Neisseria

Obstet Gynecol, 1985 May, 65(5), 669 - 72
Microorganisms in semen used for artificial insemination; Leiva JL et al.; The effect of freezing semen in a cryopreservative media consisting of egg yolk glycerol with or without erythromycin was tested for its effect on the viability of microorganisms present in donor semen and on sexually transmitted pathogens seeded into semen . All donor semen contained two or three species of microorganisms that could be considered skin flora . Five of ten donor semen specimens contained Ureaplasma urealyticum that was not affected by either freezing or antimicrobial treatment . Some strains of Neisseria gonorrhoeae, when seeded into semen, survived all conditions except freezing in egg yolk glycerol containing erythromycin . Chlamydia trachomatis was erradicated when erythromycin was present in the cryopreservative . There was no detectable effect of any treatment tested on the survival of herpes simplex virus.

J Clin Microbiol, 1985 May, 21(5), 857 - 8
Rapid enzyme system for the identification of pathogenic Neisseria spp; Brown JD et al.; Gonochek II is a combination of three enzyme substrates in one tube which will give a rapid identification (30 min) of those pathogenic Neisseria spp . which can be isolated on Thayer Martin or similar selective media . Eighty isolates were tested by Gonochek II and a carbohydrate utilization method; total agreement was achieved between the two methods.

Sex Transm Dis, 1985 Apr-Jun, 12(2), 93 - 6
Effect of amoxicillin on simultaneous Chlamydia trachomatis infection in men with gonococcal urethritis: comparison of three dosage regimens; Csango PA et al.; Of 92 men with gonococcal urethritis who were treated orally with amoxicillin, 25 (27.1%) had a simultaneous Chlamydia trachomatis infection . At the first visit 25 patients were treated with a single dose of 1 g of amoxicillin plus 1 g of probenecid (group 1); 24 men were treated with 1 g of amoxicillin twice a day for two days (group 2); and 43 men were treated with 0.75 mg of amoxicillin three times a day for seven days (group 3) . At the follow-up visit, one patient in each group still had Neisseria gonorrhoeae-positive cultures . C . trachomatis was not isolated again after treatment from men in group 3, but was isolated from 81.8% in groups 1 and 2 combined (P less than 0.05) . One (10%) of the ten men in group 3 who were C . trachomatis-positive before treatment developed postgonococcal urethritis, as compared with seven (63.6%) of 11 in groups 1 and 2 combined (P less than 0.05) . Thus a multiple-dose amoxicillin regimen may prove to be a useful alternative to the present-day treatment of chlamydial infections of the urogenital tract.

Antimicrob Agents Chemother, 1985 Apr, 27(4), 570 - 3
In vitro susceptibility of Neisseria gonorrhoeae to 2-acetylpyridine thiosemicarbazones; Christenson B et al.; MICs of 20 2-acetylpyridine thiosemicarbazones and penicillin were determined for 25 clinical isolates of beta-lactamase-positive and beta-lactamase-negative Neisseria gonorrhoeae strains . The compounds most active against the beta-lactamase-producing strains were the N4,N4-disubstituted derivatives and the thiosemicarbazone derivatives of the 2-acetylpyridines, followed by the other compounds related to the 2-acetylpyridine thiosemicarbazones.

Sex Transm Dis, 1985 Apr-Jun, 12(2), 90 - 2
Treatment of uncomplicated gonorrhea in women with single-dose cefonicid; Handsfield HH et al.; The efficacy of cefonicid (1.0 g given in a single intramuscular dose) was assessed in 50 women with uncomplicated infections due to beta-lactamase-negative strains of Neisseria gonorrhoeae . Forty-three (96%) of 45 cervical infections but only 23 (82%) of 28 anorectal infections were eradicated; overall, 44 (90%) of 49 women were cured of anogenital gonorrhea . Cefonicid failed to eradicate six (55%) of 11 pharyngeal gonococcal infections and 17 (85%) of 20 endocervical infections with Chlamydia trachomatis . Cefonicid had good activity against N . gonorrhoeae in vitro; 41 (98%) of 42 isolates were inhibited by less than or equal to 1.0 micrograms/ml . However, because of its poor efficacy against anorectal and pharyngeal gonococcal infections, single-dose cefonicid is not suitable for the treatment of gonorrhea in women or homosexually active men.

Sex Transm Dis, 1985 Apr-Jun, 12(2), 76 - 82
Construction and characterization of chimeric beta-lactamase plasmids of Neisseria gonorrhoeae with altered ability to be mobilized during conjugation; Tenover FC et al.; A series of chimeric plasmids derived from the transfer factor, beta-lactamase-encoding R factor, and cryptic plasmid of Neisseria gonorrhoeae was constructed . Two of these plasmids, each lacking a 1.9-kilobase-pair (kb) HinfI fragment, could not be mobilized by the 40-kb gonococcal transfer factor to recipient strains of N . gonorrhoeae or Escherichia coli during conjugation . The proteins encoded by both the naturally occurring and chimeric plasmids were examined with an E . coli cell-free transcription-translation system and in E . coli maxicells . Six plasmid-specific proteins were identified when DNA from a naturally occurring 7.1-kb R factor was used as template . A small protein (16,000 daltons), which is apparently not encoded by the two plasmids lacking the 1.9-kb HinfI fragment, appears to be necessary for plasmid transfer during conjugation.

J Clin Microbiol, 1985 Apr, 21(4), 575 - 7
Proctitis associated with Neisseria cinerea misidentified as Neisseria gonorrhoeae in a child; Dossett JH et al.; An 8-year-old boy developed proctitis . Rectal swabs yielded a Neisseria sp . that was repeatedly identified by API (Analytab Products, Plainview, N.Y.), Minitek (BBL Microbiology Systems, Cockeysville, Md.), and Bactec (Johnston Laboratories, Towson, Md.) methods as Neisseria gonorrhoeae . Subsequent testing in a reference laboratory yielded an identification of Neisseria cinerea . It is suggested that identification of a Neisseria sp . isolated from genital or rectal sites in a child be confirmed by additional serological, growth, and antibiotic susceptibility tests and, if necessary, by a reference laboratory . The implications of such misidentifications are discussed.

Surg Gynecol Obstet, 1985 Apr, 160(4), 304 - 6
Periappendicitis and chlamydial salpingitis; Mardh PA et al.; Periappendicitis seems to be a novel manifestation of infections with Chlamydia trachomatis . In seven of 112 women with laparoscopically verified acute salpingitis, secondary appendicitis was diagnosed and histologically confirmed . The genital tract in all seven patients harbored Chlamydia trachomatis but not Neisseria gonorrhoeae . The fallopian tubes should be scrutinized when an inflamed appendix is removed from a sexually active woman . Signs of salpingitis should then lead to appropriate microbiologic, therapeutic and epidemiologic measures, including contact tracing.

J Bacteriol, 1985 Apr, 162(1), 170 - 5
Identity of Escherichia coli D-1-amino-2-propanol:NAD+ oxidoreductase with E . coli glycerol dehydrogenase but not with Neisseria gonorrhoeae 1,2-propanediol:NAD+ oxidoreductase; Kelley JJ et al.; The properties of D-1-amino-2-propanol oxidoreductase from wild-type Escherichia coli have been compared with those of a glycerol dehydrogenase from mutant E . coli 424 and of a 1,2-propanediol oxidoreductase from Neisseria gonorrhoeae . Several independent lines of evidence indicate that the former two enzymes are identical . (i) Both enzymatic activities purified to virtual homogeneity in an identical manner, and the ratio of specific activities (glycerol/aminopropanol) remained constant at all stages . (ii) When electrophoresed, both purified enzymes showed a major as well as a minor band of protein coincident with activity, and these two bands from each enzyme had the same mobility . (iii) The subunit molecular weights and isoelectric points were identical for each enzyme, and (iv) kinetic constants (Km and Vmax values) determined with three different substrates were the same . The somewhat greater stability of the glycerol dehydrogenase to controlled heat denaturation at 74 degrees C was the only difference observed between these two enzymes . In contrast, D-1-amino-2-propanol oxidoreductase was found to be immunochemically and kinetically distinct from the 1,2-propanediol oxidoreductase from N . gonorrhoeae.

Genitourin Med, 1985 Apr, 61(2), 99 - 102
Auxotypes and serogroups of penicillinase producing and non-producing strains of Neisseria gonorrhoeae isolated in Franceville, Gabon; Yvert F et al.; The auxotypes and serogroups of 250 consecutive isolates of Neisseria gonorrhoeae from Franceville, Gabon, including 33 penicillinase producing (PPNG) strains, were identified and the results tabulated for four periods . The PPNG and certain non-PPNG strains were isolated in clusters against a relatively stable pattern of non-PPNG biotypes . Most of the non-PPNG strains were non-requiring or proline requiring strains of serogroup WII or non-requiring strains that could not be grouped with commercially available antisera . No strain requiring arginine, hypoxanthine, and uracil was observed . The PPNG strains were all serogroup WI or ungroupable and non-requiring or proline or arginine dependent auxotypes . Only one non-PPNG strain required proline or arginine and was not serogroup WII.

Genitourin Med, 1985 Apr, 61(2), 103 - 5
Prepartal infection of the placenta with Neisseria gonorrhoeae; Yvert F et al.; Placentas from 191 consecutive deliveries were cultured for Neisseria gonorrhoeae and other bacteria before being examined histologically . N gonorrhoeae was seen on direct microscopical examination and cultured from two placentas, one of which had chorioamnionitis and the other had a granulocytic invasion of the membranes . In both patients, rupture of the membranes had occurred two hours or less before delivery, and thus after infection . A third patient was also found to have light gonococcal infection of the placenta . Six infections with group B streptococci were identified, but only one correlated with chorioamnionitis . Chorioamnionitis was observed in 16 (8.4%) and granulocytic infiltration of the membranes in 18 (9.4%) of the deliveries.

Isr J Med Sci, 1985 Apr, 21(4), 346 - 50
Prevalence of low genital tract infectious agents in young Israeli women; Herman A et al.; Low genital tract infectious agents were examined 411 times in 386 young women . Each examination included anamnesis, physical examination and broad-spectrum microbiologic analysis for the detection of: Ureaplasma urealyticum, Chlamydia trachomatis, Trichomonas vaginalis, Candida species, Mycoplasma hominis, Streptococcus beta hemolyticus Group B, Hemophilus vaginalis, Neisseria gonorrhoeae and syphilis serology . Three hundred and six patients were symptomatic for low genital tract infection and 80 were asymptomatic . Most patients were young, 19.6 +/- 1.7 (SD) years old, single (84.7%) and sexually active (87.4%) . U . urealyticum and C . trachomatis were the most common agents recovered in 43.9 and 40.8% of symptomatic patients, respectively . All agents were isolated more frequently in the symptomatic group, but statistically significant group comparisons were obtained only for Candida sp . (P less than 0.001), T . vaginalis (P less than 0.005) and M . hominis (P less than 0.05) . N . gonorrhoeae was isolated in only one case (0.3%), which may reflect technical difficulties or a true very low prevalence of this agent . Clinical diagnoses of candidiasis and trichomoniasis in symptomatic patients were confirmed by laboratory results in only 34.9 and 54.9%, whereas negative clinical diagnoses were confirmed in 83.9 and 73.2%, respectively.

Acta Pathol Microbiol Immunol Scand {B}, 1985 Apr, 93(2), 91 - 7
Phenotypic and genotypic characterization of penicillinase-producing strains of Neisseria gonorrhoeae; Falk ES et al.; Thirty penicillinase-producing Neisseria gonorrhoeae (PPNG) strains, 26 representing 9 serovars of the protein IB and 4 representing 2 serovars of the protein IA serogroup, had 10 different patterns when investigated by the restriction enzyme (RE) technique with Hind III enzyme . One RE pattern dominated, representing 11 strains with 6 different serovars of both the protein IA and IB serogroup . Identical serovars and RE patterns were found among 7 patients (3, 2 and 2, respectively) with positive epidemiology . The majority of the strains (24/30) were resistant to, or showed decreased sensitivity to, doxycycline with minimum inhibitory concentrations between 1 and 8 mg/l, consistent with the Far East origin . All the 30 PPNG strains showed by agarose gel electrophoresis to harbour a 2.8 Mdalton, a 4.4 Mdalton, as well as a 24.5 Mdalton plasmid, whereas the two non-PPNG strains had only the 2.8 Mdalton plasmid.

JAMA, 1985 Mar 22-29, 253(12), 1749 - 54
Bacterial meningitis in the United States, 1978 through 1981 . The National Bacterial Meningitis Surveillance Study; Schlech WF 3rd et al.; From 1977 to 1981, 18,642 cases of bacterial meningitis were reported to the Centers for Disease Control . We analyzed data from 27 states with full participation from 1978 through 1981 . Hemophilus influenzae was the most frequent cause of bacterial meningitis (48.3%), followed by Neisseria meningitidis (19.6%) and Streptococcus pneumoniae (13.3%) . Overall attack rates for males were greater than for females (3.3 v 2.6 cases per 10(5) population per year) . Attack rates were highest in children under 1 year of age (76.7 per 10(5) population per year) . Case-fatality ratios were highest for gram-negative and miscellaneous causes of bacterial meningitis (33.7%) and lowest for meningitis caused by H influenzae (6.0%) . Neisseria meningitidis and S pneumonia meningitis occurred preponderantly during the winter, while H influenzae meningitis had peak activity in the spring and fall . Ampicillin resistance among H influenzae increased from 18.7% in 1978, to 23.9% in 1981 . Serogroup B Neisseria meningitidis was the most common serogroup identified during the reporting period (51.1%), followed by serogroup C (22.3%), serogroup Y (5.8%), and serogroup A (4.7%) infections.

Am J Obstet Gynecol, 1985 Mar 15, 151(6), 765 - 71
Chlamydial endocervical infections and cytologic findings in sexually active female adolescents; Shafer MA et al.; The association of infection with Chlamydia trachomatis and cytologic changes on Papanicolaou smear was examined in 148 sexually active postmenarchial++ female subjects, aged 13 to 21 years (mean = 17.2) attending a teen clinic . Endocervical samples for micro-organisms (C . trachomatis and Neisseria gonorrhoeae) and a cervical sample for cytologic examination were taken . A detailed evaluation of the cytologic results was made independently of the C . trachomatis status . In 23 (15.5%) subjects tests for isolation of C . trachomatis were positive . Inflammatory changes in epithelial cells, nuclear changes in metaplastic cells, and lymphocytes in the inflammatory exudate were associated with C . trachomatis isolation but suspected "chlamydial inclusions" and cytoplasmic vacuoles in metaplastic cells were not . The results reported here do not support the use of cervical cytologic examination as a definitive diagnostic test for presence of an endocervical chlamydial infection . However, it may be possible to use the cytologic pattern described here to identify a population with a high prevalence of C . trachomatis.

Am J Obstet Gynecol, 1985 Mar 15, 151(6), 771 - 7
Cefotaxime treatment for women with community-acquired pelvic abscesses; Hemsell DL et al.; Forty-one women with pelvic abscesses complicating salpingitis were treated with parenteral cefotaxime, a newer cephalosporin . Abscesses ranged in size from 4 by 4 to 13 by 15 cm, and in 10 women (24%) they were greater than or equal to 10 cm . Neisseria gonorrhoeae was recovered from the endocervix in 17 women (41%) . A mean of 26.7 gm of cefotaxime was given over a mean of 6.5 days, and operation was not required during initial therapy . Only two women (5%) required the addition of another antimicrobial . Chronic pelvic pain and recurrent infection were infrequent during the 31- to 43-month follow-up period . Five women (12%) were readmitted for elective surgical therapy because of persistent or recurrent adnexal mass 1 to 33 months following study entry . Six (15%) women became pregnant and were delivered of their infants a mean of 25 months following cefotaxime therapy.

JAMA, 1985 Mar 8, 253(10), 1417 - 9
Comparative study of ceftriaxone and spectinomycin for treatment of pharyngeal and anorectal gonorrhea; Judson FN et al.; Of the currently recommended regimens for treatment of uncomplicated gonorrhea, only aqueous penicillin G procaine is effective against infections at all sites . However, procaine penicillin is not effective against penicillinase-producing Neisseria gonorrhoeae and suffers from poor patient acceptability owing to the 10-mL volume of injection and allergic and toxic procaine reactions . Ceftriaxone is a new extended-spectrum cephalosporin with a long serum half-life and is many times more active than penicillin G against both beta-lactamase-positive or -negative strains of N gonorrhoeae . Ceftriaxone was compared as a single, 125-mg, 0.5-mL injection with a single 2-g injection of spectinomycin in difficult to treat pharyngeal gonorrhea in men and women and anorectal gonorrhea of men . Ceftriaxone cured 30/32 (94%) pharyngeal and 52/52 anorectal infections, compared with 6/14 (43%) and 9/9, respectively, for spectinomycin . Both regimens were well tolerated . Ceftriaxone may prove to be a drug of choice for uncomplicated gonorrhea, particularly where homosexual men are treated and/or penicillinase-producing N gonorrhoeae is prevalent.

