging to oral streptococci other than Streptococcus mutans, were examined for their inhibitory capacity against the same indicator . The authors stress the importance of mutacins production in oral ecology and Streptococcus mutans pathogenicity. Cutis, 1987 Oct, 40(4), 363 - 4 Oral cavity abscess due to Neisseria gonorrhoeae; Marini D et al.; A patient with an abscess in the oral cavity caused by Neisseria gonorrhoeae is presented . The suspected gonococcal cause was confirmed by the presence of gonococci in smears of material evacuated from the abscess and the growth of bacteria in a modified Thayer-Martin culture medium . This represents, to our knowledge, the first reported case of oral cavity abscess due to N . gonorrhoeae. Am Fam Physician, 1987 Oct, 36(4), 162 - 4 Fitz-Hugh-Curtis syndrome; Perlman PE et al.; The Fitz-Hugh-Curtis syndrome consists of right upper quadrant abdominal pain, perihepatitis and genital tract infection . Neisseria gonorrhoeae and Chlamydia trachomatis have been identified as causative agents . This syndrome frequently mimics other diseases and typically occurs in sexually active young women . A high index of suspicion is essential for early diagnosis . Laparoscopy may be indicated for diagnosis and for lysis of adhesions. South Med J, 1987 Oct, 80(10), 1323 - 4 Neisseria mucosus septicemia after near-drowning; Manser TJ et al.; Neisseria mucosus is a normal inhabitant of the upper respiratory tract which may rarely cause serious infection . A 21-year-old woman had N mucosus bacteremia and the adult respiratory distress syndrome (ARDS) after a near-drowning episode . Despite appropriate antibiotic therapy and intensive respiratory support, the patient died . Bacteremia with this organism is rare, and we believe it has not previously been reported in association with near-drowning. Sex Transm Dis, 1987 Oct-Dec, 14(4), 227 - 30 Ceftriaxone for treatment of uncomplicated gonorrhea: routine use of a single 125-mg dose in a sexually transmitted disease clinic; Handsfield HH et al.; We retrospectively analyzed the efficacy of ceftriaxone in a single dose of 125 mg given intramuscularly for treatment of uncomplicated gonorrhea . Neisseria gonorrhoeae was eradicated from 152 (99%) of 154 patients who returned for test-of-cure, including all 83 heterosexual men and women and 69 (97%) of 71 homosexual men . Cure was achieved for 109 (99%) of 110 urethral or cervical infections, 52 (98%) of 53 rectal infections, and 15 of 15 pharyngeal infections . All infected sites were cured in 58 additional patients treated with ceftriaxone (125 mg) plus tetracycline (500 mg four times daily for seven days) . These results confirm those of earlier clinical trials showing that 125 mg of ceftriaxone is effective therapy for uncomplicated gonorrhea in a geographic area with a high prevalence of gonococci with chromosomally mediated antibiotic resistance. Sex Transm Dis, 1987 Oct-Dec, 14(4), 231 - 3 Gonococcal endocarditis: a case report and review of the literature; Jurica JV et al.; Despite the increasing incidence of gonococcal urethritis and cervicitis, endocarditis has become an infrequent consequence of infection with Neisseria gonorrhoeae . However, we recently had the opportunity to diagnose and treat a patient with this uncommon infection . He presented with febrile illness and a history of dysuria . After six days of incubation, cultures of blood yielded an isolate of N . gonorrhoeae . Treatment with penicillin plus streptomycin led to rapid resolution of the fever . Sequelae included left ventricular dilatation and aortic valve insufficiency . The latter was corrected by surgery . Our experience with this patient, as well as the 33 other cases reported in the literature since 1949, indicate that the diagnosis of gonococcal endocarditis should be suspected for any sexually active adult who presents with fever and a heart murmur. Ann Acad Med Singapore, 1987 Oct, 16(4), 645 - 7 Ophthalmia neonatorum--the Middle Road Hospital perspective; Ng SK et al.; In a retrospective study of ophthalmia neonatorum seen in Middle Road Hospital between 1983 and 1986, 68% were caused by Neisseria gonorrhoeae . 40% of the Neisseria gonorrhoeae isolates were PPNG strains . For therapy of gonococcal ophthalmia neonatorum, 1% kanamycin eyedrops combined with a single intramuscular injection of kanamycin or a third generation Cephalosporin (Ceftriaxone or Cefotaxime) were all effective regimens . The use of intramuscular kanamycin was stopped because of concern for ototoxicity . Chlamydia trachomatis remains an uncommon cause of ophthalmia neonatorum in Singapore, in only 2 cases was this agent identified. Ann Acad Med Singapore, 1987 Oct, 16(4), 636 - 8 Susceptibility of Neisseria gonorrhoeae to pefloxacin; Chan KP et al.; 144 strains each of penicillinase producing (PPNG) and non-penicillinase producing (NPPNG) Neisseria gonorrhoeae were tested for susceptibility to pefloxacin . All isolates but one (99.65%) were susceptible to 0.06 mg/l . No significant difference was detected between the minimum inhibitory concentrations (MICs) of PPNG and NPPNG strains . The MIC50 and MIC90 of both types of strains were 0.015 mg/l and 0.06 mg/l respectively . Since pefloxacin was more effective than norfloxacin and rosoxacin against PPNG as well as NPPNG, it should prove useful in the therapy of gonorrhoea. Sex Transm Dis, 1987 Oct-Dec, 14(4), 221 - 6 Bactericidal properties of urine for Neisseria gonorrhoeae; Noble RC et al.; Some human urine is bactericidal for the F-62 strain of Neisseria gonorrhoeae . Gonococci of three auxotypes (Pro-; Arg-, Hyx-, Ura-; and Pro-, Arg- . (Orn*), Ura-) were tested by in-vitro exposure to 31 samples of urine from 14 men . Nineteen of the urine specimens were bactericidal, and 12 were not . Except for one sample, all cidal urines came from five men . Cidal activity was associated with acidic, concentrated urines; it was unaffected by exposure to lowered pH, pronase, heat or cold, and was dialyzable with use of a dialysis membrane with a cut-off molecular weight of 1000 . Neutralization of the acid urines removed the antigonococcal activity . Noncidal acid urines became cidal urines when concentrated by lyophilization . Zinc, lysozyme, fluoride ions, and fatty acids are substances that have antibacterial activity and are also present in urine . These substances were examined for antigonococcal activity . Neither zinc salts, fluoride ions, lysozyme, nor fatty acids in concentrations exceeding those found in urine were bactericidal for the gonococci . These results show that sufficiently concentrated, acidic urines kill gonococci by an unknown mechanism. Antimicrob Agents Chemother, 1987 Oct, 31(10), 1642 - 3 Plasmid-mediated sulfonamide resistance in Neisseria meningitidis; Facinelli B et al.; An 8.5-megadalton plasmid coding for sulfonamide resistance was found in a clinical isolate of Neisseria meningitidis, as demonstrated by plasmid elimination and transformation experiments . The plasmid complemented a mutation which determines the production of a thermosensitive dihydropteroate synthetase in Escherichia coli, thus suggesting that the mechanism of resistance involved a plasmid-encoded dihydropteroate synthetase. Genitourin Med, 1987 Oct, 63(5), 309 - 11 Single dose piperacillin in treating uncomplicated gonococcal urethritis in men; Thirumoorthy T et al.; A single intramuscular dose of piperacillin 2 g, with probenecid 1 g orally, was used to treat 82 men with uncomplicated gonococcal urethritis due to penicillinase producing strains of Neisseria gonorrhoeae (PPNG) or non-PPNG . All 49 patients infected with non-PPNG strains were cured, as opposed to only 25 (76%) of 33 patients infected with PPNG strains, giving an overall success rate of 90% . No serious side effects of treatment were observed . Post gonococcal urethritis (PGU) occurred in 18% of the patients treated . Antibiotic susceptibility tests showed that 44 (96%) of the 46 non-PPNG strains tested had MICs of piperacillin of 2 mg/l or less and 26 (76%) of the 34 PPNG strains had MICs of 32 mg/l or more . This regimen is not recommended for use as first line treatment in areas where there is a high incidence of infection with PPNG strains . It is, however, highly effective against non-PPNG strains. Genitourin Med, 1987 Oct, 63(5), 305 - 8 Chromosomally mediated intrinsic resistance to penicillin of penicillinase producing strains of Neisseria gonorrhoeae isolated in Sydney: guide to treatment with Augmentin; Tapsall JW et al.; Single dose Augmentin treatment fails to cure an appreciable proportion of patients infected with penicillinase producing Neisseria gonorrhoeae (PPNG) strains in parts of the world where high levels of chromosomally mediated intrinsic resistance are also present in gonococci . The levels of intrinsic resistance to penicillin of 31 PPNG strains isolated in Sydney were assessed by obtaining beta lactamase negative variants of these strains and measuring the minimum inhibitory concentration of penicillin by agar plate dilution techniques . The levels of intrinsic resistance found in these imported PPNG strains were higher than those recorded for local isolates of non-PPNG strains, which indicates that caution should be exercised in the use of single dose Augmentin treatment of infections with PPNG strains in Sydney. J Clin Microbiol, 1987 Oct, 25(10), 1982 - 4 Phadebact Monoclonal GC OMNI Test for confirmation of Neisseria gonorrhoeae; Carlson BL et al.; The Phadebact Monoclonal GC OMNI Test (Pharmacia Diagnostics, Piscataway, N.J.) is used for the definitive identification of Neisseria gonorrhoeae . In this test, boiled organisms are examined by using a 1-min coagglutination technique . A total of 776 Neisseria strains, confirmed to the species level by patterns of acid production from carbohydrates incorporated in cysteine-tryptose agar or morphologically consistent with Neisseria meningitidis and fluorescent antibody negative, were tested by the coagglutination technique . Of the 516 isolates of N . gonorrhoeae, 8 (1.6%) were negative with the OMNI Test . Of the 260 isolates of Neisseria spp . other than N . gonorrhoeae, none showed a positive coagglutination reaction . The Phadebact Monoclonal GC OMNI Test provided rapid, accurate identification of N . gonorrhoeae (sensitivity, 98.4%; specificity, 100%). Ann Acad Med Singapore, 1987 Oct, 16(4), 639 - 44 A decade of PPNG in Singapore; Chan RK et al.; It has been more than 10 years since PPNG was first diagnosed in Singapore . Since then the prevalence of PPNG has increased progressively, and is now maintained at between 30 to 35% of all gonococcal infections inspite of a decrease in the overall incidence of gonorrhoea in Singapore . PPNG infections have been recorded with all forms of complicated gonorrhoea including pelvic inflammatory disease, ophthalmia and disseminated gonococcal infection . Penicillin alone cannot be used to treat gonorrhoea . The use of antibiotics active against PPNG and NPPNG both in uncomplicated and complicated gonorrhoea as first-line therapy is now essential . The medical cost of treatment of gonorrhoea has increased by 100 to 200% as a result of the emergence of PPNGPIP: The prevalence of penicillinase-producing Neisseria gonorrhoea (PPNG) has increased progressively in Singapore since its emergence in 1976, while non-PPNG cases have shown a steady decline since 1979 . The proportion of total gonorrhea cases represented by PPNG has remained at about 35% since 1982, with female prostitutes accounting for 2.3 of PPNG cases . 80% of males in Singapore infected with PPNG in 1984 were 15-29 years of age and over 70% were single . In a 1978 survey, 72% of male patients with PPNG treated at the Middle Road and Singapore General Hospitals acknowledged sexual contact with professional prostitutes . Clinical manifestations of PPNG have included gonococcal ophthalmia neonatorum, epididymo-orchitis, pelvic inflammatory disease, parostitis, and disseminated gonococcal infection . The emergence of PPNG has necessitated a search for antibiotics both resistant to beta-lactamase and effective against chromosomally mediated resistant Neisseria gonorrhoea . Following unacceptably high failure rates with kanamycin and spectinomycin, second and third generation cephalosporins have become the mainstay of treatment . A single 500 mg intramuscular dose of cefotaxime combined with 1 gm of oral probenecid cures 93% of PPNG infections in men and 100% of those in women . Although this treatment regimen has maintained the prevalence of PPNG cases at 35%, the medical costs of treatment have increased 100-200% over those for non-PPNG . Future control of PPNG in Singapore will be based on a multifaced strategy of effective drug treatment, control of infections in prostitutes and efforts to curb their practice of self-medication, increased laboratory bacteriological surveillance, and contact tracing . Zentralbl Bakteriol Mikrobiol Hyg {A}, 1987 Oct, 266(3-4), 522 - 5 {Spectinomycin sensitivity of Neisseria gonorrhoeae}; Naher H et al.; Using the agar dilution technique minimal inhibitory concentrations (MIC) with respect to spectinomycin were determined . 92 Neisseria gonorrhoeae isolates collected in a STD outpatient clinic and 160 Neisseria gonorrhoeae isolates collected from prostitutes were investigated . One isolate imported from Asia had a MIC of greater than 1024 micrograms/ml and was resistant . All other isolates, three penicillinase producing strains included, had MICs of 4-32 micrograms/ml and were sensitive to spectinomycin. Sex Transm Dis, 1987 Oct-Dec, 14(4), 191 - 4 Gonorrheal keratoconjunctivitis in African adults; Kestelyn P et al.; We describe six cases of keratoconjunctivitis due to Neisseria gonorrhoeae in adults . All strains tested were penicillinase-producing N . gonorrhoeae (PPNG), and we conclude that the rising incidence of corneal involvement, a classic complication in the pre-antibiotic era, is due to ineffective treatment with penicillin . Indeed, the progression of the ocular lesions was stopped and microbiologic cure was obtained in all our patients after treatment with either spectinomycin or cefotaxime . These results demonstrate that early and effective treatment of adult gonococcal conjunctivitis is mandatory to avoid potentially blinding complications such as corneal ulceration and perforation of the eye. Epidemiol Infect, 1987 Oct, 99(2), 455 - 62 Analysis of penicillinase-producing Neisseria gonorrhoeae isolates in Madrid (Spain) from 1983-85; Fenoll A et al.; Between April 1983 and December 1985, 576 strains of Neisseria gonorrhoeae were isolated in our laboratory from patients attending Sexually Transmitted Diseases (STD) clinics . Of these, 61 (10.6%) were penicillinase-producing . Studies on these strains by plasmid analysis, auxotyping and serogrouping showed that the predominant type strains harboured the Asian resistance plasmid, were prototrophic, and were of serogroup W II/W III . About half of the strains, both of the African and Asian type, harboured the transfer plasmid . Strains of serogroup W II/W III were less sensitive to tetracycline and cefoxitin than serogroup W I strains. Sex Transm Dis, 1987 Oct-Dec, 14(4), 201 - 4 Underlying complement deficiency in patients with disseminated gonococcal infection; Ellison RT 3rd et al.; The complement system was evaluated in 22 individuals with disseminated gonococcal infection . Three of the 22 patients exhibited a total serum complement activity that was greater than 2 SD below the normal mean . Of these three, one had a complete deficiency of C1r, a second patient had pre-existing systemic lupus erythematosus with low levels of C4, and the third had a C8 concentration that was 60% of normal . We conclude that the prevalence of inherited or acquired complement deficiency among patients with disseminated gonococcal infection exceeds that among the general population and is an important host factor predisposing to systemic infection with Neisseria gonorrhoeae. Antimicrob Agents Chemother, 1987 Oct, 31(10), 1507 - 13 Role of extracellular iron in the action of the quinone antibiotic streptonigrin: mechanisms of killing and resistance of Neisseria gonorrhoeae; Cohen MS et al.; The quinone antibiotic streptonigrin is believed to kill bacteria by promoting formation of oxygen radicals . This antibiotic has also been used to select resistant bacterial mutants, some of which vary in iron utilization . We examined the effects of streptonigrin on Neisseria gonorrhoeae and several types of gonococcal mutants . Streptonigrin (0.025 microgram/ml) efficiently killed gonococcal strain FA1090, and this effect depended on iron . Streptonigrin-resistant mutant FA6271 had normal iron uptake but was moderately deficient in total iron . Resistance most likely resulted from failure of FA6271 to divert electrons to streptonigrin, as demonstrated by a reduction in KCN-insensitive respiration (a hallmark of the action of quinones) and superoxide formation . Other mutants selected for inability to use human iron-binding proteins (strains FA6273 and FA6275) had no increase in streptonigrin MIC and no decrease in KCN-insensitive respiration . Mutants did not demonstrate an increase in superoxide dismutase or catalase . Streptonigrin killing of gonococci depended on a reaction(s) in which extracellular iron was important, presumably because iron was required for catalysis of hydroxyl radical . The results suggest that a membrane component may be a target for the actions of streptonigrin. Am J Ophthalmol, 1987 Sep 15, 104(3), 280 - 2 Neisseria meningitidis conjunctivitis in children; Al-Mutlaq F et al.; We examined two children from the same family who had purulent conjunctivitis . Isolates of Neisseria species were obtained from eye cultures and Gram stain of conjunctival scrapings disclosed many gram-negative intracellular diplococci . Colony structure and growth characteristics of the organism with subsequent carbohydrate fermentation tests and serotyping were consistent with Neisseria meningitidis Group B . The patients had no neurologic signs or symptoms . Results of laboratory investigations and blood cultures were normal . Early diagnosis is mandatory and aggressive systemic therapy with appropriate antibiotics may prevent ocular, neurologic, or systemic complications. Schweiz Med Wochenschr, 1987 Sep 12, 117(37), 1374 - 9 {Neisseria gonorrhoeae in Zürich . Incidence, minimal inhibiting concentration of various antibiotics and penicillinase-forming strains 1981 to 1985}; Eichmann A et al.; From 1981-1985 2232 strains of Neisseria gonorrhoeae were isolated and examined in the VD laboratory of the Department for Dermatology of the University Hospital of Zurich . 86 isolates were penicillinase producing Neisseria gonorrhoeae strains (PPNG) . The MIC ranges for penicillin of the non-PPNG strains was 0.0035 to 16 mg/l, for tetracycline 0.03 to 8 mg/l, for spectinomycin 3.5 to 120 mg/l and for thiamphenicol 0.125 to 8 mg/l . 42 out of 86 PPNG strains (48.8%) had been imported from South-East Asia . Six patients (6.9%) with PPNG strains had been infected in Zurich . Plasmid patterns of all PPNG strains were determined . The 4.4 MD-plasmid ("Asian" type plasmid) was found in 68 of 86 strains . The 3.2 MD-plasmid ("African" type plasmid) in 8 of 86 and the 24.6 MD-plasmid (transfer plasmid) in 56 PPNG strains respectively . The range of the MIC for penicillin of the PPNG strains was 1-16 mg/l, for tetracycline 0.25-8 mg/l, for spectinomycin 7-30 mg/l and for thiamphenicol 0.125-2 mg/l . The frequency of PPNG strains increased from 1.7% in 1981 to 6.7% in 1985. Urologe A, 1987 Sep, 26(5), 277 - 82 {Current status of vaccine development in sexually transmissible diseases}; Kohl PK et al.; A prophylactic vaccine represents a major hope for the control of sexually transmitted diseases . The current general vaccine strategies and the status of vaccine development against infections with Neisseria gonorrhoeae, Treponema pallidum, Chlamydia trachomatis and Herpes simplex virus are described . Vaccines consisting of whole infectious agents are replaced by protective subunits . A subunit vaccine has the advantage to be free from other components, which are not relevant for protection and which may confer unwanted side effects . At the present time vaccine development against infections with Neisseria gonorrhoeae and Herpes simplex virus seems to be the most progressed . With monoclonal antibodies several surface components could be identified, which are of importance for the pathomechanism . With Treponema pallidum and Chlamydia trachomatis the development is delayed by unsolved problems of immunity . For the production of vaccines molecular-biologic methods, like protein synthesis or gene-cloning will be used . Genetically modified live vaccines or polytope hybrid vaccines will gain importance in the future. Urologe A, 1987 Sep, 26(5), 237 - 45 {Uncomplicated gonorrhea and disseminated gonococcal infections--clinical aspects, diagnosis and therapy}; Korting HC; Gonorrhoea is not only the oldest but also still one of the most frequent sexually transmitted diseases . Under therapeutic aspects it seems worthwhile to distinguish between uncomplicated and complicated forms . Uncomplicated gonorrhoea - urethritis being its most important variant - can be cured by adequate single injection treatment while complicated disease cannot . Disseminated infection is one of the major threats of gonococcal infection . The outcome is potentially fatal . Therapeutic considerations today have to take antibiotic-resistant or even multi-resistant Neisseria gonorrhoeaestrains into account . Third-generation cephalosporins and second-generation quinolones represent potential alternatives to conventional agents. J Gen Microbiol, 1987 Sep, 133 ( Pt 9), 2671 - 8 