Clin Rheumatol, 1985 Mar, 4(1), 83 - 5
Septic arthritis of the knee due to Neisseria mucosa; Abiteboul M et al.; We report a case of septic arthritis of the knee due to Neisseria mucosa a widespread commensal of the oropharynx following an infiltration of the joint . Evolution was favorable in ten weeks, with antibiotics (amoxicillin then erythromycin), and without surgery.

Obstet Gynecol, 1985 Mar, 65(3), 384 - 8
Chlamydia trachomatis as a cause of prepubertal vaginitis; Bump RC; Chlamydia trachomatis was encountered in four cases during the evaluation of 29 premenarchal girls with gynecologic complaints during 1983 . Only one of the patients had antecedent infection with Neisseria gonorrhoeae . The importance of using specific tests to actively establish a definite diagnosis of chlamydia is stressed . The susceptibility of the thin premenarchal vaginal mucosa to chlamydial infection is discussed as is the role of chlamydia as a marker for sexual abuse . Once a diagnosis of chlamydial rectogenital infection is established in a child, it is mandatory to investigate for child abuse and sexual molestation as the source of the infection.

J Reprod Med, 1985 Mar, 30(3 Suppl), 244 - 9
Problems in the culture diagnosis of gonorrhea; Schink JC et al.; PIP: The diagnosis of gonorrhea in men can be established by observing gram-negative intracellular diplococci in Gram's stained urethral discharge, but more sensitive screening is required for women, who may be asymptomatic in 80% of cases . Routine screening for gonorrhea detects only 65-85% of infected women . Careful sampling from the endocervix and use of a 2nd specimen can improve the yield . Care should be taken to avoid disenfectants and lubricants that might inhibit culture growth . Allowing adequate time for absorption of organisms onto the swab and prewarming the culture medium improve the recovery rate . Dacron and calcuim alginate swabs are theoretically better than cotton because they do not contain fatty acids hostile to N . gonorrhoeae . 3 media are recommended by the Centers for Disease Control: Martin-Lewis (ML), modified Thayer-Martin (MTM), and modified New York City (MNYC) . Each of the 3 has unique advantages and disadvantages, and each can enhance growth and isolation of Neisseria . Strains inhibited by the vancomycin in all 3 media can be detected by parallel cultures on chocolate agar, a procedure not always practical for routine screening . 16% fewer infections are detected when longterm transport of gonorrhea culture specimens is required instead of on-site bacteriologic testing . For longterm transport, culture media in a CO2 enriched environment are best . The JEMBEC system with a CO2 generating tablet enclosed in a ziploc bag is a convenient system . The cultures must be incubated before transport . For onsite testing and transport lasting less than 3 hours, a nonnutrient system such as modified Stuart's medium is sufficient . The JEMBEC system and direct plating on selective media with transport in a candle jar are also acceptable for short-term transport . Presumptive identification is based on 1) the opaque, convex, and gray-white appearance of colonies incubated for 24-48 hours at 35 degrees Celsius with increased CO2 2) identification of typical gram-negative diplococci on Gram's staining of a characteristic colony, and 3) demonstration of the presence of cytochrome oxidase in the colonies . Presumptive identification is at least 98% specific . Confirmation is usually based on carbohydrate utilization tests or immunologic methods, including fluorescent antibody and coagglutination systems . These tests are quicker than carbohydrate utilization tests but have a 2-3% false-positive rate . Carbohydrate utilization techniques require 48-72 hours but are more specific than immunologic methods and should be used for medicolegal cases .

Trop Geogr Med, 1985 Mar, 37(1), 74 - 6
Sensitivity pattern and beta-lactamase screening of Neisseria gonorrhoeae strains isolated in Zaria, Northern Nigeria; Joshi RM et al.; One hundred and sixty strains of N . gonorrhoeae were studied for their in-vitro sensitivity to six different antimicrobial agents and tested for beta-lactamase production in Zaria, Northern Nigeria . While 82% of strains were sensitive to erythromycin, 70% to tetracycline and 61% to chloramphenicol, only 35%, 33% and 24% were sensitive to ampicillin, penicillin and streptomycin respectively . Penicillin is no more the drug of choice in the treatment of gonorrhoea in this environment since two thirds of strains are either partially resistant or completely resistant to penicillin and 44% of strains are beta-lactamase producers . Erythromycin/tetracycline are recommended as the drugs of choice.

Ann Inst Pasteur Microbiol, 1985 Mar-Apr, 136A(2), 233 - 9
{Sensitivity of Neisseria polysacchareae to antibiotics}; Dabernat H et al.; A new taxon had previously been described in the genus Neisseria and it was proposed that "Neisseria polysacchareae" be the provisional epithet for this new "species" . In the present work, susceptibility to antibiotics was determined using agar dilution tests . The tested strains of "N . polysacchareae" were isolated from throat, those of N . meningitidis from cases and carriers, and those of other species of Neisseria were from culture collections . The strains of "N . polysacchareae" were less sensitive than those of N . meningitidis, particularly to rifampicin, mecillinam and macrolide antibiotics; they were resistant to colistin and vancomycin and could therefore be isolated on selective medium for pathogenic Neisseria spp.

Diagn Microbiol Infect Dis, 1985 Mar, 3(2), 125 - 30
Evaluation of the RIM system and Gono Gen test for identification of Neisseria gonorrhoeae from clinical specimens; Robinson A et al.; RIM-N (Austin Biological Laboratories) and Gono Gen (Micro Media Systems) were evaluated for accuracy and compared with conventional carbohydrate degradation tests for identification of Neisseria gonorrhoeae . A total of 127 fresh clinical isolates of N . gonorrhoeae were tested; 118 (93%) were identified by RIM-N, and 100 (79%) yielded positive reactions with Gono Gen . Seventy nongonococcal isolates including other Neisseria species, Branhamella catarrhalis, Kingella kingae, and Moraxella species were evaluated to determine the specificity of the test methods . Both rapid tests were 100% specific in the identification of N . gonorrhoeae isolates . RIM-N was the most sensitive test for the identification of N . gonorrhoeae and offers a useful, more rapid alternative to conventional carbohydrate degradation methods.

J Bacteriol, 1985 Mar, 161(3), 861 - 7
Role of lipid intermediate(s) in the synthesis of serogroup B Neisseria meningitidis capsular polysaccharide; Masson L et al.; Neisseria meningitidis serogroup B strain M986 was examined for the involvement of lipid intermediate(s) participating in the biosynthesis of the sialic acid capsular polysaccharide . The addition of exogenous undecaprenyl phosphate, phosphatidylethanolamine, or phosphatidylglycerol to particulate membranes, in the presence of cytidine 5'-monophosphosialic acid, resulted in the stimulation of sialyltransferase activity specifically by undecaprenyl phosphate . Sialyltransferase activity, after delipidation of particulate membrane proteins, was specifically reconstituted by undecaprenyl phosphate . After the addition of 14C-labeled cytidine 5'-monophosphosialic acid to particulate membranes, the level of labeled lipid intermediate(s), extracted by chloroform-methanol (2:1), increased up to a maximum level between 3.75 and 5.0 min, which subsequently decreased to a lower steady-state level . Pulse-chase experiments revealed a transient, solvent-extractable, lipid-linked component . The extracted N-acetylneuraminic acid was in polymeric form . Sequential oxidation and reduction of the extracted radioactivity followed by neuraminidase treatment revealed an average degree of polymerization of four or five N-acetylneuraminic acid residues . Bacitracin-sensitive peptidoglycan was synthesized in vitro by particulate membranes . Cross-competition experiments between peptidoglycan and capsular polysaccharide synthesis by preincubation of precursors of one pathway during synthesis of the other revealed a competitive effect for a common component . This component was believed to be a common pool of undecaprenyl phosphate . A model for the production and regulation of the capsular polysaccharide is proposed.

J Bacteriol, 1985 Mar, 161(3), 1236 - 7
Type III 5-methylcytosine modification of DNA in Neisseria gonorrhoeae; Korch C et al.; We present here the first report of a type III methyltransferase that modifies a cytosine . Neisseria gonorrhoeae 82409/55 (pJD1) modifies the first cytosine on only one strand from the 5' end of the nonpalindromic sequence: (Formula; see text) . We have called this modifying activity M X NgoVIII.

J Immunol, 1985 Mar, 134(3), 1920 - 5
Bactericidal but not nonbactericidal C5b-9 is associated with distinctive outer membrane proteins in Neisseria gonorrhoeae; Joiner KA et al.; In this study, we examined the bacterial constituents associated with the complement C5b-9 complex in detergent extracts from serum-treated Neisseria gonorrhoeae (GC) . 125I surface-labeled GC were incubated in 10% serum, were washed, and were solubilized in the zwitterionic sulfobetaine detergent SB12 . Immunoprecipitation of 125I-GC from the extract with anti-C5 Sepharose was followed by 12.5% sodium dodecyl sulfate-polyacrylamide gel electrophoresis autoradiography of immunoprecipitated material . Polyacrylamide gel analysis of surface-labeled 125I-GC showed prominent bands for proteins I and III for both serum-resistant GC strain 6305 and serum-sensitive GC strain 7189 . These same bands were visible with similar intensity in the SB12 extracts from presensitized and non-presensitized 6305 and 7189 after serum incubation . For those organisms bearing bactericidal C5b-9 (6305 + IgG and 7189 +/- IgG), additional distinctive bands immunoprecipitated with antibody to C5 Sepharose . These components were of 93,000, 44,000 40,000, and 15,000 daltons for 6305 + IgG, and were of 90,000, 50,000, 44,000, and 19,000 daltons for 7189 +/- IgG . Nonbactericidal C5b-9 extracted from the surface of 6305 incubated in serum, but not sensitized with antibody, was not associated with these distinctive proteins . However, this nonbactericidal C5b-9 did have a different pattern of associated bacterial surface constituents from that observed in control samples incubated with antibody to human serum albumin, which were similar to those with nonserum-incubated organisms . These studies support our earlier experiments which demonstrated that C5b-9 is in a different molecular configuration on the surface of serum-resistant GC from that on the surface of serum-sensitive GC or resistant GC rendered sensitive with bactericidal antibody.

Gastroenterology, 1985 Mar, 88(3), 804 - 7
Spontaneous bacterial peritonitis caused by Neisseria gonorrhoeae . Evidence for a transfallopian route of infection; Stassen WN et al.; We describe the clinical and laboratory features of a case of spontaneous bacterial peritonitis caused by Neisseria gonorrhoeae in a sexually active woman with Laennec's cirrhosis, ascites, and asymptomatic cervical gonorrhea . Treatment of the infection with high-dose parenteral penicillin was associated with resolution of the infection . This first report of spontaneous gonococcal peritonitis provides highly suggestive evidence that the transfallopian route is a mechanism whereby bacteria may enter the peritoneal cavity . Appropriate cultures for this organism should be included when a woman with chronic liver disease, who is sexually active, presents with spontaneous peritonitis.

Adv Contracept, 1985 Mar, 1(1), 63 - 76
Pelvic inflammatory disease, intrauterine contraception, and the conduct of epidemiologic studies; Struthers BJ; Pelvic inflammatory disease (PID) has been described in the medical literature for more than a century as a specific entity . Neisseria gonorrhoeae, Chlamydia trachomatis, and Mycoplasma hominis, along with Bacteroides fragilis and other anaerobic bacteria, have been most frequently associated with PID . Factors affecting the occurrence of PID have been extensively studied during the past two decades and include number of sexual partners, age, race, socioeconomic status, education, and contraceptive method . As knowledge concerning factors that contribute to PID increases, epidemiologic studies addressing such issues must become increasingly sophisticated, and the literature needs to be re-evaluated in light of present knowledge . Various risk factors for PID, types of epidemiologic studies, methods for conducting such studies, and data interpretation are reviewed.

J Reprod Med, 1985 Mar, 30(3 Suppl), 290 - 4
Problems in specimen collection for sexually transmitted diseases; Larsen B; PIP: The diagnosis of infectious diseases including sexually transmitted diseases (STDs) requires adequate specimen collection, rapid transport to the laboratory, cultivation on appropriate media, and evaluation by experienced laboratory personnel, All available techniques should be sued in diagonsis, It is holpful to have knowledge of the population groups at highest risk, potential modes of transmission, and signs found on physical examination . Microscopy can be useful, especially in gonorrhea in men and syphillis in both sexes . Cytosmears may cntribute to the diagnosis of viral and chlamydial infection although the inclusions and cytopathologic changes are nonspecific . Microscopic evaluation alone may be sufficient for diagnosis of vaginal candidiasis, trichomoniasis, and Gardnerella vaginalis vaginitis . For either culture of immunologic techniques to be effective, adequate and appropriate specimens must be collected for laboratory analysis, Selecting the appropriate site for culture may be difficult, and extragenital sites of infection should be considered due to recent changes in sexual practices . Appropriate target media are essential because may STD agents are susceptible to such environmental influences as dessication . Direct innoculation of appropriate bacteriologic media for Neisseria gonorrhea G vaginalis, and Trichomonas vaginalis allows protection of the organisms . Selective growth media may be helpful for gonorrhea, but some strains of the gonococcus are inhibited by the vancomycin which is used to suppress growth of normal flora . The strains of gonococcus most frequently associated with disseminated infection are very sensitive to antibiotics, and may be associated frequently with asymptomatic disease . New York City medium has several advantages for gonococcus culture . chocolate agar containing 1% IsoVitalex and 3 mcg vancomycin provides a good selective medium for Hemophilus ducreyi, a fastidious organism . Care is needed for specimen preservation when fragile organisms including anaerobic bacteria, viral and chlamydial cultures are suspected . As much material as possible should be obtained for cultures to ensure success . Cultures should be obtained whenerer possible before initiating antimicrobial therapy . The clinician should be aware of potential problems in culture of material exposed to spermicides, douche preparations and lubricating gels . Immunologic tests for diagnosis of STDs apart from syphilis have been developed only recently . The Phadebact coagglutination test identifies gonococci after they have been grown byu standard culture techniques, and the Gonozyme test detects the gonococcal antigen in urogenital secretions, with no need for culture . Typically, both culture and rapid nonculture tests differ in therir sensitivity and specificity, depending on the population being studied--high or low risk, male or female, genital sites of extragenital sites .

J Reprod Med, 1985 Mar, 30(3 Suppl), 250 - 7
Assessment of an enzyme immunoassay for diagnosing gonorrhea; Finch CA; PIP: Gonozyme, a nonculture enzyme immunoassay for the detection of Neisseria gonorrhea antigen from urogenital swab specimens, was introduced into the US in 1982 and modified to improve specificity in 1983 . The original Gonozyme assay was compared to culture in several independent studies . Populations with different disease prevalences were examined using study designs that varied considerably . The sensitivity and specificity of Gonozyme as compared to culture were sufficiently high in symptomatic male populations to indicate that Gonozyme was an acceptable diagnostic test, but sensitivity and specificity for female specimens were not as high . Clinical evaluations comparing the modified Gonozyme to culture were conducted on specimens from 410 males, 1245 high risk females and 1234 low risk females at 8 geographically dispersed sites in the US . A single specimen was collected from each patient and processed for culture and Gonozyme . Culture plates were incubated for 48 hours before being reported as negative . Gonozyme tests were done within 5 days of collection . In males the sensitivity and specificity of Gonozyme as compared to culture were both 100% at 3 of the 4 clinics . At the 4th the sensitivity and specificity were 93.1% and 98.8% respectively, giving Gonozyme an overall sensitivity and specificity of 98.0% and 99.4% . 2 males with positive Gonozyme and negative culture results also had urethral smears demonstrating intracellular gram-negative diplococci and were thus considered to have gonococcal infection . The sensitivity and specificity of Gonozyme with regard to gonococcal infections thus rose to 98.0% and 100.0% respectively . The high-risk female group was studied at 5 sites . The overall sensitivity and specificity to Gonozyme as compared to culture were 84.0% and 96.9% respectively . Sensitivity ranged from 80.5% to 90.7% and specificity from 95.8% to 99.2% . The overall sensitivity and specificity of Gonozyme in the low-risk female population studied at 4 cliniaal sites were 90.5% and 98.0% respecitively . Sensitivity ranged from 83.3% to 100.0% and specificity from 97.3% to 98.8% . Statistical tests demonstrated that the specificity of the modified Gonozyme as compared to the original had improved without an adverse effect on the sensitivity . Although Gonozyme specimens cannot be used for beta-lactamase testing or for confirmatory tests, the test offers advantages to clinics and physicians offices in which laboratory services are unavailable and transport conditions are uncertain .

Ann Inst Pasteur Microbiol, 1985 Mar-Apr, 136A(2), 271 - 6
{Presence of plasmids in Neisseria meningitidis}; Prere MF et al.; The plasmid content of twenty-nine Neisseria meningitidis strains, isolated from CSF and blood cultures, was investigated by agarose gel electrophoresis . The strains (twenty-seven from serogroup B and two from serogroup C) were sensitive to antibiotics, but 50% were resistant to sulphonamide (MIC greater than or equal to 16 mg/l) . Two serogroup-B strains from CSF harboured an extrachromosomal element . These two cryptic plasmids differed in size: 8.4 Kb for pNMT1 and 82 Kb for pNMT2.

Cell Immunol, 1985 Mar, 91(1), 119 - 31
Specific binding of endotoxin to human monocytes and mouse macrophages: serum requirement; Haeffner-Cavaillon N et al.; Specific binding of Bordetella pertussis and Neisseria meningitidis endotoxins to human monocytes and murine macrophages was demonstrated . Binding of B . pertussis endotoxin could be inhibited by endotoxins of Salmonella minnesota, Escherichia coli, and Klebsiella pneumoniae, the extent of inhibition being dependent on the origin of the lipopolysaccharides and on the origin of the mononuclear phagocytic cells . The binding of B . pertussis and N . meningitidis endotoxins which was mediated by the polysaccharide region of the endotoxins was serum dependent . The results indicated that the binding of endotoxin was promoted neither by natural antibodies directed against the endotoxin nor by proteins known to combine with endotoxins: immunoglobulins, albumin, or fibronectin; we have provided some evidence that complement components may play a role in the specific binding of endotoxins to the monocyte/macrophage membrane.

J Gen Microbiol, 1985 Mar, 131 ( Pt 3), 601 - 10
Association of resistance of Neisseria gonorrhoeae to killing by human phagocytes with outer-membrane proteins of about 20 kilodaltons; Parsons NJ et al.; The determinant(s) of gonococcal resistance to killing by human phagocytes has been extracted from outer membrane vesicles (OMV) of a phagocyte-resistant strain, BS4 (agar), with sodium cholate (1%, w/v) . The extracts, like the OMV, nullified the effect of antiserum raised against whole BS4 (agar) to promote intracellular killing of the latter by human peripheral blood phagocytes . Fractionation of the extract on Sephadex G75 produced an active fraction with much less protein and lipopolysaccharide (LPS) than in the original extract . Furthermore, crude LPS prepared from the resistant gonococci was inactive . These results imply that the factor(s) promoting intracellular resistance is a protein . SDS-PAGE of the active fraction suggested that the factor was not a principal outer membrane protein nor one of three proteins previously thought to be associated with resistance . In contrast to a similar preparation from a phagocyte-susceptible strain, BSSH, the active fraction from BS4 (agar) showed faintly staining proteins in the regions of 20 and 60 kDal . When eluted from the gels, the former but not the latter neutralized the above effect of antisera, thus associating the 20 kDal protein(s) with resistance to intracellular killing.

Vaccine, 1985 Mar, 3(1), 3 - 10
Pilus vaccines; Tramont EC et al.; Bacterial pili (fimbriae) are protein appendages which extend from the cell surface and serve to adhere the microorganism to body surfaces . These appendages have been isolated, purified and characterized as vaccine candidates . These vaccines stimulate an immune response which serves at least with regards to Neisseria gonorrhoeae to block the adherence of the microorganism to epithelial cells . Thus far, these vaccines have proven effective in some animal studies and in a limited number of human challenge studies . The problems that remain are: lack of broad cross reactivity of the vaccines thus far developed poor immunogenicity of the important binding ligands both in terms of quality and quantity of antibody produced and inadequate stimulation of antibody response at the local site of infection.

Ann Cardiol Angeiol (Paris), 1985 Feb, 34(2), 89 - 92
{Emboligenic abscess of the aortic ring disclosing gonococcal endocarditis . Value of echocardiography}; Drui S et al.; Echocardiography has become a valuable diagnostic modality in bacterial endocarditis and of even more importance in following the subsequent course of the infection while on medical therapy . It can play an extremely important role in certain clinical circumstances, even before blood culture results are available or hemodynamic or auscultatory abnormalities appear . Nevertheless, in spite of this usefulness, the limitations of echocardiography should be recognized . The examination lacks absolute specificity and sensitivity which could result in inaccurate or delayed information in diagnosing a lesion or in recognizing local or regional complications . These advantages and limitations are well illustrated in an unusual case due to Neisseria gonorrhoeae, a causative agent whose incidence may increase over the years to come.

J Med Microbiol, 1985 Feb, 19(1), 115 - 25
Phagocytosis by human leukocytes, phagosomal pH and degradation of seven species of bacteria measured by flow cytometry; Bassoe CF et al.; Phagocytosis by human leukocytes, phagosomal pH and degradation of seven species of bacteria were studied by a flow cytometric method . The percentage of phagocytosing leukocytes was similar for all bacterial strains examined, but Salmonella typhi and Neisseria meningitidis were more slowly phagocytosed than other bacteria . The phagosomal pH surrounding the different bacterial species 15 min after the start of phagocytosis were: Streptococcus pneumoniae 4.4; N . meningitidis 4.9; Str . pyogenes 5.1; Staphylococcus aureus 5.2; Escherichia coli 5.3; S . typhi 5.4; and Klebsiella pneumoniae 5.7 . For longer incubation periods, the phagosomal pH remained nearly constant . Staph . aureus, E . coli and S . typhi were the most readily degraded of the species tested . The proteins of all bacteria were degraded more rapidly than their DNA as determined by measurements of the loss of fluorescein-isothiocyanate-fluorescence and ethidium bromide-fluorescence, respectively . The rate of degradation varied from one bacterial species to another . The degradation of proteins and DNA was maximal for bacteria residing in a phagosomal environment estimated to be between pH 5.2 and 5.4.

Genitourin Med, 1985 Feb, 61(1), 48 - 50
Genital infections with Chlamydia trachomatis and Neisseria gonorrhoeae in Ghanaian women; Bentsi C et al.; PIP: The prevalence of Chlamydia trachomatis and Neisseria gonorrhoea in women of Accra, Ghana was estimated by culturing 162 gynecology clinic patients and 39 postpartum inpatients at Korle Bu Hospital . Chlamydia endocervical specimens were frozen and tested in Seattle by culture . N . gonorrhoea was identified by sugar tests, and isolated and tested for beta-lactamase with a cephalosporin assay . Sera from 95 patients were tested for IgG and IgM antibodies to C . trachomatis . Chlamydia were isolated from 8 (4.9%) of the 162 gynecology patients and from 3 (7.7%) of the postpartum patients . N . gonorrhoea was isolated from 5 (3.1%) of the gynecology patients and from 5 (3.4%) of the postpartum patients . C . trachomatis serovars D, E, F and G were the most common . C . trachomatis was more common than N . gonorrhoea in these women, and accounted for 10% of gynecology patients complaining of lower abdominal pain .

Genitourin Med, 1985 Feb, 61(1), 39 - 43
Relation between nutritional requirements and susceptibilities to antibiotics of strains of Neisseria gonorrhoeae from pharyngeal and anogenital sites; Ansink-Schipper MC et al.; Auxotyping and antibiotic susceptibility testing was carried out on 100 consecutive isolates of non-penicillinase producing strains of Neisseria gonorrhoeae (non-PPNG) taken on the same occasion from throat and anogenital sites, 100 non-PPNG strains isolated from the throat only, and 100 non-PPNG strains from anogenital sites only . Non-requiring, non-requiring and phenylalanine inhibited, proline requiring, amino acid group requiring, and arginine requiring auxotypes predominated in all groups of patients . Strains of the arginine requiring type found in anogenital sites tended to have additional requirements . The auxotypes and susceptibility to antibiotics of 93 of the 100 paired cultures from the throat and anogenital sites were identical . There appeared to be a slight preponderance of moderately susceptible strains in isolates from the throat . A strong correlation was found between nutritional requirements and sensitivity to antibiotics . Auxotypes of and minimum inhibitory concentrations (MICs) for N gonorrhoeae isolated from the throat were mostly the same as the auxotypes of and MICs for strains that were circulating during the study period in Amsterdam.

Genitourin Med, 1985 Feb, 61(1), 36 - 8
Survey of cases of gonorrhoea caused by penicillinase producing Neisseria gonorrhoeae in the United Kingdom; Adler MW et al.; A postal survey of clinicians working in departments of genitourinary medicine in the United Kingdom was carried out to assess the accuracy of the routine surveillance system for penicillinase producing Neisseria gonorrhoeae (PPNG) . A discrepancy was found between the number of cases that had been seen by clinicians and those notified to the Communicable Disease Surveillance Centre . The difference varied from 4% in 1979 to 23% in 1981 . This increasing discrepancy presents problems for the control of PPNG strains, as the time when alternative strategies for the treatment of gonorrhoea should be implemented may go unnoticed.

J Gen Microbiol, 1985 Feb, 131 ( Pt 2), 253 - 63
Turnover of the cell wall peptidoglycan during growth of Neisseria gonorrhoeae and Escherichia coli . Relative stability of newly synthesized material; Greenway DL et al.; The peptidoglycan of a number of strains of Neisseria gonorrhoeae and Escherichia coli turned over during exponential growth as monitored by the loss of radioactivity (supplied as {14C}glucosamine) from SDS-insoluble material . However, no turnover of the peptide side chains of E . coli peptidoglycan was observed (monitored by diamino{3H}pimelic acid) even though turnover of glycan material was occurring . Turnover rates of 9 to 15% per generation were recorded for all the N . gonorrhoeae strains studied except for the autolytic variant RD5 which showed a higher rate of turnover (20 to 26% per generation) . In contrast to previous interpretations, these rates of turnover were not affected by benzylpenicillin, unless sufficient antibiotic was present to affect culture turbidity, when lysis occurred . Examination of the fragments (monomer, dimer and their O-acetylated counterparts, and oligomers) produced by Chalaropsis B muramidase treatment of prelabelled peptidoglycan revealed that no fraction of the peptidoglycan was immune from turnover . However, peptidoglycan pulse-labelled for only 10 min did not show immediate turnover . The lapse of time before turnover commenced was strain dependent, with a maximum value of 1.5 generations . This work confirms that the peptidoglycan of N . gonorrhoeae undergoes a period of maturation and suggests that only mature peptidoglycan turns over.

Infect Immun, 1985 Feb, 47(2), 527 - 33
Immunity and protection of mice against Neisseria meningitidis group B by vaccination, using polysaccharide complexed with outer membrane proteins: a comparison with purified B polysaccharide; Moreno C et al.; A methodology for preparing outer membrane proteins (type specific) complexed to group B polysaccharide of Neisseria meningitidis is described . These complexes, low in nucleic acid and lipopolysaccharide content, were immunogenic in mice with induction of humoral antigroup B and antiprotein responses . Immunized mice were also protected against challenge with N . meningitidis group B strains of the same or a different type from that used for vaccination . Both immunity and protection were enhanced when the mice received a secondary immunization with the protein-polysaccharide complex . Additional data have shown the capacity of purified B polysaccharide to induce immunological memory, even though it is incapable of inducing a humoral response when given alone.

Infect Immun, 1985 Feb, 47(2), 401 - 7
Anaerobiosis increases resistance of Neisseria gonorrhoeae to O2-independent antimicrobial proteins from human polymorphonuclear granulocytes; Casey SG et al.; We investigated the in vitro resistance of Neisseria gonorrhoeae FA19 to the O2-independent antimicrobial systems of human polymorphonuclear leukocytes . Acid extracts of polymorphonuclear leukocyte granules (crude granule extracts) and a purified granule protein (57 kilodaltons) were, at low concentrations, bactericidal for gonococci under aerobic conditions that permitted growth . However, they were less effective under anaerobic conditions that imposed bacteriostasis . We found that adding sodium nitrite to reduced growth media permitted the growth of strain FA19 in an anaerobic environment . Under these conditions with nitrite, anaerobic cultures of strain FA19 were no more resistant to the crude granule extract and the 57-kilodalton protein than aerobic cultures . In contrast, Salmonella typhimurium SL-1004, a facultative anaerobe, was readily killed by both the crude granule extract and the 57-kilodalton antimicrobial protein regardless of the presence or absence of free molecular oxygen . This is the first demonstration that an isolated antimicrobial protein from polymorphonuclear leukocyte granules is active against bacteria under anaerobic conditions . Our results also indicated that the efficacy of human polymorphonuclear leukocyte O2-independent killing of N . gonorrhoeae may, in part, be inhibited by bacteriostatic conditions imposed by hypoxia.

Ann Intern Med, 1985 Feb, 102(2), 229 - 43
Gonococcal infections; Hook EW 3rd et al.; Gonorrhea may be the most extensively studied infection of the past 20 years . The gonorrhea epidemic in the United States began in the early 1960s and peaked in 1975 . Ironically, since 1976 the declining overall incidence has been offset by the advent of plasmid-mediated beta-lactamase production by Neisseria gonorrhoeae and by a growing problem with outbreaks due to strains with chromosomally mediated penicillin and tetracycline resistance . This new antimicrobial resistance, coupled with the frequency of concurrent chlamydial infection in developed countries and concurrent syphilis in some developing countries, has created a need for new approaches to gonorrhea therapy . With the introduction of certain new antimicrobial agents, highly effective forms of therapy are again available . New approaches to rapid diagnosis are also becoming available, but require critical appraisal . Unfortunately, in most of the world's population, gonorrhea remains epidemic, diagnosis of gonorrhea in women is extremely difficult, and highly effective antimicrobial agents are no longer affordable . Thus, vaccine development remains an extremely important goal . Although no candidate gonococcal vaccine currently holds high promise, the increasing understanding of the biology of the gonococcus and the pathogenesis of gonorrhea will serve to focus future research on vaccine development.

Infect Immun, 1985 Feb, 47(2), 388 - 94
Response of Neisseria gonorrhoeae to iron limitation: alterations in expression of membrane proteins without apparent siderophore production; West SE et al.; For acquisition of iron, an essential nutrient, most microorganisms produce siderophores (low-molecular-weight iron-chelating compounds) and membrane proteins to serve as receptors for the iron-siderophore complexes . The gonococcus does not appear to produce a siderophore, since the quantity of siderophore detected by bioassays of culture supernatants from strains F62 and FA19 was never greater than the amount present in the uninoculated medium . Iron limitation of the laboratory strains F62 and FA19 and 12 recent clinical isolates resulted in the expression of several iron-repressible membrane proteins . The expression of proteins in the apparent molecular weight range of 70,000 to 100,000 was strain dependent . All strains expressed 36,000-dalton (36K) and 19.5K proteins . FA19 and F62 were also grown in medium containing iron sources commonly encountered in vivo (i.e., transferrin, lactoferrin, hemoglobin, or hemin) . Comparison of growth rates indicates that transferrin and lactoferrin were more readily utilized as iron sources than hemin and hemoglobin were . Expression of the iron-repressible proteins varied depending upon the iron source . Fewer iron-repressible proteins were observed when cells were supplied with transferrin or lactoferrin than when the cultures were grown with either hemin or hemoglobin . The 36K protein was expressed with all four iron sources.

Genitourin Med, 1985 Feb, 61(1), 44 - 7
Two regimens of sultamicillin in treating uncomplicated gonorrhoea; Farthing C et al.; Sultamicillin is a covalent union of ampicillin and the beta lactamase inhibitor, sulbactam (CP-45,899) . Two studies were conducted to assess its efficacy in treating uncomplicated gonorrhoea . In the first study treatment comprised sultamicillin 1.5 g and probenecid 1 g; 124 (89.2%) of 139 patients responded including seven of 11 patients harbouring beta lactamase (penicillinase) producing strains of Neisseria gonorrhoeae (PPNG) . In the second study sultamicillin 2.25 g and probenecid 1 g were given; 122 (93.8%) of 130 patients responded . Only two of seven pharyngeal infections resolved, and if pharyngeal infections are excluded the overall cure rate rose to 95.3% . Thirteen of 14 patients infected with PPNG strains were cured by the larger dose . Side effects were mild and transitory . It may be concluded that sultamicillin 2.25 g plus probenecid 1 g is an effective regimen to treat uncomplicated rectal and genital gonorrhoea and is useful for treating infections with PPNG strains . Most beta lactamase resistant antimicrobials must be given parenterally; sultamicillin is given by mouth.

Zh Mikrobiol Epidemiol Immunobiol, 1985 Feb, (2), 32 - 4
{Production of immobilized SalI and PvuII restrictase preparations}; Bakh NL et al.; Conditions for the immobilization of specific endonucleases Sal I and Pvu II on BrCN-activated Sepharose 4B have been selected . Some physico-chemical properties of the preparations of immobilized restrictases Sal I and Pvu II have been characterized . The specific and general activity values of the preparations thus obtained have been established . The immobilized enzymes have been used for the multiple restriction of the DNA of phage lambda and the DNA of Neisseria meningitidis.