Evidence that the serum resistance genetic locus sac-3 of Neisseria gonorrhoeae is involved in lipopolysaccharide structure; Stephens DS et al.; The gonococcal chromosome contains a sequence of closely linked genes (for example, sac-1, sac-3, nmp) known or presumed to affect cell envelope structure and which appear to influence susceptibility of gonococci to killing by normal human sera (NHS) . Previous work has shown that the serum-resistant isolate FA19, and FA899, a serum-sensitive transformant of FA19, differ in outer membrane protein I (PI) and at the sac-3 genetic locus . However, the sac-3 locus is separable from changes determined by nmp-3, the gene determining PI species . We found that FA19 and FA899 differ in lipopolysaccharide (LPS) molecular size and in reactivity with a monoclonal antibody which recognizes an LPS (L8) epitope . To address the question of whether the changes in LPS were due to the sac-3 locus, we constructed new transformants of FA19 using donor DNA prepared from FA899 . The new transformants could be divided into three groups: (1) those identical to FA19 in serum resistance (greater than 90% survival at 120 min), in LPS molecular size and in expression of the L8 epitope; (2) those identical to FA899 in serum sensitivity (100% killed at 30 min), in LPS molecular size and in lack of expression of the L8 epitope; (3) those significantly killed by 50% NHS at 120 min, whose LPS molecular size was greater than that of FA19 but less than that of FA899 and which did not express the L8 epitope . Except for PI there were no differences in other outer-membrane proteins (e.g . PII, PIII, H.8) among these transformants.(ABSTRACT TRUNCATED AT 250 WORDS) J Clin Pathol, 1987 Sep, 40(9), 1088 - 97 Neisseria gonorrhoeae: a versatile pathogen; Easmon CS et al.; Neisseria gonorrhoeae is one of the most important causes of sexually transmitted disease . We do not fully understand the pathogenesis of infection with this organism, although recent improvements in immunological and molecular techniques have brought us closer to an answer . These techniques are now also being used to detect and identify N gonorrhoeae and to analyse the epidemiology of gonorrhoea . Plasmid and chromosomal mediated antibiotic resistance increases the difficulty of controlling gonorrhoea . Resistant strains occur all over the world and new patterns of resistance are still emerging . A better understanding of gonococcal pathogenicity is necessary for the development of an effective vaccine . Despite work on pili and outer membrane proteins no vaccine yet exists . The control of gonorrhoea still depends on diagnosis, treatment, and epidemiological control, facilities that are not widely available in many of those parts of the world where gonorrhoea is a major problem. J Clin Microbiol, 1987 Sep, 25(9), 1641 - 4 Murine monoclonal antibodies for detection of antigens and culture identification of Neisseria meningitidis group B and Escherichia coli K-1; Krambovitis E et al.; Four murine monoclonal antibodies which reacted with a (2----8)alpha-linked sialic acid polysaccharide were produced . Three of the antibodies reacted specifically with Neisseria meningitidis serogroup B and Escherichia coli K-1 polysaccharide antigens, whereas one antibody cross-reacted with N . meningitidis group C polysaccharide antigen, a (2----9)alpha-linked homopolymer of sialic acid . By using the most avid antibody (MB 62), a latex particle agglutination test was developed which could detect capsular polysaccharide at 10 ng/ml . It also detected antigen in the cerebrospinal fluid (CSF) of all seven N . meningitidis group B- and two E . coli K-1-infected patients, whereas 57 control CSF samples, including 8 from neonates, were negative . Cultures of 21 N . meningitidis group B strains, 7 E . coli K-1 strains, and 1 Moraxella nonliquefaciens strain gave a positive result, whereas 53 strains from other serogroups were all negative . In a separate clinical evaluation, the overall sensitivity of the latex particle agglutination test was 81% (22 of 27) with fresh CSF samples, 48% (15 of 31) with stored CSF samples, and 94% (32 of 34) with blood cultures . No false-positive reactions were recorded with 165 control CSF samples, and the specificity with blood cultures was 99.4% (519 of 522). South Med J, 1987 Sep, 80(9), 1194 - 5 Neisseria gonorrhoeae endocarditis on a prosthetic valve; Williams C et al.; Neisseria gonorrhoeae is now a rare cause of infective endocarditis . We have reported the first case of N gonorrhoeae infection on a prosthetic valve, showing the possible consequences of a late diagnosis. Infect Immun, 1987 Sep, 55(9), 2026 - 31 Antigenic and structural differences among six proteins II expressed by a single strain of Neisseria gonorrhoeae; Barritt DS et al.; Gonococci express a family of related outer membrane proteins designated protein II (P.II), which undergo both phase and antigenic variation . Six P.II proteins have been identified in strain FA1090 . We developed monoclonal antibodies specific for each P.II protein . Using these antibodies as probes, we purified the six different P.II proteins of this strain . Despite the relatedness of the proteins, we could not purify all of them by a single purification scheme . Four P.II proteins were purified by chromatofocusing, and the remaining two proteins were purified by hydrophobic interaction chromatography on phenyl-Sepharose . The N-terminal amino acid sequence of the proteins showed a high degree of sequence conservation . However, there was variability at specific amino acid residues, giving each P.II protein a unique N-terminal amino acid sequence . Thus P.II proteins of one strain differ among themselves not only in antigenic determinants and primary structure, but also in other characteristics affecting their properties in different chromatographic systems. Diagn Microbiol Infect Dis, 1987 Sep, 8(1), 13 - 8 Treatment of ordinary and penicillinase-producing strains of Neisseria gonorrhoeae in Mexico City; Calderon E et al.; Since being recognized in 1976 and 1983, respectively, penicillinase-producing strains of Neisseria gonorrhoeae (PPNG) and chromosomally mediated resistance (CMRNG) have attained a worldwide distribution . The high endemicity of both types of resistance in some regions precludes the continued routine use of procaine penicillin (APPG) as treatment for gonorrhea . In this study, we have evaluated 72/216 men with uncomplicated gonococcal urethritis at the venereal clinic in Mexico City . These men were part of a blinded randomized comparative study for treatment with group (P) penicillin having 33 patients and group (S) spectinomycin having 39 . Efficacy with (P) was 24/33 (72.7%); nine failures retreated and were cured with spectinomycin . Efficacy with (S) was 35/39 (89.7%); four failures retreated and were cured with cefotaxime . We found correlation between MICs and resistance; all the strains with MICs of greater than or equal to 1.0 mcg/ml of penicillin failed to be cured, the MICs of greater than or equal to 32 mcg/ml of spectinomycin failed to be cured . The overall resistance to both regimens was 23/72 to penicillin (31.9%) (22 PPNG and one CMRNG) and 4/72 (5.5%) to spectinomycin. Ann Trop Paediatr, 1987 Sep, 7(3), 177 - 80 Chlamydial and gonococcal ophthalmia neonatorum in The Gambia; Mabey D et al.; Swabs were taken for isolation of Chlamydia trachomatis and Neisseria gonorrhoeae from 112 infants with ophthalmia neonatorum attending a hospital in The Gambia . C . trachomatis was isolated from 37 (33%) and N . gonorrhoeae from 28 (25%), with both organisms being present in three cases (3%) . A prospective study of 335 neonates was also undertaken in a Gambian town . Fifty-five infants (16%) showed clinical evidence of ophthalmia neonatorum . C . trachomatis was isolated from nine of these (16%) and N . gonorrhoeae from seven (13%). J Clin Microbiol, 1987 Aug, 25(8), 1574 - 5 Ocular infection in a newborn caused by Neisseria mucosa; Gini GA; Neisseria mucosa was isolated in pure culture from a purulent ocular infection of a newborn . The initial Gram-stained smear revealed intracellular gram-negative diplococci . The organism showed resistance to vancomycin, colistin, and trimethoprim in susceptibility testing and grew well on Thayer-Martin medium. Aust N Z J Obstet Gynaecol, 1987 Aug, 27(3), 213 - 5 The prevalence of sexually transmitted disease agents in pregnant women in Suva; Gyaneshwar R et al.; Routine testing of 440 women (257 Fijians, 183 Indians) at the first antenatal attendance identified Chlamydia trachomatis in 50% of Fijians and 38% of Indians; the seropositivity rates for syphilis were 14.2% and 1.7% respectively, and the isolation rates for N . gonorrhoeae were 3.1% in Fijians and 1.1% in IndiansPIP: A total of 440 women under 28 weeks' gestation comprising 257 Fijians and 183 Indians attending the antenatal clinic at the Anderson Maternity Unit in Suva, Fiji, between November, 1985, and April, 1986, were selected for the study on their first visit . After an obstetric history was taken and a general physical examination performed, specimens for microbial studies were collected from the cervix and the posterior vaginal fornix . Blood was collected for serological tests for syphilis . Neisseria gonorrhea was identified on colonial morphology, Gram stain and oxidase reactivity . Specimens for Chlamydiazyme immunoassay test were stored at 40 C and tested within 5 days of collection . Tests for syphilis were performed using Venereal Disease Research Laboratory (VDRL) and treponema pallidum hemagglutination (TPHA) tests . Results for chlamydia are available for only 244, as this was introduced midway in the study . All STD pathogens were isolated in significantly higher rates from Fijian compared to Indian women p 0.01) . Chlamydia trachomatis was the most common agent, affecting 50% of Fijian women and 37.5% of Indian women . Candida albicans was the next most common pathogen in both groups, accounting for 40% . Trichomonas vaginalis was found in 8.2% of both groups . N gonorrhea was isolated in 2.3% of the population studied . The average age of women with gonorrhea was 22 years, whereas the average age of the whole population studied was 26.1 years . They were also predominantly single or living in a consensual relationship . Group B beta hemolytic streptococci were identified in only 9 of the 440 women studied . Serological tests were interpreted to be positive for syphilis if both VDRL and TPHA were positive in the absence of a history of previous treatment for syphilis . The difference in infection rates of 14.2% for Fijians and 1.7% for Indians was highly significant (p 0.01) . Zhonghua Min Guo Wei Sheng Wu Ji Mian Yi Xue Za Zhi, 1987 Aug, 20(3), 262 - 8 Auxotyping of Neisseria gonorrhoeae isolated in Taiwan; Ding MJ et al.; One hundred and seventy eight out of 319 clinical isolates (55.8%) of Neisseria