Zh Mikrobiol Epidemiol Immunobiol, 1985 Feb, (2), 57 - 60
{Cell motility in a system of mononuclear phagocytes from different strains of mice in the presence of bacteria and their components}; Taranov VA; The motility of organospecific macrophages of the abdominal cavity, spleen, lungs and liver, observed in the presence of serogroup A Neisseria meningitidis polysaccharide, formalin-killed Bordetella pertussis and acetone-treated Salmonella typhimurium, has been studied . In these experiments CBA, C57BL/6 and (CBA X C57BL/6)F1 mice have been used . The in vitro study of the motility of cells in the system of mononuclear phagocytes in the presence of bacterial antigens has revealed that these cells are functionally heterogeneous, which is manifested differently in mice of varying strains.

Am J Obstet Gynecol, 1985 Jan 15, 151(2), 185 - 90
The association of sexually transmitted diseases with cervical intraepithelial neoplasia: a case-control study; Guijon FB et al.; Thirty-three women with histologically confirmed cervical intraepithelial neoplasia (grades I to III, with one case of microinvasive carcinoma) and 54 women without evidence of the disease were prospectively studied to determine the relationship of genital infection to cervical neoplasia . Demographic and sexual data for patients and control subjects were collected, with standardized clinical and colposcopic evaluation by means of predefined diagnostic categories . Cultures from the cervix were examined for herpes simplex virus, cytomegalovirus, Chlamydia trachomatis, and Neisseria gonorrhoeae . Human papilloma virus infection was identified by characteristic changes of koilocytosis in cytologic or histopathologic specimen . Cultures from the vagina were evaluated for Gardnerella vaginalis, Trichomonas vaginalis, Ureaplasma urealyticum, Mycoplasma hominis, Candida albicans, and other yeasts . Separate Gram strains were prepared from endocervical secretions and from vaginal secretions . More lifetime sexual partners, larger area of transformation zone, evidence of human papilloma virus infection, and altered vaginal flora were observed in women with cervical intraepithelial neoplasia . The association of human papilloma virus infection and altered vaginal flora with cervical intraepithelial neoplasia was independent of sexual experience.

Scand J Infect Dis, 1985, 17(3), 233 - 43
Kingella kingae infections: a review and a presentation of data from 10 Swedish cases; Claesson B et al.; Kingella kingae is a fastidious gram-negative rod related to the Neisseriae . Together with data from published cases of K . kingae infection, we report the clinical and laboratory findings from 10 cases in western Sweden; a specific serological reaction is also described . The diagnoses were osteomyelitis, septic arthritis, discitis, endocarditis, occult bacteraemia and phlegmon . The data from the Swedish cases, together with those from previous reports in the literature provided the basis for an analysis of a total of 33 cases, ranging from self-limiting to potentially fatal infections . In orthopaedic infections (n = 19), including 3 cases of discitis, the course was usually protracted but subacute and benign, although the full-blown, acute septic arthritis was also encountered . Endocarditis (n = 10) was characterized by a stormy clinical course and the development of significant sequelae . The majority of the patients were previously healthy children . 42% of them had a current or recent upper respiratory tract infection . After start of antibiotic treatment patients were afebrile within a few days . Betalactam antibiotics should be regarded as the drugs of choice for coping with K . kingae . We stress the insidious course of skeletal infections in children and urge the importance of early puncture of a suspected focus to establish a correct diagnosis without delay . The clinical data suggest that K . kingae should be regarded as a significant pathogen.

Ann Clin Res, 1985, 17(2), 60 - 3
A prospective study of Chlamydia trachomatis in first trimester abortion; Shiootz H et al.; Chlamydia trachomatis was isolated from 34 (17.9%) of 190 unselected women applying for first trimester abortion and from 27 (15.9%) of the 170 women who actually had the operation . C . trachomatis was more common among the younger women . Neisseria gonorrhoeae was isolated from 3 (1.6%) of 190 women . Culture positive patients and partners were given antibiotic treatment for 10 days, usually postoperatively . Early postoperative genital infection developed in 2 (7.4%) of the 27 chlamydia-positive and in 3 (2.0%) of the 143 chlamydia-negative women . There were no late infections . The antibiotic treatment significantly reduced the rate of postoperative pelvic inflammatory disease . At examination after 4-7 weeks all cultures were negative . Significantly more women with chlamydia-positive cultures were sero-positive preoperatively: with a microimmunofluorescence method, IgG titres greater than or equal to 1:160 were found in 74.1% of culture positive and in 47.6% of culture negative patients (p = 0.01) . However, serological IgG screening does not identify individual high risk patients and so is of little clinical use in this context . We recommend preoperative screening for C . trachomatis in all women requesting an abortion and 10 days antibiotic treatment for all carriers.

Dermatologica, 1985, 170(6), 276 - 9
{Gonorrhea and pustules of the hands}; Dubois D et al.; Two similar cases of disseminated infection by Neisseria gonorrhoeae were observed at the same time . The patients presented with fever, arthralgia, tenosynovitis, cutaneous pustules of the extremities . In one case, N . gonorrhoeae has been recovered from vaginal discharge; in the other, bacteriological investigations failed . From a review of the literature, it appears that: (1) acral vesiculo-pustular lesions and tenosynovitis represent the most suggestive signs of the disease; (2) it is obviously important to repeat the bacteriological investigations; (3) biological data, included serology, are useless . However, immunofluorescence techniques might detect altered germs in the skin.

Hinyokika Kiyo, 1985 Jan, 31(1), 193 - 6
{Clinical effectiveness of pipemidic acid on gonorrhoeal urethritis}; Yasumoto R et al.; Twenty cases of gonorrhoeal urethritis were orally treated with pipemidic acid (PPA) . The results are as follows . The clinical effect of PPA was excellent in 9 cases and good in 6 cases, the efficacy rate being 75% . The usefulness of PPA was satisfactory in 12 cases (60%) . No side effects were observed . The minimal inhibitory concentrations against 14 isolated Neisseria gonorrhoeal strains ranged from 0.78 to 3.13 micrograms/ml with a median value of 1.56 micrograms/ml . A beta-lactamase-producing strain was observed among the 14 strains and the case infected by this strain was successfully treated with PPA . These results indicate that PPA is a useful drug for the treatment of gonorrhoeal urethritis.

Diagn Microbiol Infect Dis, 1985 Jan, 3(1), 65 - 7
Branhamella catarrhalis bacteraemia and immunosuppression--part of a larger problem?
Bannatyne RM, Kolodej V.
Attention is drawn to the striking association between bacteraemia due to Branhamella catarrhalis and immunosuppression and evidence is cited suggesting a special relationship between this and other Neisseria of intermediate virulence and systemic disease in the immunologically compromised.

Bull World Health Organ, 1985, 63(6), 1107 - 13
Tubal infertility in the Gambia: chlamydial and gonococcal serology in women with tubal occlusion compared with pregnant controls; Mabey DC et al.; PIP: Levels of immunoglobulin G (IgG) antibodies to Chlamydia trachomatis and Neisseria gonorrhoeae were determined by enzyme-linked immunosorbent assay (ELISA) in 37 infertile Gambian women with bilateral fallopian tube occlusion and in 37 pregnant controls matched for age, ethnic group, and domicile . The infertile women had a significantly higher prevalence of antibodies to C . trachomatis serotype L1 (P=0.1) and to purified N . gonorrhoeae pili, outer membrane, and Lipopolysaccharide antigens (P0.01 in each case) . Serological studies of immunoglobulin A (IgA) antibodies to C . trachomatis were less sensitive than the IgG studies in discriminating between the pregnant and infertile groups, suggesting that much of the infertility due to chlamydiae was the result of past rather than current infection . Data suggest that both C . trachomatis and N . gonorrhoea are important causes of infertility due to tubal pathology in Gambian women . (author's)

Microbiol Immunol, 1985, 29(10), 921 - 6
Plasmid profiles of Neisseria gonorrhoeae in Peninsular Malaysia; Kalaimathee KK et al.; The plasmid profiles of 160 strains of Neisseria gonorrhoeae isolated in Peninsular Malaysia, comprising 80 penicillinase-producing (PPNG) and 80 non-penicillinase-producing (non-PPNG) isolates, were determined . The 80 PPNG isolates were divided into two plasmid groups . All of them harbored two common plasmid species, a 4.4 megadalton (Md) R plasmid previously associated with beta-lactamase production in PPNG strains from the Far East and a 2.6 Md multicopy plasmid of unknown function . In addition to these two plasmids, 60 (75%) PPNG isolates also carried a large 24.5 Md conjugative plasmid . In contrast, the 80 non-PPNG strains were divided into three plasmid groups . All of them possessed the 2.6 Md cryptic plasmid, and 35 (44%) isolates also harbored the 24.5 Md transfer plasmid . Besides these two plasmids, one non-PPNG isolate carried an additional 7.8 Md cryptic plasmid.

Dermatologica, 1985, 171(4), 264 - 8
Treatment of gonorrhoea with cefotiam: activity in vitro and clinical results of a 1-gram single-dose regimen; Korting HC et al.; Cefotiam is clearly more active against Neisseria gonorrhoeae in vitro than penicillin . This applies especially to strains producing beta-lactamase but also to those which do not . No strain requires more than 0.25 micrograms/ml for inhibition . 1 g of cefotiam dissolved in 3 ml of 1% lidocaine solution cures 90.0% of patients suffering from uncomplicated genital gonorrhoea if injected once intramuscularly . Tolerance of this regimen is very good, no major side-effect being found.

Dermatologica, 1985, 171(3), 175 - 9
{Importance of the auxotyping of Neisseria gonorrhoeae for evaluating gonorrhea therapy studies}; Korting HC et al.; So far, there was no absolutely reliable way to distinguish between failure and reinfection in clinical trials on the treatment of gonorrhoea . If one, however, analyzes the auxotypes of the gonococcal strains isolated before and after application of the drug from non-cured patients, reinfection can clearly be demonstrated in cases with a changed auxotype . Thus, in a trial on the single intramuscular application of cefotiam 1 g for uncomplicated gonorrhoea, the bacteriological cure rate increased from 90 to at least 95%.

Scan Electron Microsc, 1985, (Pt 3), 1183 - 90
Scanning and transmission electron microscopy of bacterial attachment to mucosal surfaces with particular reference to the human fallopian tube; Cooper MD et al.; Neisseria gonorrhoeae and Chlamydia trachomatis are the common bacteria isolated from bacterial cervicitis and are the leading etiological agents for pelvic inflammatory disease . Neisseria gonorrhoeae cause infection of the mucosa of fallopian tubes in organ culture by attaching to microvilli of nonciliated cells, phagocytosis by these cells, transport across and exocytosis from the epithelial cells . In contrast the Chlamydia attach to the epithelial surface without apparent ligand binding and are taken into the cytoplasm of the epithelial cell . Exocytosis of Chlamydia is into the tubal lumen and not into the subepithelial spaces . The ciliated epithelial cells of the fallopian tube are damaged by a gonococcal toxin but chlamydia do not exhibit such activity . These observations suggest that the mechanism of attachment to and invasion of the mucosal epithelium by gonococci and chlamydia are quite different and their potential for disease production occurs by different methods.

Chemotherapy, 1985, 31(5), 346 - 50
Activity of nine antibacterial agents on penicillinase- and nonpenicillinase-producing Neisseria gonorrhoeae isolated from clinical specimens obtained in northern Norway; Melby K et al.; 34 penicillinase-producing (PPNG) and 102 nonpenicillinase producing (non-PPNG) strains of Neisseria gonorrhoeae were tested against 9 antibacterial agents . Cefoxitin, latamoxef, cefotaxime and imipenem inhibited all PPNG (MIC less than 2 mg/l); chloramphenicol (2 mg/l) inhibited 86%, and 3% and 8%, respectively, were inhibited by 1 mg/l of doxycycline when disk diffusion or agar dilution sensitivity testing were performed . All PPNG strains were sensitive to spectinomycin (MIC less than 32 mg/l) . Non-PPNG strains were uniformly sensitive to all antibacterial agents, doxycycline being slightly less active than the other compounds.

Ann Clin Res, 1985, 17(2), 73 - 5
Localization of gonococci in the anterior oral cavity--a possible reservoir of the gonococcal infection?
Tikjob G, Petersen CS, Ousted M, Ohlenschlaeger J.
In a 6 months period pharyngeal gonococci were detected by routine cultures in 74 (8%) of 951 patients with gonorrhoea . In approximately one third of the 74 patients, a positive culture from the pharynx was the only sign of a gonococcal infection . Fourteen (19%) of the 74 patients with pharyngeal gonorrhoea also had positive cultures of Neisseria gonorrhoea from vestibulum oris . In spite of thorough contact tracing and interview concerning sexual practices in all these patients and when possible their sexual partners, we were not able to show directly that gonococci located in the oral cavity and especially in its anterior part also served as a reservoir of infection . However, three patients with exclusively pharyngeal gonorrhoea denied genito-oral sexual intercourse and could probably have been infected by strictly oro-oral contact . It is concluded that the existence of pathogenic bacteria in the anterior oral cavity in a large proportion of patients with pharyngeal gonococcal infection strengthen the possibility of this localization as a source of the infection.

Med Microbiol Immunol (Berl), 1985, 174(3), 151 - 6
Adherence and hydrophobicity in Neisseria meningitidis and their relationship with surface charge; Criado MT et al.; The influence of surface charge on hydrophobicity and adherence of four strains of Neisseria meningitidis was studied . After neutralization of negative (treatment with EDC-methylamine), positive (treatment with formaldehyde) or both charges, adherence to buccal cells and hydrophobicity were determined and analysed . It was found that surface charges are relevant for adherent processes . Surface hydrophobicity was also found to be influenced by charge but uncorrelated with adherence.

Exp Biol, 1985, 43(4), 251 - 6
Effect of subminimal inhibitory concentrations of antibiotics on adherence of Neisseria gonorrhoeae in an experimental model; Jacques M et al.; The effect of subminimal inhibitory concentrations (subMICs) of six commonly used antibiotics on adherence of Neisseria gonorrhoeae to rabbit mesentery was studied . We found that, at 1/2 MIC, ampicillin, cefoxitin and penicillin G decreased adherence of gonococci by more than 65%, and erythromycin by approximately 40%; doxycycline and tetracycline had no appreciable effect . Results suggest that subMICs of some antibiotics could affect interactions of gonococci with some mammalian cells, more specifically adherence, a critical step in the pathogenesis of an infection.

Exp Biol, 1985, 43(4), 231 - 42
Comparison of bacteriostatic and bactericidal inhibitors of Neisseria gonorrhoeae growth produced in vitro by urogenital staphylococci; Bisaillon JG et al.; Coagulase-negative staphylococci are known to produce bactericidal and bacteriostatic antigonococcal activities . Out of 12 staphylococci, Staphylococcus haemolyticus (four isolates) was identified as the principal source of bactericidal activity, whereas Staphylococcus epidermidis (six isolates) was primarily responsible for producing bacteriostatic activity . A comparison of the bacteriostatic substance produced by S . epidermidis isolate 66 with the bactericidal substance produced by S . haemolyticus isolate 7, which had been previously purified, showed that they were similar lipoproteins or lipid-associated proteins . However, these two inhibitors migrated differently under electrophoresis on agarose gel . The protein component of the bacteriostatic inhibitor was more difficult to separate from the lipid component when chromatographed on Ultrogel AcA 54 in the presence of urea (4 M) than the protein component of the bactericidal inhibitor . The protein component of both types of inhibitors was responsible for the antigonococcal activity and was dissociable into subunits of approximately 1,400 daltons . However, these protein components had different migration patterns on agarose gel . The bacteriostatic substance displayed a bactericidal effect when dissociated from its lipidic component suggesting that the lipids might play a role in the type of inhibitory activity produced . All of the bactericidal and bacteriostatic substances contained in the different crude preparations were antigenically related.

Exp Biol, 1985, 43(4), 225 - 30
Quantitative determination of catalase activity produced by Neisseria gonorrhoeae, Staphylococcus epidermidis, Neisseria meningitidis and other bacterial strains using the Catalasemeter; Bisaillon JG et al.; The conventional catalase test only gives qualitative or semi-quantitative information of the amount of catalase activity produced . Using such a method, we have selected two strong catalase activity producers (Neisseria gonorrhoeae G-10, Staphylococcus epidermidis 66) and a weak producer (Neisseria meningitidis 34702) . Quantitative determination of the catalase activity produced by these strains was done by the disk-flotation method using the Catalasemeter . The production of catalase activity in liquid culture by N . gonorrhoeae, S . epidermidis and N . meningitidis occurred mainly during the logarithmic growth phase . The maximum concentration of catalase activity found in these cultures was, for both strong producers, 160 units (U)/ml while it was around 20 U/ml for the weak producer . Some of the other bacteria tested showed high concentrations of catalase activity (130-162 U/ml) and these were: N . gonorrhoeae strain PR 77112 (penicillin resistant), Staphylococcus strain 7 (coagulase negative), Micrococcus sp . strains 2 and 42.