gonorrhoeae isolated in Taiwan were identified as penicillinase-producing Neisseria gonorrhoeae . Two hundred and ninety six isolates were subdivided into 24 distinct auxotypes . The majority of gonococci tested were non-requiring (43.6%) and proline-dependent (43.2%) . No arginine-hypoxanthine-uracil requiring strain was obtained in this study . Only one arginine-requiring strain was obtained from 296 isolates . Different auxotypes of gonococci were isolated from the same patient who had contracted gonorrhea . Each of 17 patients was infected by at least two different auxotypes of gonococci. Genitourin Med, 1987 Aug, 63(4), 244 - 5 Trends in gonococcal resistance to antibiotics in Rotterdam, The Netherlands, 1975-86; Wagenvoort JH et al.; The incidence of resistance of Neisseria gonorrhoeae to penicillin and tetracycline was periodically monitored during 1975-86 . The incidence of resistance to penicillin (minimum inhibitory concentration (MIC) of more than 1.28 mg/l) of non-PPNG strains remained low (less than 2.5%) . The incidence of penicillinase producing N gonorrhoeae (PPNG) strains decreased after a peak of 14% in 1982 to a mean of 8% in more recent years . After a gradual increase, the incidence of tetracycline resistant (MIC of more than 1.28 mg/l) strains has remained stable at around 20% during the past five years . This indicates that a continuing increase in incidence of resistance was not observed in this outpatient clinic. Genitourin Med, 1987 Aug, 63(4), 239 - 43 Chromosomal resistance of gonococci to antibiotics; Ison CA et al.; Three hundred and twenty nine strains of non-penicillinase-producing Neisseria gonorrhoeae (non-PPNG) isolated from men and women were tested for their susceptibility to a range of antibiotics, and were also auxotyped and serogrouped . Nearly 6% (18) of 312 strains tested were resistant to 1 mg/l or more penicillin (compared with 4.4% of PPNG strains isolated in 1981) . Many (198, 64%) strains showed intermediate resistance to penicillin (0.12-0.5 mg/l) . Nearly 5% (15) of 312 strains tested were resistant to 0.5 mg/l or more cefuroxime, and there was a high degree of cross resistance between these two antibiotics . High levels of resistance to erythromycin and tetracycline were also found, and there was also appreciable cross resistance between these antibiotics and the beta lactam drugs . Resistance to spectinomycin was rare, and there was no cross resistance between spectinomycin and other agents tested . Levels of resistance between strains isolated from different anatomical sites did not differ, except that resistance to erythromycin was greater in rectal isolates . Four main auxotypes were detected . Strains requiring arginine, hypoxanthine, and uracil (AHU-) were more prevalent from the cervix . We have shown that there is an association between auxotype, serogroup, and level of sensitivity to penicillin, cefuroxime, and tetracycline. Genitourin Med, 1987 Aug, 63(4), 225 - 32 Serological classification of Neisseria gonorrhoeae with monoclonal antibody coagglutination reagents; Coghill DV et al.; A total of 357 clinical isolates of Neisseria gonorrhoeae from 286 patients were classified serologically using two independently developed panels of monoclonal coagglutination reagents . The Pharmacia (Ph) Diagnostics panel comprised 14 reagents, five specific for serogroup WI strains and nine specific for serogroup WII/III strains, whereas the Genetic Systems (GS) panel comprised 14 reagents, seven specific for serogroup WI strains and seven specific for serogroup WII/III strains . Serogroup WI represented 45% and WII/III represented 55% of the patients . Using the monoclonal antibody reagents, the serogroups could be further subdivided into so-called serovars . The Ph reagents identified four WI serovars and 21 WII/III serovars, whereas the GS reagents identified 10 WI serovars and 18 WII/III serovars . By combining the results obtained with each panel, 15 Ph/GS WI serovars and 33 Ph/GS WII/III serovars were recognised . In the WI isolates, one predominating serovar was recognised, whereas in the WII/III isolates, no single serovar predominated and a much greater variety of serovars was identified . The serovar patterns for men and women patients were very similar, except for one WII/III serovar that was 10 times more common in isolates from men than from women . Most isolates from different anatomical sites in the same patient were of the same serogroup and serovar . Two double infections were found . One patient had a genital infection with serogroup WII/III and a rectal infection with serogroup WI . Another patient with genital, rectal, and throat infections with serogroup WI was found to have gonococci of different GS serovars at each site . It was concluded that the level of discrimination achieved with the monoclonal antibody reagents should prove to be valuable in studying the micro epidemiology of gonococcal infection. J Am Acad Dermatol, 1987 Aug, 17(2 Pt 1), 197 - 200 A new technic for transport, enrichment, and cultural detection of Neisseria gonorrhoeae; Gernand K et al.; This article describes a new transport and enrichment technic that improves growth conditions of Neisseria gonorrhoeae and that is particularly suitable for use in dermatology clinics with no bacteriology facilities . The deep-prick culture makes use of a simple and proven selective medium, which is placed in small plastic or glass vessels . After inoculation deep into the agar medium, the gonococci themselves create the required microaerophilic environment . Inoculated smear material can therefore be transported without loss . Our experience, which has lasted for more than 3 years and which has included more than 4000 patients, showed that in 98% to 99% of cases of suspected gonorrhea, gonococci can be detected with a contamination rate of less than 3%. J Bacteriol, 1987 Aug, 169(8), 3414 - 21 Aerobactin utilization by Neisseria gonorrhoeae and cloning of a genomic DNA fragment that complements Escherichia coli fhuB mutations; West SE et al.; Aerobactin, a dihydroxamate siderophore produced by many strains of enteric bacteria, stimulated the growth of Neisseria gonorrhoeae FA19 and F62 in iron-limiting medium . However, gonococci did not produce detectable amounts of aerobactin in the Escherichia coli LG1522 aerobactin bioassay . We probed gonococcal genomic DNA with the cloned E . coli aerobactin biosynthesis (iucABCD), aerobactin receptor (iutA), and hydroxamate utilization (fhuCDB) genes . Hybridization was detected with fhuB sequences but not with the other genes under conditions which will detect 70% or greater homology . Similar results were obtained with 21 additional strains of gonococci by colony filter hybridization . A library of DNA from N . gonorrhoeae FA19 was constructed in the phasmid vector lambda SE4, and a clone was isolated that complemented the fhuB mutation in derivatives of E . coli BU736 and BN3307 . These results suggest that fhuB is a conserved gene and may play a fundamental role in iron acquisition by N . gonorrhoeae. Infect Immun, 1987 Aug, 55(8), 1792 - 800 Physical heterogeneity of neisserial lipooligosaccharides reflects oligosaccharides that differ in apparent molecular weight, chemical composition, and antigenic expression; Griffiss JM et al.; We studied the oligosaccharides (OS) of outer membrane lipooligosaccharides (LOS) of Neisseria gonorrhoeae and Neisseria meningitidis . OS from the LOS of an individual neisserial strain always eluted from Sephadex G-50S as multiple peaks; the polyacrylamide gel elution profiles were nearly identical to the polyacrylamide gel electrophoresis profiles of the sodium dodecyl sulfate-disaggregated native LOS from which the OS were derived . Neisserial OS coeluted with Dex14 to Dex27 dextran oligomers (Mr, 2,210 to 4,320) . Monosaccharide composition varied among the several OS released from the LOS of a single strain . The two OS of a gonococcal strain sensitive to normal human serum (NHS) bacteriolysis (sers) varied in their ability to inhibit the binding of NHS immunoglobulin M to their parental LOS . The OS that was rich in hexosamines inhibited NHS immune lysis of its parent strain; the OS that was poor in hexosamines did not . We conclude that structural differences in their OS account for the Mr heterogeneity of the LOS of a strain. Genitourin Med, 1987 Aug, 63(4), 246 - 9 Epidemiology and treatment of uncomplicated gonorrhoea caused by non-PPNG strains in Córdoba, Argentina: auxotypes, susceptibility profiles, and plasmid analyses of urethral isolates from men; Monayar HK et al.; The official records of uncomplicated gonorrhoea for Cordoba state show that between 1975 and 1985, about one in 1000 sexually active people acquired gonorrhoea each year . A study was therefore undertaken to obtain information about treatment of uncomplicated gonorrhoea, as well as the nutritional requirements, plasmid analyses, and susceptibility profiles of gonococci in this geographical area . From August 1983 to April 1984, 219 men with uncomplicated gonorrhoea were treated with one of four antibiotic schedules, all of which were over 95% efficient . All 98 strains isolated and purified were non-penicillinase-producing Neisseria gonorrhoeae (non-PPNG) . The minimum inhibitory concentrations (MICs) of benzylpenicillin, tetracycline, thiamphenicol, spectinomycin, kanamycin, and cefoxitin were assessed . The MIC of benzylpenicillin showed that 88% (86) of the strains were inhibited by 0.5 mg/l of the drug, and also showed a bimodal sensitivity pattern to that antibiotic . The nutritional requirements of the 62 strains tested showed that 53% (33) were of the non-requiring (wild type) auxotype, 42% (26) required proline (pro-) and 5% (3) required proline and arginine (pro- arg-) . Resistance to antibiotics was more notable in the pro- than in the wild type strains. Antimicrob Agents Chemother, 1987 Aug, 31(8), 1288 - 90 Changing antibiotic susceptibility of Neisseria gonorrhoeae in Franceville, Gabon; Peeters M et al.; Susceptibilities to penicillin, cefotaxime, kanamycin, tetracycline, and spectinomycin were measured for 5 reference strains and 302 Neisseria gonorrhoeae isolates collected between 1980 and 1985 . After an initial rise, the number of penicillinase-producing strains decreased . A gradual decrease in susceptibility to spectinomycin and the appearance of tetracycline-resistant strains were also documented. Infect Immun, 1987 Aug, 55(8), 1755 - 61 Phenotypic variation in epitope expression of the Neisseria gonorrhoeae lipooligosaccharide; Apicella MA et al.; Gonococcal lipooligosaccharides (LOSs) are a series of antigenically complex heteropolymers . To investigate whether all members of clonally selected populations of Neisseria gonorrhoeae express antigenically similar LOS, we studied gonococcal strains 4505 and 220 with monoclonal antibodies 6B4 and 3F11 which have specificity for