Antimicrob Agents Chemother, 1985 Jan, 27(1), 76 - 8
Activities of new quinoline derivatives against genital pathogens; Aznar J et al.; The in vitro activities of four quinoline carboxylic acids against 48 strains of Neisseria gonorrhoeae, 10 of Chlamydia trachomatis, and 32 of Ureaplasma urealyticum were compared . Ciprofloxacin was the most active against N . gonorrhoeae and C . trachomatis but had poor bactericidal activity against U . urealyticum, whereas ofloxacin showed the most bactericidal activity against U . urealyticum but was less active than ciprofloxacin against the two former pathogens . Norfloxacin and enoxacin were less active against all the studied pathogens.

J Clin Microbiol, 1985 Jan, 21(1), 127 - 8
Comparison of the effect of refrigerated versus room temperature media on the isolation of Neisseria gonorrhoeae from genital specimens; Ratner HB et al.; We evaluated the effect of medium temperature at the time of inoculation on the isolation of Neisseria gonorrhoeae from urethral and cervical swabs . There were no major differences in the isolation rates of 176 positive cultures on cold or warm media . Colonies tended to be larger and more numerous on room temperature plates after 24 h; however, colonies on most refrigerated plates were easily recognized at 24 h, and growth was essentially the same on both plates after 48 h.

Diagn Microbiol Infect Dis, 1985 Jan, 3(1), 41 - 6
Evaluation of GonoGen coagglutination test for serodiagnosis of Neisseria gonorrhoeae: identification of problem isolates by auxotyping, serotyping, and with a fluorescent antibody reagent; Minshew BH et al.; GonoGen (Micro-Media Systems, Potomac, MD) is a commercially available coagglutination test for the identification of Neisseria gonorrhoeae . We tested 84 strains of Neisseria spp . and Branhamella catarrhalis, including 50 clinical isolates of N . gonorrhoeae . Eighty-six percent (51/59) of N . gonorrhoeae, including 86% (43/50) of clinical isolates of N . gonorrhoeae, were identified correctly in the GonoGen test . In contrast, all N . gonorrhoeae isolates reacted with a fluorescent antibody research reagent composed of monoclonal antibodies . Both reagents were specific for N . gonorrhoeae . Clinical isolates were classified by auxotyping and were serotyped with research monoclonal antibody reagents in coagglutination tests to characterize problem isolates; two auxotype/serovar classes, prototrophic/IA-4 and proline-requiring/IA-4, accounted for 71% (5/7) of GonoGen-negative clinical isolates . Five of the seven isolates that were missed with the first GonoGen lot we tested did react with a second lot of GonoGen reagent . Investigators from different cities in the U.S . have reported different rates of success with GonoGen . Our results indicate that certain N . gonorrhoeae serovars may account for the difference in performance observed with serological tests.

J Infect Dis, 1985 Jan, 151(1), 33 - 41
Opsonophagocytosis of Neisseria gonorrhoeae: interaction of local and disseminated isolates with complement and neutrophils; Ross SC et al.; The phagocytosis of serum-sensitive (SS) and serum-resistant (SR) gonococci by neutrophils was examined . SS strains were more rapidly and completely ingested and killed than were SR strains (8.8% +/- 3.4% vs . 64.4% +/- 7.7% survival at 30 min {P less than .005}) in C8-deficient serum or C8-depleted normal serum . Opsonic requirements of the two types of isolates differed . Heat-labile and -stable serum factors played an important role in the phagocytosis of SS but not SR strains . Indeed, killing of SR strains by polymorphonuclear neutrophils did not vary over a 1,000-fold change in serum concentration . SS strains consumed and fixed C3 more rapidly and in greater amounts than did SR strains (83.3% +/- 17.4% vs . 20.8% +/- 5.0% at 10 min {P less than .01}) . However, this difference in C3 consumption and fixation did not completely account for the difference in phagocytosis because killing of SS strains was still greater than that of SR strains under conditions of equal C3 fixation.

Biomed Pharmacother, 1985, 39(4), 170 - 3
Infection and Branhamella catarrhalis; McLeod DT et al.; Of the Gram-negative cocci found in the nasopharynx to which any pathogenic status can be attributed, Neisseria meningitidis and Neisseria (Branhamella) catarrhalis have gained significant notoriety . Traditionally, B . catarrhalis is regarded as a nasopharyngeal commensal and thus there is, in general, considerable reluctance to accept that B . catarrhalis may be a pathogen when it is seen . Hence, it is under-reported or totally ignored though there is more awareness regarding its pathogenic potential, particularly as an increasingly high incidence of beta lactamase producing strains is being reported from many countries . The importance of this development concerns the choice of routine antibiotic therapy as ampicillin, to which this organism was previously sensitive, may no longer be effective.

Prog Clin Biol Res, 1985, 189, 67 - 79
Interaction of endotoxins, blood elements and the vessel wall; Osterud B; Endotoxins are potent activators of the complement system . Formed activated complement factors, in turn, are capable of inducing metabolite production that may be essential in the killing of parasites . However, the products formed may also induce severe damage and cause great pathological changes that can be fatal for the individual infected . In the present review article the interaction of endotoxin with monocytes, granulocytes and endothelial cells, as well as the central role of complement activation will be discussed . Also a method is provided for the detection of cell activation in Neisseria meningitidis infection.

Sex Transm Dis, 1985 Jan-Mar, 12(1), 52 - 4
Efficacy of gentamicin and kanamycin in the treatment of uncomplicated gonococcal urethritis in Zambia; Hira SK et al.; As a result of the sudden increase in the incidence of penicillinase-producing Neisseria gonorrhoeae (PPNG) from 3.2% in 1980 to 25% in 1982 at a sexually transmitted disease clinic in Lusaka, Zambia, an open clinical trial comparing single-dose gentamicin (280 mg) and kanamycin (2 g) was performed; the drugs were administered intramuscularly to male patients with gonococcal urethritis . Gentamicin was given to 302 men, 220 of whom were followed for two weeks . Kanamycin was given to 113 men, 89 of whom were followed for the same interval . Cure rates of 98% and 95%, respectively, were obtained . Both drugs were well tolerated, with no adverse reactions . All isolates were screened for penicillinase production by the rapid iodometric method; the incidence of PPNG was 41.0% . In view of the high incidence of PPNG associated with failures of penicillin treatment, this drug is no longer useful in situations like that studied here . Since gentamicin and kanamycin have proved to be effective, they are now recommended for the treatment of gonococcal urethritis in Zambia.

Sex Transm Dis, 1985 Jan-Mar, 12(1), 49 - 51
The outcome of single-dose cefuroxime treatment in patients with pharyngeal gonorrhea; Graudal C et al.; This study of single-dose cefuroxime treatment of pharyngeal gonorrhea included 13 patients from whose throat specimens taken on the day of treatment Neisseria gonorrhoeae was isolated and who returned for follow-up examinations one and two weeks later . The regimen used was cefuroxime (1.5 g im) plus probenecid (1 g orally) . The treatment failed in six patients (46%) . Failure of treatment was not associated with decreased in vitro susceptibility of the infecting strain to cefuroxime . In pharyngeal gonorrhea the diagnosis by culture and effective control of treatment require repeated sampling for bacteriologic examinations.

Sex Transm Dis, 1985 Jan-Mar, 12(1), 19 - 24
Use of gonococcal W serogrouping in the evaluation of a clinical trial of rosoxacin; Ruden AK et al.; Serogrouping by co-agglutination was used for the characterization of isolates of Neisseria gonorrhoeae in a clinical trial of rosoxacin in Stockholm . Twenty-four isolates (56%) belonged to serogroup WI, 17 (40%) to WII, and two (5%) to WIII . The proportion of WI isolates in Stockholm was reported in earlier studies to be approximately 40% . On the basis of serogrouping data and clinical information, five (10%) of 48 patients in this study were classified as therapeutic failures . Of the initial WI isolates, 22 (92%) of 24 were inhibited by less than or equal to 0.03 microgram of rosoxacin/ml, as compared with ten (59%) of 17 of the initial WII isolates (.05 greater than P greater than .01) . Thus, this study might underestimate the failure rate as compared with that for patient populations in which WII isolates are more prevalent, since WI isolates are more susceptible to rosoxacin than WII isolates . A certain WII serovar was correlated with decreased susceptibility to rosoxacin (P less than .001) . Correlations were found between decreased susceptibility to rosoxacin and decreased susceptibility to other antibiotics (P less than or equal to .01) . A high frequency of side effects (40%) was seen among the patients studied.

Sex Transm Dis, 1985 Jan-Mar, 12(1), 1 - 4
Women at risk for gonorrhea: comparison of rosaramicin and ampicillin plus probenecid in the eradication of Neisseria gonorrhoeae, Chlamydia trachomatis and genital mycoplasmas; Batteiger BE et al.; Rosaramicin is a macrolide antibiotic with activity against Neisseria gonorrhoeae, Chlamydia trachomatis, and the genital mycoplasmas Ureaplasma urealyticum and Mycoplasma hominis . Its efficacy in the treatment of genital infections was evaluated and compared with that of single-dose ampicillin plus probenecid in women with known, or suspected, uncomplicated gonococcal infection . Isolation rates for N . gonorrhoeae, C . trachomatis, U . urealyticum, and M . hominis were 72%, 44%, 95%, and 65%, respectively . Rosaramicin cured 24 (89%) of 27 gonococcal infections and 11 (92%) of 12 chlamydial infections . It transiently reduced the carriage of U . urealyticum but had little effect on carriage of M . hominis . Rosaramicin may be of value in the treatment of concurrent gonococcal and chlamydial infections when tetracycline is contraindicated.

Antimicrob Agents Chemother, 1985 Jan, 27(1), 120 - 4
Multiresistance plasmid from commensal Neisseria strains; Pintado C et al.; Antibiotic-resistant commensal strains of Neisseria spp . and Branhamella catarrhalis were isolated from throat cultures, on the basis of their capacity to grow in the presence of penicillin, streptomycin, or sulfamethoxazole-trimethoprim . Several strains, which belonged to different species of Neisseria, were resistant to beta-lactams, streptomycin, sulfamethoxazole, and trimethoprim, harbored a 6.0-megadalton plasmid with identical HinfI restriction patterns, and produced beta-lactamase and streptomycin phosphotransferase . The resistance determinants for beta-lactams, streptomycin, and sulfamethoxazole, but not for trimethoprim, were transferred from all these strains to Escherichia coli by conjugation or transformation . The resulting transconjugants or transformants acquired the plasmid and the capacity to produce beta-lactamase and streptomycin phosphotransferase . The 6.0-megadalton plasmid complemented a mutation which determines production of thermosensitive dihydropteroate synthetase in E . coli . We conclude that an R plasmid coding for beta-lactamase, streptomycin phosphotransferase, and a sulfonamide-resistant dihydropteroate synthetase is common to these strains.

Acta Obstet Gynecol Scand, 1985, 64(2), 145 - 9
Chlamydia, mycoplasmas, ureaplasmas, and yeasts in the lower genital tract of females . Comparison between a group attending a venereal disease clinic and a control group; Moller BR et al.; 162 women were investigated . Group I consisted of 85 women, who were partners to men with non-gonococcal urethritis (NGU) or presented macroscopic signs of cervicitis; patients who had harbored Neisseria gonorrhoeae were excluded from the study . Group II was a control group of 77 women without any complaints from the urogenital tract and with normal findings at pelvic examination . All the women were tested for infection with Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum, and Candida albicans . In group I, chlamydiae and mycoplasmas were recovered in 44% and 36%, respectively, the corresponding figures for the control group (group II) being 5% and 19% . The difference is highly significant . No such difference between the two groups was found for ureaplasmas . Sixteen percent of the patients in group I were positive for C . albicans; 12% were positive in group II . Fifty per cent of asymptomatic NGU-partners were chlamydia-positive, and about one-third of patients with either dysuria or vaginal discharge harbored the organism . No difference in the isolation frequency of mycoplasmas was observed between asymptomatic partners to male NGU carriers and women with increased vaginal discharge, whereas the organism was isolated more frequently from patients with dysuria . Fifty-nine per cent of patients with cervicitis were chlamydia-positive, compared with 30% of patients with normal cervical appearance and normal vaginal discharge . Samples obtained from the cervix were more often positive than samples from the urethra . In conclusion, if samples can be taken from only one of the two sites in patients with lower genital tract infection, the cervix is the optimal sampling site.

J Clin Microbiol, 1985 Jan, 21(1), 1 - 3
Nosocomial pneumonia caused by a glucose-metabolizing strain of Neisseria cinerea; Boyce JM et al.; We describe what appears to be the first reported case of nosocomial pneumonia caused by Neisseria cinerea . The isolate metabolized glucose when tested in BACTEC Neisseria Differentiation Kits (Johnston Laboratories), but did not produce detectable acid in cystine-Trypticase (BBL Microbiology Systems) agar medium or in modified oxidation-fermentation medium . Clinical laboratories that rely on the BACTEC method for differentiation of pathogenic neisseriae should be aware of the fact that N . cinerea may mimic N . gonorrhoeae when tested in BACTEC Neisseria Differentiation kits . The ability of N . cinerea to grow well on tryptic soy and Mueller-Hinton agars and its inability to grow on modified Thayer-Martin medium are characteristics which help to distinguish N . cinerea from N . gonorrhoeae.

Drugs, 1985, 29 Suppl 5, 18 - 23
In vitro activity of temocillin against Neisseria gonorrhoeae including penicillinase-producing strains; Jephcott AE et al.; 169 penicillinase-producing strains of Neisseria gonorrhoeae (PPNG) isolated in the United Kingdom were examined for susceptibility to temocillin and spectinomycin . A further 25 PPNG strains and 214 non-penicillinase-producing strains were examined against temocillin, spectinomycin, amoxycillin, cefuroxime and penicillin . Minimum inhibitory temocillin concentrations ranged from 0.36 to 5.0 mg/L with a mode at 1.25 mg/L . The distributions of sensitivities to other agents were in keeping with those previously described.

Infect Immun, 1985 Jan, 47(1), 322 - 5
Cloning of the gene for the common pathogenic Neisseria H.8 antigen from Neisseria gonorrhoeae; Black WJ et al.; Neisseria gonorrhoeae DNA that encodes the pathogenic Neisseria H.8 common antigen was cloned in the lambda phage sep6 . The recombinant phage, designated s6H.8, was detected immunologically with a monoclonal antibody that binds to the H.8 antigen . The gonococcal and s6H.8 forms of the antigen yielded identical partial proteolysis epitope maps . Neisseria species that did not manifest the H.8 antigen showed little or no DNA homology with s6H.8 . This clone should facilitate investigation into the clinical utility of this antigen and determination of its possible function in gonococcal pathogenesis.

Curr Med Res Opin, 1985, 9(9), 591 - 3
The use of aztreonam in the treatment of uncomplicated gonorrhoea; Spencer RC et al.; A total of 57 men and 26 women with uncomplicated gonorrhoea was treated with 1 g aztreonam intramuscularly . The cure rate was 96% and included successful treatment of 4 infections due to beta-lactamase producing organisms and 8 patients with pharyngeal involvement . The minimum inhibitory concentrations of aztreonam in vitro were lower than those of penicillin and similar to cefuroxime, and side-effects were minimal . It is concluded that aztreonam is effective against Neisseria gonorrhoeae in vivo and in vitro.

Int Urol Nephrol, 1985, 17(4), 349 - 58
The causes of male infertility in 504 consecutive Nigerian patients; Osegbe DN et al.; The causes of infertility in 504 men were studied prospectively . The major causes were varicocele (28.8%), infection (20.8%), bilateral testicular failure (15%), idiopathic oligospermia (6.6%), multifactorial (5.6%), cryptorchidism (4%), sexual problems (3.8%) and surgical injury (1.6%) . Unilateral testicular torsion and sickle cell disease though of less frequent occurrence were of particular interest because their roles are only now beginning to be realized . Gonadotrophin deficiency was an insignificant cause of subfertility . In spite of the high incidence of infection and past history of urethritis Neisseria gonorrheae was surprisingly not isolated from any patient . Compared with Caucasian studies, the high incidence of infection, and the low incidence of gonadotrophin deficiency are major points of difference.