different oligosaccharide epitopes on the same or comigrating LOS unit(s) on sodium dodecyl sulfate-polyacrylamide gel electrophoresis . Fluorescent-antibody and immunoelectron microscopy studies indicated that all members of the clonally selected populations were not homogenous for the epitopes these antibodies recognized . Fluorescence-activated cell sorting studies of 3F11-coated strain 220 indicated that the density of epitope expression was a function of time of growth . The population could be separated into two broad groups corresponding to organisms staining strongly or weakly for the 3F11 epitope, and the epitope density decreased during the late-log and stationary phases of growth . Sequentially staining organisms on Formvar grids with 6B4 and 3F11, followed by staining with either 5- or 15-nm colloidal gold spheres conjugated to goat anti-mouse immunoglobulin M demonstrated the following populations of cells among organisms derived from a single clone: organisms which stained for both 6B4 and 3F11 epitopes and organisms which stained for either 6B4 epitopes alone or 3F11 epitopes alone . Immunofluorescence microscopy studies with rhodamine and fluorescein goat anti-mouse immunoglobulin M conjugates sequentially staining organisms on Formvar grids with 3F11 and 6B4 also demonstrated these three populations . Analysis of LOS preparations made over the last 5 years indicated no change in serotype antigen concentration or in sodium dodecyl sulfate-polyacrylamide gel electrophoresis migration pattern . These studies indicate that while clonally selected strains of Neisseria gonorrhoeae undergo phenotypic variation at the epitope level, the impact of this variation on the total LOS of the population has little overall effect on its antigenic or physicochemical properties. N Engl J Med, 1987 Jul 30, 317(5), 272 - 8 Effect of spectinomycin use on the prevalence of spectinomycin-resistant and of penicillinase-producing Neisseria gonorrhoeae; Boslego JW et al.; Because of the high prevalence of penicillinase-producing Neisseria gonorrhoeae in the Republic of Korea, spectinomycin has been used there in the primary treatment of gonococcal infections in U.S . military personnel since 1981, but there have been increasingly frequent reports of treatment failures with spectinomycin . We conducted a clinical study to determine the efficacy of spectinomycin treatment in 124 U.S . servicemen in the Republic of Korea who had urethral gonococcal infections . Ninety-seven patients were treated with spectinomycin alone and evaluated in a follow-up visit . In eight patients (8.2 percent), this treatment was unsuccessful . Antibiotic-sensitivity testing on isolates from seven of the patients with treatment failure demonstrated that six isolates were highly resistant to spectinomycin (minimal inhibitory concentration, greater than or equal to 100 micrograms per milliliter) . None of the spectinomycin-resistant strains had become resistant to penicillin, either through the production of penicillinase or through a chromosomal mutation . Although the mechanism of spectinomycin resistance appears to be a chromosomal mutation, these isolates were generally sensitive to other antibiotics . The prevalence of resistance to spectinomycin resulted in the substitution of ceftriaxone for the primary treatment of gonorrhea acquired by U.S . military personnel in the Republic of Korea . We believe that the rapid emergence of spectinomycin resistance in this population mandates a cautious approach to widescale use of the drug and indicates a need to broaden current surveillance programs. Sex Transm Dis, 1987 Jul-Sep, 14(3), 125 - 9 Pelvic inflammatory disease associated with Neisseria gonorrhoeae and Chlamydia trachomatis: clinical correlates; Cromer BA et al.; The purpose of this study was to determine whether selected clinical features can distinguish salpingitis associated with endocervical Neisseria gonorrhoeae from that caused by Chlamydia trachomatis in black, inner-city adolescents . We reviewed retrospectively the charts of teenagers presenting to a university hospital outpatient department between January 1982 and January 1984 who were diagnosed as having salpingitis . We included all teenagers who presented with a history of low abdominal pain plus (1) either cervical motion tenderness (n = 15), adnexal tenderness (n = 13), or both (n = 57); and (2) either cervical cultures positive for N . gonorrhoeae and negative for C . trachomatis (n = 31) or cervical cultures negative for N . gonorrhoeae and positive for C . trachomatis (n = 54) . Discriminant analysis indicated that the presence of breakthrough vaginal bleeding (standard regression coefficient {SRC} = 0.301; P = 0.023), current usage of oral contraception (SRC = 0.408; P = 0.009), and an elevated erythrocyte sedimentation rate (SRC = 0.522; P = 0.0002) were significantly more often related to the presence of endocervical C . trachomatis . However, we found no significant differences between the two groups for other variables that have been described as distinguishing features (i.e., duration of pain, fever, and leukocyte count). J Antimicrob Chemother, 1987 Jul, 20(1), 117 - 21 Ciprofloxacin versus ampicillin and probenecid in the treatment of uncomplicated gonorrhoea in men; Scott GR et al.; Eighty-six men with uncomplicated gonorrhoea were entered into a study comparing the efficacy of a single oral dose of 250 mg of ciprofloxacin with a single oral dose of ampicillin 2 g and probenecid 1 g for urethral gonorrhoea and a course of ampicillin, 500 mg four times per day for five days in rectal and pharyngeal infection . Two patients were excluded . Of the remaining 84, 45 were treated with ampicillin and 39 with ciprofloxacin . In the ampicillin group there were two treatment failures out of 40 urethral infections . Three patients with rectal infection were cured . Only one patient out of three pharyngeal infections was cured . Ciprofloxacin cured all of 34 urethral and three rectal infections including one penicillinase producing strain of Neisseria gonorrhoeae (PPNG) . Four of five pharyngeal infections were cured but there was one treatment failure . There were no major side effects in either treatment group . In conclusion, a single oral dose of 250 mg of ciprofloxacin is an effective treatment for uncomplicated gonorrhoea in men. J Infect Dis, 1987 Jul, 156(1), 92 - 8 Postpartum upper genital tract infections in Nairobi, Kenya: epidemiology, etiology, and risk factors; Plummer FA et al.; We investigated the frequency of clinically defined upper genital tract infection (UGTI) and its relation to sexually transmitted diseases and other risk factors among 1,013 women initially studied while in labor at a Nairobi, Kenya maternity hospital . Women were enrolled during labor and followed up at seven days and one month postpartum . Cultures for Neisseria gonorrhoeae and Chlamydia trachomatis were done at enrollment and at day 7 . The prevalence of gonococcal and chlamydial infections was 6.7% and 20.8%, respectively . The overall prevalence of UGTI was 20.3% . The development of UGTI was significantly correlated with gonococcal infection (odds ratio, 4.4; P less than .0001), chlamydial infection (odds ratio, 1.7; P less than .02), presence of ophthalmia neonatorum (odds ratio, 2.6; P less than .0001), labor greater than 12 hr (odds ratio, 1.8; P less than .01), and area of residence (odds ratio, 1.5; P less than .05) . Postpartum UGTI, an enormous public health problem in Nairobi, would be partially susceptible to antenatal intervention programs focusing on sexually transmitted diseases. Med Trop (Mars), 1987 Jul-Sep, 47(3), 243 - 8 {Sexually transmitted diseases and sterility in black Africa}; Bourgeade A et al.; It is in Africa that sterility of infectious etiology is prevalent: 75% to 85% of female sterility, primary as well as secondary, are the consequence of a pelvic infection . This picture is explained by the high prevalence of genital infections caused by Neisseria gonorrhoeae and by Chlamydia trachomatis in a sanitary under-developed environment . Frequency of such sterilities is such as fecundity rates are significantly reduced. Rev Infect Dis, 1987 Jul-Aug, 9(4), 665 - 92 Clonal population structure of Neisseria meningitidis serogroup A isolated from epidemics and pandemics between 1915 and 1983; Olyhoek T et al.; A bacterial strain collection has been established consisting of 423 strains of Neisseria meningitidis serogroup A isolated from 23 epidemics or outbreaks that have occurred since 1960 as well as from earlier epidemics and from numerous nonepidemic situations . A combination of starch gel electrophoresis of seven cytoplasmic enzymes and sodium dodecyl sulfate-polyacrylamide gel electrophoresis of two outer membrane proteins was used to resolve the clonal population structure of these bacteria . Fifty electrophoretic types were assigned to 21 clones on the basis of a cluster analysis . The clones were separated into four distinct serogroup A subgroups, all of which were isolated from cases as recently as 1983 . Most epidemics or outbreaks were characterized by their association with a single or predominant clone, although some epidemics were apparently of mixed etiology and others yielded rare isolates belonging to other clones . Seven predominant clones were recognized that have caused sets of epidemics since 1915 . At least two of these sets can be considered to represent mutually exclusive pandemics first detected in 1967 and 1973, respectively . The results define a new typing scheme, which can be used for a comprehensive description of former and future epidemics . A list of strains and their epidemiologic data is appended. J Gen Microbiol, 1987 Jul, 133 ( Pt 7), 1743 - 50 Progress of O-acetylation and cross-linking of peptidoglycan in Neisseria gonorrhoeae grown in the presence of penicillin; Lear AL et al.; The synthesis, cross-linking and O-acetylation of gonococcal peptidoglycan in growing cells were studied by following incorporation of radioactive glucosamine and separation of the SDS-insoluble peptidoglycan into uncross-linked (monomer) and cross-linked (dimer and oligomer) fragments . Cultures to which penicillin or piperacillin at concentrations near the minimum growth inhibitory concentration (MIC) had been added 20 min before the radioactive label were compared with controls . The beta-lactams affected the early stage of cross-linking (up to 3 min) but had no effect thereafter . The deficit of cross-linking, however, did not recover . The O-acetylation, particularly of the monomer fraction, was decreased by beta-lactams even at concentrations that had no effect on culture optical density, viable counts or overall peptidoglycan synthesis . These effects on O-acetylation occurred mainly after the first 3 min of incorporation, rather than before . O-Acetylation of the oligomer fraction was also followed . Here penicillin led to increased levels of O-acetylation during the early stages of incorporation but the final value was never exceeded; indeed at higher drug concentrations the later stages of O-acetylation of oligomers were inhibited (e.g . almost completely at 2.5 X MIC). Sex Transm Dis, 1987 Jul-Sep, 14(3), 141 - 6 Auxotype/serovar diversity and antimicrobial resistance of Neisseria gonorrhoeae in two mid-sized American cities; Hook EW 3rd et al.; To characterize the prevalence and heterogeneity of Neisseria gonorrhoeae with chromosomally mediated resistance to penicillin G or tetracycline.HCl in Seattle, Washington, and Denver, Colorado, we auxotyped, serotyped, and determined the MICs of penicillin G and tetracycline for gonococcal isolates collected in both cities during 1984 . In Seattle 37 (18%) and ten (5%) of 205 isolates had MICs for penicillin G of greater than or equal to 1.0 and greater than or equal to 2.0 micrograms/ml, respectively; in Denver eight (3%) of 240 isolates had MICs for penicillin of 1.0 microgram/ml, and none had MICs of greater than 1.0 microgram/ml . For tetracycline.HCl, 107 (52%) and 38 (19%) of Seattle isolates had MICs of greater than or equal to 1.0 and greater than or equal to 2.0 micrograms/ml, respectively, while in Denver the respective figures were 111 (46%) and 48 (20%) . In each city, antimicrobial resistance was present in a number of auxotype/serovar (A/S) classes: isolates with MICs for penicillin G of greater than or equal to 1.0 microgram/ml were identified in 15 of 49 A/S classes in Seattle and in five of 49 A/S classes in Denver . These data indicate that chromosomal resistance to penicillin G and tetracycline.HCl varies geographically in prevalence and is a heterogeneous phenomenon involving multiple gonococcal strains. Sex Transm Dis, 1987 Jul-Sep, 14(3), 130 - 4 Antibiotic susceptibility in relation to serogroup and auxotype of Neisseria gonorrhoeae isolates from Gabon; Peeters MF et al.; We tested 75 beta-lactamase-positive (penicillinase-producing Neisseria gonorrhoeae; PPNG) and 147 beta-lactamase negative (non-PPNG) strains of N . gonorrhoeae obtained during a two-year period in Franceville, a semirural community in southeastern Gabon, for susceptibility to antimicrobial agents, auxotype, and serotype . The most common auxotypes were the nonrequiring and proline-requiring strains . Of the non-PPNG strains tested, 37% belonged to serogroup WI, 48% to serogroup WII, and 15% could not be grouped with commercially available antisera . Except for four strains that belonged to serogroup WII, the PPNG strains were classified as serogroup WI or ungroupable . We determined the concentrations at which 90% of strains were inhibited (MIC90) for spectinomycin (32 mg/liter for both PPNG and non-PPNG), kanamycin (32 mg/liter for both PPNG and non-PPNG), tetracycline (2 mg/liter for non-PPNG, 1 mg/liter for PPNG), cefotaxime (0.03 mg/liter for non-PPNG, 0.008 mg/liter for PPNG), and penicillin (1 mg/liter for non-PPNG, greater than 32 mg/liter for PPNG) . A MIC of greater than or equal to 2 mg of tetracycline/liter was noted for 17% of the strains . Strains belonging to serogroup WII were more resistant to tetracycline and cefotaxime than other strains . Proline-requiring strains were less susceptible to tetracycline, cefotaxime, and spectinomycin than the nonrequiring strains . The decreased sensitivity to penicillin (non-PPNG strains) and tetracycline was determined by proline-requiring strains belonging to serogroup WII. Sex Transm Dis, 1987 Jul-Sep, 14(3), 153 - 5 Single-dose treatment of uncomplicated acute gonococcal urethritis in Ethiopian men: comparison of rosoxacin, spectinomycin, penicillin, and ampicillin; Habte-Gabr E et al.; A total of 140 Ethiopian men with gonococcal urethritis were randomly assigned to treatment with aqueous procaine penicillin G (4.8 X 10(6) units intramuscularly {im} plus 1.0 g of oral probenicid); oral ampicillin (3.5 g plus 1.0 g of oral probenicid); spectinomycin (2.0 g im); or oral rosoxacin (Acrosoxacin; 300 mg) . Failure rates were 24%, 19%, zero, and 3%, respectively . Forty-four (31.4%) patients were infected with penicillinase-producing Neisseria gonorrhoeae (PPNG) and were evenly distributed in the treatment groups . All 39 PPNG strains analyzed for plasmid content possessed a 2.6-Mdalton plasmid; 28 (71.8%) had a 3.2-Mdalton beta-lactamase-encoding plasmid, ten (25.6%) had a 4.4-Mdalton plasmid (three with and seven without a 24.5-Mdalton plasmid), and one had only a 24.5-Mdalton plasmid . Two patients were infected with N . gonorrhoeae-possessing plasmids apparently capable of encoding but not producing beta-lactamase . Both spectinomycin and rosoxacin are excellent single-dose treatment regimens for gonococcal urethritis in men . All people receiving these drugs in Ethiopia should be tested serologically for syphilis, however, as eight (11.8%) of 68 men in this study also had active latent syphilis. J Hosp Infect, 1987 Jul, 10(1), 87 - 90 Antibiotic dependence in a strain of Neisseria pharyngis; Winstanley TG et al.; A strain of Neisseria pharyngis was isolated in pure culture from a specimen of sputum . Growth was markedly enhanced by sub-lethal concentrations of rifampicin, spectinomycin, erythromycin and clindamycin . The effect was temporary with tetracycline . The possible mechanisms of this phenomenon are discussed. Sex Transm Dis, 1987 Jul-Sep, 14(3), 147 - 52 The contraceptive sponge's protection against Chlamydia trachomatis and Neisseria gonorrhoeae; Rosenberg MJ et al.; To investigate the effect of the contraceptive sponge on the incidence of sexually transmitted diseases, we conducted a clinical trial among a high-risk population of women in Bangkok, Thailand . Two hundred fifty-five women were randomly assigned either to use the sponge or not and were evaluated weekly for gonorrhea and chlamydial infection . After adjustment by logistic regression for potentially confounding factors, women using the sponge were less likely to have contracted chlamydial infection (odds ratio {OR}, 0.6; 90% confidence interval {CI}, 0.4-1.0) and gonorrhea (OR, 0.9; CI, 0.6-1.3) as compared with women not using the sponge . These estimates probably underestimate the degree of protection because some exposure was misclassified in this pilot phase of the study . These results are consistent with other studies indicating that spermicides protect against gonorrhea and also demonstrating protection against an organism of even greater public health concern, Chlamydia trachomatis. Mol Microbiol, 1987 Jul, 1(1), 5 - 12 Common mechanism controlling phase and antigenic variation in pathogenic neisseriae; Stern A et al.; The expression of the Neisseria gonorrhoeae opacity protein (Op, protein II), a major antigenic determinant of the outer membrane, is subject to frequent phase transitions . At least nine expression loci (opaE) are involved in the production of a large number of serologically distinct Op types . Using opa-specific oligonucleotides as probes in genomic blots, we detect Op-related gene sequences (opr) in N . meningitidis as well as in N . lactamica . DNA sequence analysis of such opr genes derived from N . meningitidis reveals distinct regions of homology with gonococcal opa E genes . As shown in the immunoblot, the proteins encoded by opa and opr are serologically related . Like the opaE genes, the 5'-coding sequences of the opr genes include a repetitive sequence composed of pentameric CTCTT units . The number of these coding repeat (CR) units is variable . This finding, together with the observation that all opr genes are constitutively transcribed, regardless of the status of protein production, suggests a translational control mechanism identical to that of the opa genes in gonococci . The related structures and control mechanisms of opa and opr genes imply a general significance of their gene products for the pathogenic character of the investigated Neisseria species. J Clin Invest, 1987 Jul, 80(1), 78 - 87 Specificity of antibodies against Neisseria gonorrhoeae that stimulate neutrophil chemotaxis . Role of antibodies directed against lipooligosaccharides; Densen P et al.; Five strains each of Neisseria gonorrhoeae sensitive or resistant to complement (C) dependent killing by normal human serum (NHS) were examined for their ability to stimulate chemotaxis of polymorphonuclear leukocytes (PMNs) after preincubation with NHS; or IgM or IgG derived from NHS . Serum-sensitive N . gonorrhoeae stimulated C-dependent chemotaxis when opsonized with IgM, but not IgG, however, serum-resistant strains, taken as a whole, failed to promote chemotaxis when opsonized with either isotype . IgM titers in NHS against lipooligosaccharide (LOS) antigens from individual serum-sensitive, but not serum-resistant strains, correlated with the magnitude of chemotaxis generated by the corresponding opsonized strains (r = 0.99) . Western blots demonstrated that IgM and IgG from NHS recognized different antigenic determinants on LOS from serum-sensitive gonococci . IgM from NHS immunopurified against serum-sensitive LOS accounted for two-thirds of the chemotaxis promoting activity present in whole serum . IgG titers in NHS against LOS antigens from individual serum-resistant strains also correlated with magnitude of chemotaxis generated by the corresponding opsonized strains (r = 0.87), although most opsonized serum-resistant strains did not generate significantly higher magnitudes of chemotaxis than controls . In contrast, a serum-resistant isolate from a patient with disseminated gonococcal infection (DGI) stimulated chemotaxis when opsonized with IgG obtained from the patient's convalescent serum . By Western blot, convalescent IgG antibody recognized an additional determinant on serum-resistant LOS not seen by normal IgG. Infect Immun, 1987 Jul, 55(7), 1652 - 6 Immunotype epitopes of Neisseria meningitidis lipooligosaccharide types 1 through 8; Tsai CM et al.; Lipooligosaccharides (LOS) of the eight immunotypes found in serogroup B Neisseria meningitidis were purified from their prototype strains grown in tryptic soy broth . Rabbit antisera to these LOS were prepared . Sodium dodecyl sulfate-polyacrylamide gel electrophoresis followed by silver staining revealed that most of the LOS antigens contained two major components; the larger components had apparent molecular weights (Mrs) in the range of 4,800 +/- 300, and the smaller components had an apparent Mr of 4,300 . Immunoblot analysis showed that the larger major component of an LOS, in general, was much more immunogenic because the rabbits produced antibodies exclusively or primarily to this component even though the LOS immunogen contained both large and small major components . Antibodies to the smaller 4,300-Mr components were infrequently observed but, when present, were cross-reactive with the same-size components of all heterologous LOS . Hence, the immunotype epitopes reside in the larger major components of all immunotypes except type 5, in which a smaller major component having an apparent Mr of 4,400 carries the epitope . Rabbit antisera to types 1, 5, and 6 were immunotype specific . Antisera to other types had cross-reactivities with some heterologous LOS, and the larger components, but not the 4,300-Mr components, of the LOS were primarily responsible for the cross-reactivities . This finding suggests that the larger components of cross-reactive LOS have a similar structure in addition to their type-specific sugar moieties . The LOS of N . meningitidis M986, a strain used for the production of a serotype 2a vaccine, was found to contain the immunotype 7 epitope. Am J Med, 1987 Jun 26, 82(6B), 35 - 9 Norfloxacin in the treatment of uncomplicated gonococcal infections; Kaplowitz LG et al.; Norfloxacin, an oral fluoroquinolone antibacterial, is active in vitro against a variety of gram-positive and gram-negative pathogens, including both penicillinase-producing and non-penicillinase-producing strains of Neisseria gonorrhoeae . An earlier study demonstrated that a two-dose regimen of norfloxacin was as effective as standard therapy with spectinomycin for treating gonococcal urethritis, including infections caused by penicillinase-producing organisms . In this randomized study of treatment for uncomplicated gonococcal infection in men and women, three oral treatment regimens were compared: patients received either two doses of norfloxacin (600 mg twice daily), a single dose of norfloxacin (800 mg), or a single-dose ampicillin (3.5 g)/probenecid (1.0 g) regimen (as recommended by the Centers for Disease Control) . All three treatment regimens achieved similar cure rates . Although the number of patients treated was too small to yield statistically significant conclusions, it appears that norfloxacin may be slightly better treatment for rectal and pharyngeal gonococcal infections than ampicillin and probenecid . Additionally, norfloxacin was well tolerated in this study . Thus, based on a review of these data, norfloxacin appears to be an alternative, single-dose, oral treatment regimen for uncomplicated gonococcal infection. Am J Med, 1987 Jun 26, 82(6B), 3 - 17 Norfloxacin, a fluoroquinolone antibacterial agent . Classification, mechanism of action, and in vitro activity; Goldstein EJ; Norfloxacin is an orally absorbed fluoroquinolone antibacterial with a fluorine at position 6 and a piperazine ring at position 7 . These changes have resulted in a marked enhancement (compared with that of the older quinolones) of in vitro antibacterial activity . Specifically, the antibacterial spectrum of norfloxacin includes Pseudomonas aeruginosa, as well as enteric pathogens . Norfloxacin is also active against both penicillin-susceptible and penicillin-resistant strains of Neisseria gonorrhoeae . Relative to its activity against gram-negative bacteria, norfloxacin is somewhat less active against gram-positive cocci . In general, the staphylococci are more susceptible to the drug than are the streptococci . As with all fluoroquinolones, norfloxacin's activity against anaerobic bacteria is poor . For urinary tract bacterial isolates, the following Bauer-Kirby disk diffusion zone-size breakpoints have been proposed: greater than or equal to 17 mm, susceptible; 13 to 16 mm, intermediate; less than or equal to 12 mm, resistant . Bacteria with minimal inhibitory concentrations (MICs) less than or equal to 16 micrograms/ml are considered susceptible; those with MICs greater than or equal to 32 micrograms/ml are considered resistant to norfloxacin . The mechanism of action of norfloxacin involves inhibition of the A subunit of the important bacterial enzyme DNA gyrase, which is essential for DNA replication . Plasmid-mediated resistance to the fluoroquinolones is not encountered . Further, although some cross-resistance within the fluoroquinolone class has occurred, there is little cross-resistance between norfloxacin and antibiotics of other classes. J Biol Chem, 1987 Jun 5, 262(16), 7514 - 22 Fast atom bombardment mass spectrometry and tandem mass spectrometry of biologically active peptidoglycan monomers from Neisseria gonorrhoeae; Martin SA et al.; Fast atom bombardment mass spectrometry (FABMS) and tandem mass spectrometry (MS/MS) were employed to define the structures of Neisseria gonorrhoeae peptidoglycan monomers that were of interest because of their abilities to mediate diverse biological reactions ranging from arthritogenicity to somogenicity . FABMS-determined molecular weights of individual components present in several different enzymatically derived classes of gonococcal monomers revealed that each of these classes was a complex mixture of up to 13 distinct peptidoglycan fragments . These ranged from the predominant disaccharide tetrapeptides possessing reducing or nonreducing 1,6-anhydro-N-acetylmuramic acid ends to relatively minor constituents containing glycine or asparagine in addition to traditional peptidoglycan amino acids, i.e . alanine, glutamic acid, and diaminopimelic acid . FABMS of high performance liquid chromatography-purified monomers yielded some sequence information; however, analysis even of unfractionated peptidoglycan mixtures using a JEOL HX110/HX110 tandem mass spectrometer operating at 10 kV provided unambiguous primary sequence data for the peptidoglycan monomers and defined the position of glycine in four compounds as well as the location of O-acetyl substituents (present on some compounds) on C-6 of the N-acetylmuramic acid residue. Diagn Microbiol Infect Dis, 1987 Jun, 7(2), 143 - 7 Bacteremia due to Neisseria cinerea: report of two cases; Southern PM Jr et al.; We report two cases of bacteremia due to Neisseria cinerea . One was a 2.5-yr-old boy with otitis media and pneumonia, who responded to treatment with amoxicillin . The other was a 47-yr-old man with underlying ethanol abuse who developed severe polymicrobial sepsis due to apparent intraabdominal disease . This man died despite extensive antimicrobial therapy. J Appl Bacteriol, 1987 Jun, 62(6), 539 - 42 A note on hydrolysis of tributyrin by Branhamella and Neisseria; Riley TV; Sixty-three strains of Branhamella and Neisseria were tested by two methods for their ability to hydrolyse glycerol tributyrate . After the conventional plate test, gas liquid chromatographical (GLC) analysis of the agar medium was carried out to detect the hydrolysis product, butyric acid, and other volatile fatty acids . All strains of Branhamella catarrhalis, Neisseria caviae, N . cuniculi and N . ovis but no other Neisseria spp . gave positive results with the conventional test . With GLC, however, most strains of Branhamella and Neisseria were shown to liberate butyric acid . In addition, some strains liberated acetic and isovaleric acids . Greater amounts of butyric acid were produced by clinical strains, in particular B . catarrhalis, compared with reference strains . It was concluded that the conventional plate test for tributyrin hydrolysis differentiates B . catarrhalis, N . caviae, N . cuniculi and N . ovis from other Neisseria. Isr J Med Sci, 1987 Jun, 23(6), 713 - 6 Mycoplasma hominis in patients with pelvic inflammatory disease; Miettinen A; The role of Mycoplasma hominis in pelvic inflammatory disease (PID) was studied among 35 patients with laparoscopically confirmed salpingitis or histopathologically confirmed plasma cell endometritis . M . hominis was isolated from the cervix of 15 patients, from the rectum of 13 patients, and from the endometrium of 5 patients . Only two of these five patients had M . hominis isolated from the endometrium in the absence of Chlamydia trachomatis or Neisseria gonorrheae, the major PID-causing organisms . None of the patients had M . hominis isolated from the fallopian tubes . Of the 35 patients, 7 demonstrated a significant change in enzyme immunoassay antibody levels to M . hominis, suggesting a recent infection with the organism . Six of the seven patients had M . hominis isolated from the cervix, and one had the organism isolated from the endometrium . Compared with patients not having M . hominis isolated from the cervix or endometrium, those who did more frequently had positive serum antibody findings for M . hominis and abnormal gas-liquid chromatographic findings of the vaginal fluid, indicative of bacterial vaginosis. Fertil Steril, 1987 Jun, 47(6), 985 - 91 The effect of an IgA1 protease on immunoglobulins bound to the sperm surface and sperm cervical mucus penetrating ability; Bronson RA et al.; A major site of impaired fertility in men with autoimmunity to sperm rests at the level of restricted sperm entry and motion within cervical mucus . We studied the effects of a protease derived from Neisseria gonorrhoeae, whose substrate specificity is limited to human IgA1, on the ability of antibody-bound sperm to penetrate human cervical mucus in vitro . IgA on the sperm surface, but not IgG, was degraded by IgA1 protease . A correlation was seen between the levels of IgA bound relative to IgG and the improvement in sperm cervical mucus penetrating ability after IgA1 protease exposure . These results provide evidence that antisperm autoantibodies of both IgA and IgG classes impair the ability of spermatozoa to populate the female reproductive tract . They implicate the Fc region of the immunoglobulin molecule in mediating this effect and offer the potential to restore male fertility by treating antibody-bound sperm in vitro with immunoglobulin-directed bacterial proteases, before insemination. J Exp Med, 1987 Jun 1, 165(6), 1688 - 702 Lipopolysaccharide induces recurrence of arthritis in rat joints previously injured by peptidoglycan-polysaccharide; Stimpson SA et al.; Rat ankle joints injected intraarticularly with 5 micrograms of group A streptococcal peptidoglycan-polysaccharide (PG-APS) developed an acute course of arthritis . Recurrence of arthritis was induced in 100% of these joints by intravenous injection of as little as 10 micrograms of Salmonella typhimurium lipopolysaccharide (LPS) 3 wk after intraarticular injection . This reaction was similar in athymic and euthymic rats . Buffalo rats were less susceptible than Lewis or Sprague-Dawley rats . Neisseria gonorrhoeae, Yersinia enterocolitica, and Escherichia coli LPS, and S . typhimurium Re mutant LPS, were also active . Re mutant LPS activity was greatly reduced by mixing with polymyxin B . E . coli lipid A was weakly active . An acute synovitis of much less incidence, severity, and duration was seen in contralateral joints injected initially with saline, and in ankle joints of naive, previously uninjected rats after intravenous LPS injection . The intravenous injection of the muramidase mutanolysin on day 0 or 7 after intraarticular PG-APS injection prevented LPS-induced recurrence of arthritis . These studies suggest that the phlogistic activities of lipid A and peptidoglycan might interact in an inflammatory disease process, and that LPS may play a role in recurrent episodes of rheumatoid arthritis or reactive arthritis. Hinyokika Kiyo, 1987 Jun, 33(6), 968 - 71 {Bacteriological and clinical evaluation of norfloxacin in male gonorrheal urethritis}; Okazaki T; Thirty male patients with gonorrheal urethritis were treated with norfloxacin (NFLX) at our urological ward between May and July, 1984, and clinically evaluated . Thirty-nine strains of Neisseria gonorrhoeae isolated from the clinical specimens of these patients were bacteriologically studied . Of the 39 strains, 3 (7.7%) were PPNG strains and the other 36 strains were non-PPNG strains . The minimum inhibitory concentration (MIC) of penicillin G, PCG to the 3 PPNG strains was 6.25-25 micrograms/ml and that to the 36 non-PPNG strains was 0.05-3.13 micrograms/ml . The MIC of NFLX to the PPNG strains was 0.025-0.1 microgram/ml and that to the non-PPNG strains was less than or equal to 0.0125-0.2 microgram/ml . The patients with gonorrheal urethritis were given NFLX orally for 3 days at a daily dose of 600 mg . The clinical efficacy rate was 100%: excellent in 12 and good in 18 cases . All 3 patients with gonorrheal urethritis caused by PPNGs were cured . No subjective side effects were found. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1987 Jun, 265(1-2), 268 - 75 Sexually transmittable organisms in the urethra of males with and without urethritis; Elsner P et al.; In 589 males, 169 with and 420 without urethritis, urethral swabs were taken and assessed semiquantitatively for the sexually transmittable infectious agents Neisseria gonorrhoeae, Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis, Trichomonas vaginalis and Candida species . The organisms were isolated in patients with and without urethritis as follows: N . gonorrhoeae with urethritis 19.5%, without 0.0%; C . trachomatis with urethritis 16.0%, without 2.9%; U . urealyticum (high cfu-counts) with urethritis 27.2%, without 11.7%; M . hominis (high cfu) with 4.7%, without 2.9% . Combined infections were more frequent in males with urethritis (20.8%) than in those without (5.4%) . None of the investigated pathogenic microorganisms could be demonstrated in 37.9% of males with and in 71.2% of males without urethritis . Using loglinear analysis, a significant coincidence of infections with N . gonorrhoeae and U . urealyticum and of infections with U . urealyticum and M . hominis was found . It is concluded that an asymptomatic infection of the male urethra with sexually transmittable organisms is to be expected in partner's control examinations and in patients presenting for other STD like venereal warts or genital herpes . Therefore in these men, even if they are asymptomatic, a comprehensive microbiological examination is strongly recommended. Rev Esp Fisiol, 1987 Jun, 43(2), 151 - 5 {Anti-phosphorylcholine response of autoimmune NZB/W mice: variations with age of serum titers and homogeneity}; Seoane R et al.; Antibody titers and avidity of sera of autoimmune NZB/W mice in responses induced by different antigens were determined . Results show an age-dependent decrease of the antibody titer in sera from female mice immunized with phosphorylcholine coupled to keyhole limpet haemocyanin . This decrease was not detected when using as immunogen an antigenic preparation of Neisseria meningitidis that naturally induces anti-phosphorylcholine antibodies, but was detected with a modification of this antigen (heat inactivation and further coupling with the hapten) . Determinations of inhibition profiles of antisera suggest that this loss of immune competence is paralleled by a decrease in avidity and homogeneity of antisera . This finding may be related to the loss of idiotypic clonal dominance recently reported to occur in these mice. Pathol Biol (Paris), 1987 Jun, 35(5 Pt 2), 791 - 5 {Characteristics of penicillinase-producing strains of Neisseria gonorrhoeae isolated in France, 1979-1986}; Riou JY et al.; Penicillinase producing Neisseria gonorrhoeae PPNG, had been first isolated in France in 1979 . Since, they regularly increased if we considered France on the whole . From 1979 to 1986, 284 strains had been collected by a multicentric group . The frequency of isolation was strongly different in France, unknown in some region they rose 12% in specific areas in Paris . The PPNG strains were more frequently isolated from male than female (sex ratio was higher with PPNG than for non producing strain) . They were more often responsible of complicated infections in female than male at the same rate than the non producing strains . Auxotype distribution was different between producing and non producing strains . Plasmidic content from african type (Af) was almost the same than from asian type (As) . Strains with Af type associated with the conjugative plasmid were increasing. J Antimicrob Chemother, 1987 Jun, 19(6), 761 - 5 The activity of the 4 quinolone Ro 23 6240 and the cephalosporins Ro 15 8074 and Ro 19 5247 against penicillin sensitive and resistant gonococci; Easmon CS et al.; We have compared the in-vitro activity of the 4-quinolone Ro 23 6240 and the oral cephalosporins Ro 15 8074 and Ro 19 5247 with that of penicillin, spectinomycin, cefuroxime, ceftriaxone, ciprofloxacin, ofloxacin and norfloxacin against 60 strains of Neisseria gonorrhoeae . MICs 90 against penicillinase producing N . gonorrhoeae (PPNG) and chromosomally-mediated resistant N . gonorrhoeae (CMRNG) respectively were: spectinomycin 16 and 16 mg/l, cefuroxime 0.12 and 1.0 mg/l, ceftriaxone 0.008 and 0.03 mg/l, Ro 15 8074 0.015 and 0.12 mg/l, Ro 19 5247 0.015 and 0.12 mg/l, Ro 23 6240 0.06 and 0.06 mg/l, ciprofloxacin 0.008 and 0.015 mg/l, ofloxacin 0.03 and 0.06 mg/l, norfloxacin 0.06 and 0.12 mg/l . The spectinomycin resistant and spectinomycin-sensitive strains did not differ . All three new agents show good activity against gonococci and warrant further clinical investigation . Ro 23 6240 in common with the other 4-quinolones appears to be as active against gonococcal strains exhibiting non-enzymic chromosomal resistance to penicillin as against PPNG and penicillin-sensitive isolates. Genitourin Med, 1987 Jun, 63(3), 160 - 8 Serological ecology of Neisseria gonorrhoeae (PPNG and non-PPNG) strains: Canadian perspective; Dillon JR et al.; One hundred and thirty eight penicillinase producing Neisseria gonorrhoeae (PPNG) and 239 non-PPNG strains were characterised serologically using a panel of seven monoclonal antibodies directed against protein 1A and seven against protein 1B . An association between serovar and susceptibility to antimicrobial agents, auxotype, and plasmid content was observed . Serogroup WI strains were more sensitive to penicillin, ampicillin, tetracycline, erythromycin, cefoxitin, and cefuroxime . Sixty five (82%) of the 79 WI strains were typed as being serovar Aedgkih, and 47 (72%) of these strains required arginine, uracil, and hypoxanthine for growth (AUH-) . Seventy one (44%) of 160 WII/WIII strains were serovar Bacejk, and 42 (59%) of these required proline, citrulline, and uracil for growth (PCU-) and were plasmid free . Serovars Bcgk, Beghjk, Bacjk, and Bajk were associated with resistance to antimicrobial agents . Analysis of PPNG isolates showed a new serovar, Af, which was associated with strains imported from Malaysia and Singapore that required proline and ornithine for growth (Pro-Orn-) and carried the 24.5 megadalton transfer plasmid, the 2.6 megadalton cryptic plasmid, and the 4.5 megadalton penicillinase producing plasmid . Other associations between serovar and geographical location were noted. Genitourin Med, 1987 Jun, 63(3), 157 - 9 Serovars, auxotypes, and plasmid contents of PPNG strains from outbreak in Amsterdam; Ansink-Schipper MC et al.; The first outbreak of penicillinase producing strains of Neisseria gonorrhoeae (PPNG) in Amsterdam in 1981-2 was caused mainly by African strains carrying the 24 megadalton transfer plasmid (Afr+) that were non-requiring (NR) and inhibited by phenylalanine (pheni), but African strains without the transfer plasmid (Afr-) that were NRpheni and Afr+ NR strains were also found . Serological classification, using two monoclonal antibody systems, showed that three main serovars (Ae/Av, Aedih/Arst, and Bacejk/Brpyust) could be distinguished in these PPNG strains, which indicated exchanges of plasmids in these serovars . The serovar Ae/Av predominated in the Afr+ and Bacejk/Brpyust in the Afr- strains. Genitourin Med, 1987 Jun, 63(3), 153 - 6 Neisseria gonorrhoeae: subdivision of auxogroups by genetic transformation; Copley CG; Genetic transformation was used in an attempt to subdivide the most prevalent auxotypes of Neisseria gonorrhoeae in local isolates . The large proline requiring (Pro-) group could be divided into two genetic types, as could the less common arginine requiring (Arg-) group . The large arginine, hypoxanthine, and uracil requiring (Arg- Hyp- Ura-) group could not be subdivided by this method . The genetic relation between these and other auxotypes was investigated. Eur J Epidemiol, 1987 Jun, 3(2), 206 - 8 Plasmid deoxyribonucleic acid in throat and cerebrospinal fluid isolates of Neisseria meningitidis; Facinelli B et al.; Ten strains of Neisseria meningitidis, isolated either from cerebrospinal fluid or from throat cultures, were typed and screened for the presence of plasmid DNA . Three group C strains, isolated in the same area, each harboured a plasmid of similar molecular weight (approx . 8.5 Md) . No evidence of plasmid DNA was found in the other strains (whether of the same group but isolated in another area, or of other groups). J Bacteriol, 1987 Jun, 169(6), 2781 - 92 Genetic structure of Neisseria meningitidis populations in relation to serogroup, serotype, and outer membrane protein pattern; Caugant DA et al.; The genetic structure of populations of Neisseria meningitidis was examined by an analysis of electrophoretically demonstrable allelic variation at 15 genes encoding enzymes in 650 isolates of eight serogroups (A, B, C, W135, X, Y, Z, and 29E) and 38 nonserogroupable isolates . A total of 331 distinctive multilocus genotypes (electrophoretic types, ETs) was identified, among which mean genetic diversity per locus (H = 0.547) was greater than in Escherichia coli and other bacterial species thus far studied . The intercontinental distribution of some ETs and the recovery of organisms of identical genotype over periods of many years strongly suggest that the genetic structure of N . meningitidis is basically clonal as a consequence of low rates of recombination of chromosomal genes . Variation among strains in serogroup, serotype, and the electrophoretic pattern of the major outer membrane proteins has little relationship to the complex structure of populations revealed by enzyme electrophoresis, which involve