Immunol Lett, 1985, 10(1), 35 - 41
The role of serum in interleukin 1 production by human monocytes activated by endotoxins and their polysaccharide moieties; Cavaillon JM et al.; Lipopolysaccharides (LPS) as well as polysaccharide (PS) moieties of Bordetella pertussis and Neisseria meningitidis endotoxins induced in vitro interleukin 1 (IL 1) secretion by human monocytes as evaluated by the co-mitogenic assay on C3H/HeJ thymocytes . Because of the role of serum in the specific binding of endotoxins to monocytes mediated by the polysaccharide region {12}, experiments were undertaken to study the effect of serum on IL 1 induction . Although the presence of serum is not necessary for the secretion of IL 1 by monocytes stimulated by LPS or PS, the addition of very small amounts of human serum (0.1-1.6%) to the cultures of human adherent cells potentiated the IL 1 secretion, without modifying the background values . Natural anti-B . pertussis antibodies present in the serum were not responsible for the observed phenomenon . Heating at 56 degrees C for 30 min did not alter the enhancing effect . The data presented suggest that the serum component(s) and the IL 1 inducers (LPS or PS) act in synergism by two different pathways since the two signals can be delivered sequentially.

Exp Biol, 1985, 43(4), 257 - 62
Inhibitory effects of mannose and N-acetylneuraminic acid on the envelope and the adherence of a Neisseria gonorrhoeae isolate to rabbit mesentery; Jacques M et al.; Sugars and sugar derivatives were investigated as potential inhibitors of adherence of Neisseria gonorrhoeae; in this experiment rabbit mesentery was used as a reliable and convenient tissue . The adherence of N . gonorrhoeae isolate 2299 was reduced by half and more, as compared to controls, in the presence of 1,0 mg N-acetylneuraminic acid or D-mannose per ml of culture media, but not by the other sugars tested . Our data suggest that the N . gonorrhoeae isolate used in this work has mannose-binding related activity which participates in the process of its adherence to rabbit mesentery cells . In addition we observed that pretreatment of rabbit mesentery with concanavalin A, but not with peanut and wheat germ agglutinins, markedly decreased the adherence of gonococci as determined by microscopic counts of adhering bacterial cells.

Acta Pathol Microbiol Immunol Scand {C}, 1984 Dec, 92(6), 341 - 9
C3 nephritic factor in a patient with recurrent Neisseria meningitidis infections; Teisner B et al.; A 15-year-old female experienced two systemic infections with N.meningitidis (group C and B) within a two months period . Classical as well as alternative pathway CH50 determinations on the patients serum showed no lysis . All individual complement factor concentrations, except for C3, were found to be within the reference area . Crossed immunoelectrophoretic analysis of C3 revealed no demonstrable native C3 . The patient had normal levels of C3c and a markedly elevated C3d concentration . Serum from the patient was found to convert all native C3 in normal sera within 10 minutes at 37 degrees C . The active converting principle, present in the IgG fraction activated C3 in C4-depleted serum, and had a dose dependent stabilizing effect on the EA-C3bBb complex . The isolated factor showing the characteristics of C3 nephritic factor (C3 NeF), was unchanged in the patients serum over a ten months observation period . Circulating immune complexes (IC) could not be demonstrated by a C1q-dependent assay but the patients capacity to solubilize preformed IC in vitro was virtually abolished . The patient had no signs of renal disease or lipodystrophy.

Pediatrie, 1984 Dec, 39(8), 635 - 8
{Bacterial meningitis with initially clear CSF}; Teyssier G et al.; 16 bacterial meningitis on 150 observations of purulent meningitis have clear or normal CSM at the initial lumbar puncture . Neisseria meningitidis is the principal germ and there is often purpura and moderate shock . Bacteremia is present in three of the six observations with normal CSF . CSF in controlled a second time 9 to 48 h after the first control . In 14 cases CSF is purulent . Treatment is delayed in eight cases.

Fam Pract, 1984 Dec, 1(4), 219 - 21
Problems of venereal disease in Nigeria . 1 . Gonococcal resistance to antibiotics and treatment of gonorrhoea; Oboho KO; Venereal disease is becoming an increasingly serious problem in developing countries . The availability of antibiotics in chemists' shops has encouraged self-medication with sub-therapeutic doses and inadequate treatment regimens . At a health centre in Nigeria, a diagnosis of gonococcal urethritis was made in 159 out of 429 men presenting with urethritis . Neisseria gonorrhoeae was cultured in 141 cases and the sensitivity pattern to a number of antibiotics freely available at chemists was determined . The organisms were highly resistant to penicillin (84%), ampicillin (80%), tetracycline (68%), streptomycin (78%) and co-trimoxazole (83%) . These were the cheapest of the drugs available, leaving only erythromycin and the more expensive drugs gentamicin and cefotaxime still effective for general use in treatment programmes.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1984 Dec, 258(2-3), 156 - 8
Inhibition of Neisseria meningitidis by alpha-amylase; Berger U; alpha-Amylase inhibits growth not only of N . gonorrhoeae and Legionella pneumophila as obtained in literature (2), but also of N . meningitidis and certain isolates of different bacterial species . Therefore, tests for differentiation of gonococci from other species based upon sensitivity to alpha-amylase are of questionable value.

J Gen Microbiol, 1984 Dec, 130 ( Pt 12), 3189 - 201
A study by high-resolution two-dimensional polyacrylamide gel electrophoresis of relationships between Neisseria gonorrhoeae and other bacteria; Jackson P et al.; High-resolution two-dimensional polyacrylamide gel electrophoresis was used to analyse the soluble proteins from seven strains of Neisseria gonorrhoeae, six strains of Neisseria meningitidis and one or two strains of twelve other species . Approximately 200 individual polypeptides could be visualized as Coomassie Blue stained spots on an electrophoretogram of N . gonorrhoeae and similar numbers were found for the other bacteria . Each species of bacterium had a distinctly different pattern of spots which could be recognized . Quantitative comparisons of 48 selected spots derived from one strain of N . gonorrhoeae with those of five other strains of gonococcus, three strains of N . meningitidis and one of Branhamella catarrhalis, showed relationships in agreement with their current taxonomic classification but with a higher level of discrimination than that of previously used methods . It was also possible to distinguish the individual gonococcal strains . It is suggested that the method could be useful for bacterial classification and identification.

J Clin Microbiol, 1984 Dec, 20(6), 1126 - 9
Preparation and stability of freeze-dried Neisseria gonorrhoeae cultures used for external quality control; Mehaffey MA et al.; In 1976, the Center for Disease Control initiated an external quality control program for the isolation and identification of Neisseria gonorrhoeae . This program required microbial samples of sufficient stability for shipment to laboratories throughout the United States . The Centers for Disease Control undertook studies to determine the most appropriate media for the propagation of strains for freeze-drying, the cell-suspending media that would afford protection during and after freeze-drying, the most favorable growth conditions, the proper times and methods for harvesting cells, the appropriate lyophilization conditions, the critical residual moisture content, and the stability of samples . These studies resulted in the development of methods for preparing and testing freeze-dried samples suitable for shipment.

Pathol Biol (Paris), 1984 Dec, 32(10), 1013 - 8
{Epidemiological surveillance of beta-lactamase-producing gonococci . II--Characterization of plasmids of 66 strains isolated in France (May 1979-March 1983)}; Labidi A et al.; Penicillinase producing Neisseria gonorrhoeae PPNG (66 strains have been examined for the presence of plasmids coding for beta-lactamase . The 3.2 Mdal plasmid was present in 27/66 (41%) of strains . The 4.5 Mdal plasmid was present in 30/66 (45%) of strains . The association 2.6 Mdal 4.5 Mdal plasmids were only present in 9/66 (13.6%) of strains . The cryptic plasmid of 2.6 Mdal was always present.

J Pharm Sci, 1984 Dec, 73(12), 1763 - 7
2-Acetylpyridine thiosemicarbazones XI: 2-(alpha-Hydroxyacetyl)pyridine thiosemicarbazones as antimalarial and antibacterial agents; Klayman DL et al.; A series of 2-(alpha-hydroxyacetyl)pyridine thiosemicarbazones was synthesized as potential antimalarial and antibacterial agents . Their synthesis was achieved by the condensation of N4-mono- or N4,N4-disubstituted thiosemicarbazides with 2-(alpha-hydroxyacetyl)pyridine . The latter was prepared by selective bromine oxidation of (2-pyridinyl)-1,2-ethanediol . The new compounds show potent inhibitory activity against penicillin-sensitive as well as penicillin-resistant Neisseria gonorrhoeae (MIC, 0.5-0.004 micrograms/mL), against Neisseria meningitidis (MIC, 0.5-0.032 micrograms/mL), and Staphylococcus aureus (MIC, 0.5-2 micrograms/mL) . Good in vitro antimalarial effects against Plasmodium falciparum (Smith strain; ID50, 6.7-38 ng/mL) were observed in most of these new agents, but only 3 of 12 compounds exhibit moderate in vivo activity against Plasmodium berghei . These new agents appear to be less toxic to the host and more water soluble than the corresponding 2-acetylpyridine thiosemicarbazones.

Trop Geogr Med, 1984 Dec, 36(4), 341 - 4
Antibiotic resistance of Neisseria gonorrhoea in Curaçao; Eustatia JM et al.; Beta lactamase producing Neisseria gonorrhoea strains are only occasionally found in Curacao; of the non beta lactamase producing strains isolated from civilians a high percentage was moderately to highly resistant to penicillin and moderately resistant to tetracyclin . These percentages were even high in the case of gonococcal strains isolated from prostitutes . Strains which are resistant to spectinomycin were not found . These findings may warrant considering the use of alternative antibiotics in the treatment of gonococcal infections in this community.

J Antibiot (Tokyo), 1984 Dec, 37(12), 1525 - 7
Spenolimycin, a new spectinomycin-type antibiotic . III . Biological properties; Fernandes PB et al.; Spenolimycin is a new spectinomycin-type antibiotic isolated from Streptomyces gilvospiralis sp . nov . In vitro, it was active against a wide variety of aerobic Gram-positive and Gram-negative bacteria and Neisseria gonorrhoeae . It was two to four-fold more active against N . gonorrhoeae than spectinomycin . Spenolimycin was effective in the standard mouse protection test against Escherichia coli, Klebsiella pneumoniae and Streptococcus pneumoniae.

Br J Vener Dis, 1984 Dec, 60(6), 374 - 9
Susceptibility to antimicrobials of Neisseria gonorrhoeae isolated in Singapore: implications on the need for more effective treatment regimens and control strategies; Sng EH et al.; The antimicrobial susceptibility of gonococci isolated in Singapore has been studied over several years . In 1983, the prevalence of penicillinase producing Neisseria gonorrhoeae (PPNG) was 33.5% and 64% of non-PPNG isolates had minimum inhibitory concentrations (MICs) of penicillin of greater than or equal to 0.5 mg/l . After a control programme, the isolation of the gonococcus from prostitutes was reduced and there was improvement in its susceptibility to antimicrobials . The incidence of PPNG strains was stabilised with a change in the treatment regimen . An influx of foreign prostitutes, however, had an unfavourable impact on these variables . Countries in South East Asia have a high prevalence of PPNG and non-PPNG strains that have reduced susceptibility to antimicrobials . In view of increased air travel the problem should be seen from a global perspective . Better treatment regimens and control strategies are urgently needed.

J Exp Med, 1984 Dec 1, 160(6), 1782 - 91
Antigenic analysis of gonococcal pili using monoclonal antibodies; Edwards M et al.; A bank of mouse monoclonal antibodies has been produced with reactivity to gonococcal pili to investigate epitopes of the pilus structural protein, pilin . Pili of Neisseria gonorrhoeae strains R10 and MS11 were used as immunogens to elicit 19 monoclonal antibodies reactive with the homologous pili type in ELISA . Of the 19 antibodies, 16 demonstrated type-specific reactivity and 3 were cross-reactive with heterologous pili . Reactivity of the antibodies with the carboxyterminal, cyanogen bromide fragment (CB-3) of R10 pilin allowed their classification into three groups . The first group (10 antibodies) were R10 specific and equally reactive with the R10 CB-3 fragment . The second group (6) were also type specific but demonstrated poor reactivity with the CB-3 fragment . This suggested that the epitopes of the first group are linear, and those of the second group, nonlinear . The third group (3), consisting of the cross-reactive antibodies, were not reactive with the CB-3 fragment . Two of the antibodies in group 3 were examined in detail to localize their epitopes . The epitope of one, 9B9/H5, was shown to be a linear determinant . This antibody was reactive with a fragment of MS11 pilin (residues 31-111) and to a synthetic peptide representing residues 69-84 in MS11 pilin . The epitope was more finely mapped, with shorter synthetic peptides conjugated to bovine serum albumin, to an eight amino acid segment (residues 69-76) . The epitope of 1E8/G8, a strongly reactive antibody, proved elusive to this type of analysis and probably results from conformational restraints . The significance of species-specific epitopes in the pilin protein is discussed.

J Med Microbiol, 1984 Dec, 18(3), 347 - 54
The systematic serology of Neisseria gonorrhoeae: antigens associated with pathogenesis in Neisseria spp . from man; Saikh KU et al.; Sonicates of eight Neisseria species from man were analysed in a micro-Ouchterlony double-diffusion absorption assay in comparison with a gonococcal reference antiserum-antigen system . Five major gonococcal precipitin zones were identified which comprised genus-, species- and type-specific components . One antigen was found in all strains of three species with pathogenic capability--N . gonorrhoeae, N . meningitidis and N . flavescens . It was not detected in N . lactamica, N . pharyngis, N . elongata, N . cinerea or N . catarrhalis.

J Gen Microbiol, 1984 Dec, 130 ( Pt 12), 3165 - 73
On the role of pili in transformation of Neisseria gonorrhoeae; Mathis LS et al.; Transformation of competent transformable Neisseria gonorrhoeae F62 to streptomycin resistance was unaffected by antibodies directed against the pilus protein (pilin) of this organism . The pilin component of either crude or purified pilus preparations, separated by SDS gel electrophoresis and transferred to nitrocellulose, failed to bind detectable amounts of DNA; DNA binding to other gonococcal polypeptides was observed under these conditions . These results suggest that gonococcal pilin does not play a direct role in gonococcal transformation.

Lancet, 1984 Dec 1, 2(8414), 1234 - 7
Single-dose kanamycin therapy of gonococcal ophthalmia neonatorum; Fransen L et al.; 117 infants with gonococcal ophthalmia neonatorum, including 27 with infections due to penicillinase-producing Neisseria gonorrhoeae, were treated as outpatients with five different regimens of single-dose intramuscular kanamycin (75 mg or 150 mg) with saline eye washes, gentamicin eye ointment, or chloramphenicol eye drops . There were no treatment failures among 68 patients treated with 75 mg or 150 mg kanamycin and gentamicin eye ointment (for 3 days) . However, the minimum and maximum cumulative probabilities of cure of single-dose kanamycin with saline eye washes (for 3 days) were only 60% and 89% . 1 patient of 15 treated with 150 mg kanamycin plus chloramphenicol eye drops did not respond to treatment . Postgonococcal conjunctivitis developed in 14 (12%) infants, of whom 13 had positive cultures for Chlamydia trachomatis . Nasopharyngeal infection with N gonorrhoeae was eradicated in 9 of 11 infants colonised.

Clin Orthop, 1984 Nov, (190), 36 - 49
The use of penicillins in orthopaedic surgery; Cunha BA; The main use of the penicillins in orthopedic surgery is in the treatment of infections due to Hemophilus influenzae, Staphylococcus aureus, Pseudomonas aeruginosa, Neisseria gonorrhoeae, Escherichia coli, Proteus mirabilis, Streptococcus pneumoniae, and Group D streptococci (enterococci) . Penicillins have antimicrobial activity and have a characteristic pharmacodynamic action, including side effects . The tissue penetration characteristics of the penicillins into synovial fluid and human bone are significant . Semisynthetic penicillins, antistaphylococcal penicillins, and the antipseudomonal penicillins are used for treatment of septic arthritis and osteomyelitis . Oral penicillin therapy can be useful in treatment of osteomyelitis.

J Gen Microbiol, 1984 Nov, 130 ( Pt 11), 2767 - 70
Red blood cells, a source of factors which induce Neisseria gonorrhoeae to resistance to complement-mediated killing by human serum; Patel PV et al.; Lysates of guinea pig or human red blood cells (RBC) contain far more of the factors that induce resistance in gonococci to complement-mediated killing by fresh human serum that do plasma or serum . As was previously found with serum, most of the resistance-inducing activity of guinea pig RBC lysates was found in ultrafiltrates with molecular weights of less than 5000 . In contrast, and as with human serum, most of the resistance-inducing activity of human RBC lysates did not pass ultrafilters which removed molecules of less than 5000 daltons, although some active material of low molecular weight was present.

Rev Infect Dis, 1984 Nov-Dec, 6 Suppl 4, S875 - 9
Single-dose treatment of uncomplicated gonorrhea: a comparison of cefonicid and penicillin; Duncan WC et al.; Cefonicid, a parenteral semisynthetic cephalosporin, achieves high and sustained serum levels in humans . Activity against strains of Neisseria gonorrhoeae, including those that produce beta-lactamase, has been shown in vitro . The efficacy of 1.0 g of cefonicid was evaluated noncomparatively in 50 men with gonococcal urethritis; four failed to respond to treatment . Additionally, 57 men and 34 women received either 1.0 g of cefonicid or 4.8 X 10(6) units of procaine penicillin G plus 1.0 g of probenecid in a double-blind study . Among 17 men treated with penicillin, two failed to respond, and one failed among the 33 patients treated with cefonicid . Seventeen women received 1.0 g of cefonicid, and all cervical infections were cured . Among those who received cefonicid, 13 had rectal infections; and four had positive cultures at follow-up four to seven days posttreatment . Among the 17 women receiving penicillin, none failed to respond to therapy; only seven had both cervical and rectal infection . Of the 116 pretreatment and seven posttreatment isolates tested, 45 (37%) were inhibited by less than 0.0625 microgram of penicillin/ml and 121 (98%) were inhibited by less than 1.0 microgram/ml . Forty-one (33%) of the 123 isolates were inhibited by less than 0.0625 microgram of cefonicid/ml and 122 (99%) by less than 1.0 microgram of cefonicid/ml . The median MIC of cefonicid for the strains isolated from the women whose rectal infections were cured was 0.125 microgram/ml; that for the strains isolated from the women with rectal infections who failed to respond was 0.5 microgram/ml . Administration of 1.0 g of cefonicid intramuscularly is effective therapy for uncomplicated gonococcal urethritis in men.(ABSTRACT TRUNCATED AT 250 WORDS)

Can J Microbiol, 1984 Nov, 30(11), 1319 - 25
Growth inhibition of Neisseria gonorrhoeae isolates by L-phenylalanine and its analogues in defined media; Hendry AT et al.; Growth inhibition by phenylalanine (0.25 mmol/L in defined agar media) was present in about 1% of over 1000 clinical isolates of Neisseria gonorrhoeae isolates tested . Turbidometry of several phenylalanine-sensitive isolates showed that their growth rates decreased in proportion to phenylalanine concentrations up to about 1 mmol/L . The growth rate was unaffected if 0.04 mmol/L tyrosine was also present . The phenylalanine analogue DL-3-fluorophenylalanine inhibited the growth of all 23 isolates further tested on agar . This inhibition was depressed by phenylalanine in all 17 phenylalanine-resistant isolates . Phenylalanine plus tyrosine were required to derepress the analogue inhibition in the other six phenylalanine-sensitive isolates . Phenylalanine-sensitive isolates may have a defect in aromatic amino acid synthesis, not involving auxotrophy, but manifested through regulation of the pathways . Phenylalanine effectively repressed tyrosine and phenylalanine synthesis . In 125 isolates including 85 beta-lactamase producers (PPNG) and 32 phenylalanine-sensitive isolates, phenylalanine inhibited 63.2% of 38 PPNG isolates carrying the 3.2 megadalton (Md) plasmid, but only one of 47 PPNG isolates carrying the 4.5 Md plasmid . PPNG isolates are most often of the proline, ornithine, or nonrequiring auxotypes . Phenylalanine sensitivity did not appear to be auxotype dependent.

Antimicrob Agents Chemother, 1984 Nov, 26(5), 770 - 2
In vitro antimicrobial susceptibilities of penicillinase-producing and non-penicillinase-producing strains of Neisseria gonorrhoeae isolated in Durban, South Africa; Coovadia YM et al.; The in vitro susceptibilities of 22 penicillinase-producing and 32 non-penicillinase-producing strains of Neisseria gonorrhoeae to 13 antimicrobial agents, including the new semisynthetic penicillins and cephalosporins, are reported . Ceftriaxone, ceftazidime, and cefotaxime were the most active agents tested; none of them had an MIC of greater than 0.03 micrograms/ml . Amoxycillin plus clavulanic acid and temocillin also showed good activity against both strains of gonococci.

J Clin Microbiol, 1984 Nov, 20(5), 905 - 8
Laboratory and clinical evaluation of modified New York City medium (Henderson formulation) for the isolation of Neisseria gonorrhoeae; Anstey RJ et al.; The growth-promoting properties of several ingredients of New York City (NYC) medium were investigated by using 100 recently isolated clinical strains of Neisseria gonorrhoeae . Difco GC medium base promoted the growth of large colonies of gonococci significantly better than other commercial GC medium bases . A 1% agar concentration resulted in the growth of larger colonies than 2% agar, without affecting the stability of the gel . Neither replacement of horse plasma with horse serum nor reducing the concentration of added serum from 12 to 3% affected the growth of even the most fastidious strains tested . From these observations, a modified NYC medium (Henderson) has been formulated which is easy to prepare and less expensive than NYC or Thayer-Martin medium . In a direct clinical comparison with 1,275 specimens, an isolation rate of 6.5% was achieved with both NYC medium and the Henderson formulation.

J Clin Pathol, 1984 Nov, 37(11), 1276 - 81
Immunological identification of Neisseria gonorrhoeae with monoclonal and polyclonal antibody coagglutination reagents; Young H et al.; The reliability of immunological identification of Neisseria gonorrhoeae using polyclonal and monoclonal antibody coagglutination reagents has been evaluated . When clinical isolates of neisseriae were tested in an "in use" trial the sensitivity and specificity of each reagent were similar and the overall agreement with carbohydrate utilisation was 97.9% (141/144) for the polyclonal antibody reagent and 97.2% (140/144) for the monoclonal reagent . When results of testing 13 stock cultures of N lactamica and five stock cultures of beta-lactamase producing Branhamella catarrhalis were combined with the results for clinical isolates of non-gonococcal neisseriae the agreement with carbohydrate utilisation was 86.5% (64/74) for the polyclonal reagent and 97.3% (72/74) for the monoclonal reagent: this difference is statistically significant at the 5% level . Calculation of positive and negative predictive values showed differences in the reliability of the coagglutination reagents when testing Gram negative diplococci isolated from various anatomical sites . The value and limitations of the polyclonal and monoclonal reagents were similar with respect to anogenital isolates: N gonorrhoeae was confirmed by a positive result but not excluded by a negative result . The monoclonal reagent was superior for testing throat isolates; although a negative result with either reagent confirmed Gram negative diplococci as non-gonococcal neisseriae, a positive result with the monoclonal reagent was more reliable (predictive value 93%) than a positive result with the polyclonal reagent (predictive value 86%).

J Infect Dis, 1984 Nov, 150(5), 737 - 44
Attachment to and invasion of human fallopian tube mucosa by an IgA1 protease-deficient mutant of Neisseria gonorrhoeae and its wild-type parent; Cooper MD et al.; In an investigation of the possible role of IgA1 protease in the initial encounter of Neisseria gonorrhoeae with human genital mucosa, the pathogenicity of an isogenic, piliated, wild-type gonococcal clone was compared with that of its IgA1 protease-deficient mutant in organ cultures of human fallopian tubes . The fallopian tube mucosa released IgA into the organ culture medium throughout the course of the infection; the rate of release was substantially higher in gonococcus-infected organ cultures . The wild-type gonococcus but not the IgA1 protease-deficient mutant elaborated IgA1 protease into the medium . The rate and extent of attachment, damage, and invasion of the fallopian tube mucosa by the IgA1 protease-deficient mutant were indistinguishable from those by the parental clone . These data are compatible with the hypothesis that, in the initial encounter with previously uninfected human genital mucosa, the production of IgA1 protease is not critical to the ability of the gonococcus to act as a mucosal pathogen.

Rev Infect Dis, 1984 Nov-Dec, 6 Suppl 4, S857 - 64
Treatment of bacterial osteomyelitis and Staphylococcus aureus endocarditis and single-dose therapy for uncomplicated Neisseria gonorrhoeae infections: an overview; Mader JT et al.; Cefonicid is a new second-generation cephalosporin that has broad-spectrum antibacterial activity, achieves high peak serum concentrations, and has a long half-life . The high serum concentration and long half-life of cefonicid make it feasible to administer the drug once daily either intravenously or intramuscularly . For the treatment of bacterial osteomyelitis, a specific antibacterial agent is administered for four to eight weeks . Ideally, the optimal antibiotic should have good activity against organisms commonly implicated in bone infections, be easy to administer, be stable in inflammatory conditions, achieve good concentrations in bone, and have minimal toxicity . For treatment of Staphylococcus aureus endocarditis, the same criterion of minimal toxicity should be met for the agent used; in addition, it should have excellent antistaphylococcal activity in vivo and in vitro, be stable to beta-lactamase, and exhibit good bactericidal activity at trough serum levels . In uncomplicated Neisseria gonorrhoeae infections, the ideal antibiotic should be one that could be administered in a single dose in a small volume and would not be painful on intramuscular injection . The antibiotic should be nontoxic; stable to N . gonorrhoeae beta-lactamase; and reliably able to eradicate urethral, endocervical, rectal, and pharyngeal infections . Cefonicid may fulfill some of these criteria.

Jpn J Antibiot, 1984 Nov, 37(11), 2169 - 73
{Ceftriaxone as a single-dose treatment for male gonococcal urethritis}; Urabe S et al.; Ceftriaxone was used in single intravenously dose of 1 g to treat 20 men with gonorrhoea caused by penicillinase-producing Neisseria gonorrhoeae (PPNG) and non-PPNG . Of 14 patients followed up, 13 (92.9%) were cured . Cure rates for PPNG infections and non-PPNG infections were 100% and 90.9% respectively . No side effect was observed except 1 case of vomiting out of 20 cases . It is concluded that this drug is safe and effective in treating both PPNG and non-PPNG infections.

Antimicrob Agents Chemother, 1984 Nov, 26(5), 683 - 5
Therapeutic trial and pharmacokinetics of sulbactam for uncomplicated gonorrhea in men; Caine VA et al.; The efficacy of intramuscular sulbactam for uncomplicated gonorrhea was assessed in 20 men infected with beta-lactamase-negative Neisseria gonorrhoeae . Ten subjects received 2.0 g of sulbactam given in a single intramuscular dose with 1.0 g of probenecid orally; 4 of 10 urethral infections persisted, as did one rectal infection . Ten subjects were treated with 0.5 g of intramuscular sulbactam given twice, 4 h apart; 3 of 10 urethral infections and 2 of 2 rectal infections persisted . The geometric mean MIC of sulbactam for 20 pretreatment isolates of N . gonorrhoeae was 1.37 microgram/ml (range, 0.25 to 8.0 micrograms/ml) . Serum levels of sulbactam, determined for nine subjects in the two treatment groups, fell below the MIC of some gonococci after less than 6 h with both regimens . In the regimens studied, sulbactam alone is not suitable as therapy for uncomplicated gonorrhea . determined for nine subjects in the two treatment groups, fell below the MIC of some gonococci after less than 6 h with both regimens . In the regimens studied, sulbactam alone is not suitable as therapy for uncomplicated gonorrhea.

Lancet, 1984 Oct 27, 2(8409), 944 - 5
Screening for Chlamydia trachomatis and Neisseria gonorrhoeae in adolescent males: value of first-catch urine examination; Adger H et al.; 50 adolescent males attending a general teen clinic (aged 13-21) were evaluated for urethritis . After examination of sediment from the initial 15-20 ml of voided urine, first-catch urine (FCU), specimen urethral swabs were taken for culture of Chlamydia trachomatis and Neisseria gonorrhoeae . 21 of 23 (91%) males with greater than 10 leucocytes per high-power field of resuspended sediment (FCU-positive) had positive urethral cultures for C trachomatis or N gonorrhoeae compared with only 1 of 27 (4%) FCU-negative subjects (p less than 0.001) . 12 of 22 culture-positive subjects had no genitourinary symptoms and 11 of the 12 had C trachomatis infections . The sensitivity of FCU examination in identifying culture-positive urethritis was 95%, the specificity 93%, and the predictive value of a positive FCU 91% . FCU examination is a useful, noninvasive screening test to detect urethritis associated with C trachomatis and N gonorrhoeae . The test may be especially helpful in identifying symptom-free males with chlamydia-associated urethritis.

J Immunol Methods, 1984 Oct 26, 73(2), 251 - 7
Collection of mucosal secretion by synthetic discs for quantitation of secretory IgA and bacteria; Kristiansen BE; A practical method for collection and processing of mucosal secretion was developed to facilitate quantitation of its contents of secretory IgA (sIgA) and bacteria . Small discs were punched out from a commercially available synthetic electrophoresis wick . The discs absorbed a constant volume of saliva (52.4 +/- 3.9 microliters), and antibodies and encapsulated bacteria (Neisseria meningitidis) could subsequently be completely eluted . Serum IgA, IgM and IgG antibody activity was preserved both in discs stored dry for 3 days at 22 degrees C and in discs stored at -22 degrees C for 2 months . The secretory IgA concentrations of multiple samples of nasal secretion collected from 1 person were stable, demonstrating the reproducibility of the disc collecting method.

Br Med J (Clin Res Ed), 1984 Oct 20, 289(6451), 1032 - 4
Spectinomycin as initial treatment for gonorrhoea; Easmon CS et al.; The prevalence of penicillinase producing Neisseria gonorrhoeae at this hospital increased exponentially from less than 0.5% in 1978 to 6.5% of all isolates in 1982 . In January 1983 first line treatment for uncomplicated heterosexual anogenital gonorrhoea was therefore changed from ampicillin and probenecid to spectinomycin . This subsequently cured 95% of cases seen at the Praed Street Clinic . Although there was an initial fall in the monthly isolation rate of penicillinase producing N gonorrhoeae after the introduction of spectinomycin, this was not maintained . The exponential increase in the prevalence of the strain did slow in 1983, rising to only 8.7% . This, however, may have reflected a general decline in the rate of increase of penicillinase producing N gonorrhoeae throughout Britain . The failure to influence the prevalence of penicillinase producing N gonorrhoeae to any great degree may have been due in part to spectinomycin resistance in both penicillinase producing and non-penicillinase-producing N gonorrhoeae . All of the isolates appeared identical, apart from the presence of the 4.4 megadalton plasmid in penicillinase producing N gonorrhoeae, but they could not be linked epidemiologically . Changing treatment in only one of the many venereal diseases clinics in London, where patients have open access to all such clinics, is unlikely to affect the prevalence of penicillinase producing N gonorrhoeae . This has probably been more important than spectinomycin resistance in limiting the effectiveness of spectinomycin in reducing the prevalence of the strain.

Am J Med, 1984 Oct 19, 77(4C), 68 - 72
Comparative study of ceftriaxone and spectinomycin in the treatment of uncomplicated gonorrhea in women; Collier AC et al.; Single-dose ceftriaxone, 125 mg given intramuscularly, was compared with spectinomycin 2.0 g given intramuscularly in the treatment of women with uncomplicated gonorrhea . Cervical or anorectal gonococcal infection was eradicated in 54 (98 percent) of 55 women treated with ceftriaxone and 22 (96 percent) of 23 treated with spectinomycin . Cure rates for pharyngeal gonococcal infections were nine of 10 for ceftriaxone and four of eight for spectinomycin (p = 0.18) . Neither agent eradicated concurrent Chlamydia trachomatis infection . The geometric mean minimal inhibitory concentration for ceftriaxone was 0.0038 microgram/ml for 65 pretreatment cervical isolates of beta-lactamase-negative Neisseria gonorrhoeae and all isolates were inhibited by 0.063 microgram/ml . Neither drug caused perceptible toxicity, but patient acceptance was better for ceftriaxone than for spectinomycin . A single 125 mg dose of ceftriaxone is an excellent regimen in the treatment of uncomplicated gonorrhea in women.

N Engl J Med, 1984 Oct 4, 311(14), 869 - 74
Prospective evaluation of hearing impairment as a sequela of acute bacterial meningitis; Dodge PR et al.; As part of a prospective study of acute bacterial meningitis in children, we studied for five years the hearing of 185 infants and children who had acute bacterial meningitis when they were more than one month of age . Nineteen (10.3 per cent) of the patients had persistent bilateral or unilateral sensorineural hearing loss . The incidence of hearing loss as determined by electric-response audiometry and conventional tests was 31 per cent with Streptococcus pneumoniae, 10.5 per cent with Neisseria meningitidis, and 6 per cent with Hemophilus influenzae infections . Transient conductive hearing impairment was found in 16 per cent of the sample, but in no case was there apparent improvement in a sensorineural deficit over time . The site of disease resulting in impaired hearing cannot be stated with certainty, but involvement of the inner ear or auditory nerve was suspected . The number of days of illness (symptoms) before hospitalization and institution of antibacterial treatment was not correlated with the development of sensorineural deafness.

Sex Transm Dis, 1984 Oct-Dec, 11(4 Suppl), 460 - 2
Clinical evaluation of thiamphenicol in treatment of nongonococcal urethritis; Saito I; The effect of thiamphenicol on nongonococcal urethritis was compared with that of doxycycline for 122 male patients, 61 of whom were randomly assigned to treatment with thiamphenicol and 61, with doxycycline . Before treatment the urethral discharges showed more than ten polymorphonuclear leukocytes per high-power field, no gram-negative cocci on the smear, and no culture positive for Neisseria gonorrhoeae . Thiamphenicol was given orally in 500-mg doses three times daily (total dose, 1,500 mg per day), and doxycycline was given orally in 100-mg doses three times daily (total dose, 300 mg per day) for seven to 14 days . Thiamphenicol was clinically effective for 86.8% of the men and doxycycline for 86.3% . In the culture-negative group, thiamphenicol was effective in 90% and doxycycline in 92%; there was no statistically significant difference between the two drugs . Of the 122 patients, one (1.6%) in the doxycycline-treated group showed digestive tract disturbance, but this reaction did not require stopping the therapy.

Sex Transm Dis, 1984 Oct-Dec, 11(4 Suppl), 428 - 9
Introductory address: microbial etiology of pelvic inflammatory disease; Mardh P; The etiology of acute pelvic inflammatory disease is multifactorial, and the pattern of organisms most frequently causing the condition fluctuates . For example, tuberculous salpingitis has gradually become a rarity in many areas, and cases of nongonococcal salpingitis have started to outnumber those of gonococcal salpingitis . Chlamydia trachomatis now causes more cases than Neisseria gonorrhoeae in many regions . Mycoplasma hominis is another (often overlooked) etiologic agent infection in the upper genital tract of women . Pelvic inflammatory disease due to anaerobic microorganisms seems to occur more frequently in some areas (i.e., the United States) than in others (i.e., Europe).

Sex Transm Dis, 1984 Oct-Dec, 11(4 Suppl), 396 - 7
Single-dose thiamphenicol for the treatment of gonorrhea; Mascaro JM et al.; Acute gonococcal urethritis was treated with a single oral dose of 2.5 g of thiamphenicol in 62 patients after diagnosis by gram-staining of urethral smears and/or cultures for Neisseria gonorrhoeae in Thayer-Martin medium . Therapy resulted in bacteriologic and clinical cure in 50 cases . Three cases were not cured by this treatment . Nine patients failed to return for follow-up examination . The only adverse reaction to treatment was diarrhea in one patient . The taste of the preparation of thiamphenicol administered was considered acceptable by most patients.

Br J Vener Dis, 1984 Oct, 60(5), 309 - 11
Treatment of uncomplicated gonorrhoea in women with a combination of rifampicin and erythromycin; Boakes AJ et al.; One hundred women with uncomplicated gonorrhoea (in five cases due to penicillinase producing strains of Neisseria gonorrhoeae (PPNG)) were treated with a single oral dose of rifampicin 900 mg and erythromycin stearate 1 g . N gonorrhoeae was reisolated from the oropharynx of one patient, who was infected with a PPNG strain, but was eradicated from the genital tract in 100% of cases . The combination eradicated Chlamydia trachomatis from only 10 (28%) of the 36 patients infected . Side effects were predominantly mild and consisted of transient nausea . The treatment merits evaluation in areas with a high incidence of PPNG strains.

Sex Transm Dis, 1984 Oct-Dec, 11(4 Suppl), 449 - 53
Acute salpingitis and thiamphenicol: a microbiologic and therapeutic study; Kunz J et al.; Eighty-five sexually active women with clinically suspected adnexitis and illness severe enough to require hospitalization were studied . The clinical diagnosis, based on anamnestic data and physical and pelvic examination, was confirmed by laparoscopy and by cultures for aerobic and anaerobic bacteria and for Chlamydia in both cervical canal and intraperitoneal secretions . A ten-day course of thiamphenicol was begun on an empirical basis after laparoscopy . The results showed that fever, an elevated erythrocyte sedimentation rate, and leukocytosis are unreliable diagnostic parameters and that laparoscopy in conjunction with microbial cultures is the only method by which a definite etiologic diagnosis can be established . Positive results of cultures of specimens from the cervical canal are sufficient for the diagnosis of infection due to Neisseria gonorrhoeae, whereas positive culture results for specimens from the intraperitoneal cavity are necessary for the diagnosis of infection caused by Chlamydia trachomatis . Primary treatment with thiamphenicol was successful in 77 (91%) of the 85 patients . Thus, thiamphenicol proved to be effective in the treatment of acute adnexitis.

Sex Transm Dis, 1984 Oct-Dec, 11(4 Suppl), 432 - 4
Activity of thiamphenicol against Chlamydia trachomatis and Neisseria gonorrhoeae; Ridgway GL et al.; The in-vitro activity of thiamphenicol against Neisseria gonorrhoeae was compared with that of penicillin . A total of 267 isolates were tested . All strains were inhibited by less than or equal to 4.0 micrograms of thiamphenicol/ml . However, the minimal inhibitory concentration of thiamphenicol was fourfold higher (MIC90 = 2.0 micrograms/ml) for beta-lactamase-producing strains or those moderately resistant to penicillin than for penicillin-sensitive strains (MIC90 = 0.5 micrograms/ml) . The MIC of thiamphenicol for Chlamydia trachomatis was determined for a control strain and for 15 recent clinical isolates . The MIC90 for thiamphenicol was 1.0 micrograms/ml, as compared with a MIC90 of oxytetracycline of 0.12 micrograms/ml against the same isolates.

Sex Transm Dis, 1984 Oct-Dec, 11(4 Suppl), 420 - 2
Minute treatment with thiamphenicol in water for acute gonococcal urethritis in male patients; Belda W et al.; Eighty-two male patients with acute gonococcal urethritis were given a single oral dose of 2.5 g of granulated thiamphenicol dissolved in water, and the results of treatment were evaluated after 48-72 hr and one week . Of the 76 patients who returned for the first follow-up examination, 75 (98.7%) no longer had Neisseria gonorrhoeae in urethral smears or cultures . Five of these patients did not return for the second follow-up examination, and another four who did return were found to be reinfected as a result of reexposure . Of the remaining 67 patients, 66 (98.5%) no longer had N . gonorrhoeae in urethral smears or cultures . Thus, the overall success rate among the 71 patients who completed the study (with the four cases of reinfection considered instances of failure of therapy) was 93% . The ease of administration, absence of adverse reactions, low failure rate, and low incidence of residual urethral secretions (4.5%) justify the use of thiamphenicol as the drug of choice for the treatment of acute gonococcal urethritis in male patients.

Sex Transm Dis, 1984 Oct-Dec, 11(4 Suppl), 418 - 9
Thiamphenicol in the treatment of male gonococcal urethritis: a study of 1,230 cases; Belda W et al.; Thiamphenicol, an aminic derivative of hydrocarbilsulfonylpropandiol, was used for the treatment of acute, uncomplicated, gonococcal urethritis in 1,446 male patients . Each patient received one oral dose of 2.5 g of thiamphenicol, which was readministered after 48-72 hr if Neisseria gonorrhoeae continued to be present in urethral smears . Of the 1,446 patients treated, 1,230 patients underwent posttreatment evaluation at 48-72 hrs and at seven days . Twenty-eight patients (2.3%) did not respond to treatment; treatment was successful in 1,140 patients (92.7%) after only one dose, and in 62 (5.0%) after two doses . The overall rate of treatment success was 97.7% . Of 352 patients evaluated one month after treatment, serologic tests in 41 (12.6%) were positive for syphilis.

Sex Transm Dis, 1984 Oct-Dec, 11(4 Suppl), 410 - 3
Treatment of Neisseria gonorrhoeae infections in men with single-dose thiamphenicol; Oriel JD et al.; A group of 50 men with uncomplicated gonococcal infections were treated with single, oral doses of 2.5 g of thiamphenicol . Reexamination, which included culture for Neisseria gonorrhoeae, was performed three to four days and seven days after treatment . Thirty-two (91%) of 35 men with urethral infections, 13 (87%) of 15 with rectal infections, and four (57%) of seven with pharyngeal infections were cured . None of the men from whom N . gonorrhoeae was reisolated admitted further sexual exposure . Treatment failure did not correlate with decreased sensitivity of the isolates to thiamphenicol in vitro . Three men had urethral infections with Chlamydia trachomatis before therapy, and the organism was reisolated after therapy in every case . No hematologic abnormalities occurred in any of the 50 patients treated with thiamphenicol, but 13 (26%) developed adverse gastrointestinal symptoms.

Sex Transm Dis, 1984 Oct-Dec, 11(4 Suppl), 376 - 8
Treatment of gonorrhea with single-dose thiamphenicol in Kenya; Nsanze H et al.; The efficacy of a single 2.5-g dose of thiamphenicol against infection with penicillinase-producing strains of Neisseria gonorrhoeae (PPNG) or non-penicillinase-producing strains (non-PPNG) was studied in a two-phase clinical trial in Nairobi . The first phase included men who had had a urethral discharge for less than seven days, were infected with either PPNG or non-PPNG, and had not received previous treatment . The second phase included men with PPNG infections that had not responded to treatment with penicillin . The overall cure rate (determined by follow-up examinations and cultures three and ten days after treatment) was 90.6% in the first phase of the study and 92.1% in the second phase . A second 2.5-g dose of thiamphenicol was administered to four of the six patients in the second phase whose cultures yielded gonococci after the initial dose; the infections of all four patients were cured . The results of disk diffusion tests of gonococcal isolates did not correlate well with the outcome of treatment.

Sex Transm Dis, 1984 Oct-Dec, 11(4 Suppl), 364 - 5
Plasmid patterns and in-vitro susceptibility of penicillinase-producing Neisseria gonorrhoeae with emphasis on thiamphenicol: results of surveillance in The Netherlands; van Klingeren B et al.; Susceptibility to thiamphenicol was tested, and plasmids were characterized for 1925 strains of penicillinase-producing Neisseria gonorrhoeae (PPNG) isolated in The Netherlands in 1981 and 1982 . Of the 1925 isolates, 771 harbored the so-called "Asia" (4.5-megadalton) resistance plasmid and 1154 had the so called "Africa" (3.2-megadalton) plasmid . Isolates in the first group were usually inhibited by 0.25 microgram of thiamphenicol ml, while the MIC for the latter isolates was 1-2 micrograms/ml . A similar bimodal distribution of MICs has been observed for non-PPNG isolates . In the period covering this study, a substantial shift from predominance of the "Africa" type to that of the "Asia" type of N . gonorrhoeae was observed.

Sex Transm Dis, 1984 Oct-Dec, 11(4 Suppl), 360 - 3
In-vitro susceptibility of Neisseria gonorrhoeae to thiamphenicol: results for selected groups of strains from different geographic areas and from different times; Lind I; The aim of this study was both to investigate the in-vitro susceptibility to thiamphenicol of Neisseria gonorrhoeae strains isolated at different times in different geographic areas and to compare results of susceptibility testing by the agar-dilution method with those of an agar disk-diffusion test . For 209 strains studied, a strong correlation between MIC values and zone diameters could be demonstrated (Spearman Rank correlation coefficient, -0.77; P less than 0.0005) . The total material consisted of 727 selected gonococcal strains: 184 from Denmark (1928-1982), 55 from Africa (1960-1966), 47 from France (1981-1982), 236 from Greenland (1982), and 205 from Indonesia (1982) . Danish strains from the preantibiotic era (1928-1940) were all susceptible to less than or equal to 1.0 microgram of thiamphenicol/ml . In 1982, the less susceptible strains (MIC, greater than or equal to 2 micrograms/ml; or zone diameter, less than or equal to 45 mm) accounted for 5% (Denmark), 28% (Greenland), 28% (France), and 82% (Indonesia), respectively . All non-penicillinase-producing strains of N . gonorrhoeae that were less susceptible to thiamphenicol were also less susceptible to penicillin (MIC, greater than or equal to 0.6 microgram/ml).

Sex Transm Dis, 1984 Oct-Dec, 11(4), 312 - 3
Single-site infection with Neisseria gonorrhoeae in homosexual men; Carlson BL et al.; To determine need to culture multiple anatomic sites of homosexual men, we examined 1803 cultures from 791 men who had positive cultures for Neisseria gonorrhoeae from one or more sites . The men were examined during fiscal year 1982 at a health center that serves the gay community . Not included are 184 patients who had positive cultures from the only site tested . Of the 607 patients cultured from two or more anatomic sites, 34 (5.6%) had cultures positive for N . gonorrhoeae from each site, and 492 (81.1%) had N . gonorrhoeae isolated from one site only . Of these 492 patients, 36 (7.3%) had positive cultures from the oropharynx only, 232 (47.2%) from the urethra only, and 224 (45.5%) from the anal canal only . Of 405 patients cultured from the urethra, anal canal, and oropharynx, 92 (22.7%) had N . gonorrhoeae at two or more sites; 313 (77.3%) had the organism at one site only . Of 84 patients cultured from the anal canal and oropharynx only, 11 (13.1%) had positive cultures from the oropharynx and negative cultures from the anal canal . Since it is highly improbable that the infected site will be selected if only one site is cultured, routine culturing of the urethra, anal canal, and oropharynx of homosexual men is necessary for accurate diagnosis.

Sex Transm Dis, 1984 Oct-Dec, 11(4), 308 - 11
In vitro susceptibility of Neisseria gonorrhoeae to cefuroxime, penicillin, and tetracycline in Denmark-1979; Bollerup AC; In vitro susceptibility to cefuroxime, penicillin, and tetracycline of 963 strains of Neisseria gonorrhoeae strains isolated in Denmark in 1979 was tested . If penicillinase-producing strains of N . gonorrhoeae were excluded from the analysis, a significant positive correlation between the 50% inhibitory concentrations (IC50) of cefuroxime and penicillin was observed (r = 0.87) . Among strains exhibiting IC50 of penicillin of greater than or equal to 0.30 microgram/ml, 80% (106/133) had an IC50 of cefuroxime of greater than or equal to 0.088 . Ninety-six per cent (106/110) of strains exhibiting an IC50 of cefuroxime of greater than or equal to 0.088 microgram/ml were less susceptible to penicillin (IC50, greater than or equal to 0.30 microgram/ml) . The IC50 values of tetracycline were positively correlated with those of cefuroxime . There was no apparent difference between the level of antimicrobial susceptibility of strains (623) isolated from urogenital sites and that of strains (109) from the pharynx.

Sex Transm Dis, 1984 Oct-Dec, 11(4), 301 - 3
Urine as a holding medium for Neisseria gonorrhoeae; Rosey CE et al.; An earlier technique for culturing of Neisseria gonorrhoeae from uncentrifuged first-voided urine from males demonstrated a sensitivity of 92-99% as compared with the gram stain of urethral exudate and the urethral swab culture . In this study the utility of urine as a holding medium for N . gonorrhoeae was tested . Determination of a reliable minimal survival time for N . gonorrhoeae in urine was made by collection of 2-60 ml of first-voided urine prior to treatment from 97 men known to have genitourinary gonorrhea . The urine specimens were held at room temperature (approximately 22 C), while separate modified Thayer-Martin culture plates were inoculated from each specimen immediately after collection and at carefully timed intervals up to 48 hr afterward . N . gonorrhoeae was recovered from 95% of the urine specimens for up to 12 hr after the specimens were collected.

Can J Microbiol, 1984 Oct, 30(10), 1297 - 301
A role for sulfite in inducing surface changes in Neisseria gonorrhoeae; Norrod EP; Addition of pyruvate to growth medium failed to induce the changes in Neisseria gonorrhoeae that have been reported previously . Addition of 3.8 mM sulfite or 1.3 mM sulfite plus 14 mM pyruvate restored the medium's reactivity in a test for cysteine and its ability to induce changes in N . gonorrhoeae . The induced changes that were restored were (i) increased colonial opacity and roughness, (ii) increased sensitivity to killing by normal human serum, and (iii) electrophoretic changes that may represent changes in lipopolysaccharide . Further characterization of the electrophoretic changes showed that the bands were resistant to treatment with proteinase K, that they were not affected by EDTA and urea, and that they were not dependent upon the stage of growth.

Jpn J Antibiot, 1984 Oct, 37(10), 1773 - 9
{Bacteriological and clinical evaluation of the effect of azthreonam on gonorrheal urethritis in man}; Okazaki T; Thirty male patients with gonorrheal urethritis were treated with azthreonam at the urological ward of Tokyo Metropolitan Taito Hospital during the period from January to March, 1984, and clinically evaluated . Sixty-one strains of Neisseria gonorrhoeae isolated from the clinical specimens including those of the patients were bacteriologically studied . Of the 61 strains, 9 (15%) were PPNG strains and the other 52 strains were non-PPNG strains . MICs of PCG to the 9 PPNG strains were 3.13--50 micrograms/ml and to the 52 non-PPNG strains were 0.024--3.13 micrograms/ml . While MICs of azthreonam to the PPNG strains were 0.024--0.20 micrograms/ml and to the non-PPNG strains were 0.0122--0.78 micrograms/ml . Those patients with gonorrheal urethritis were given a single 1 g intramuscular dose of azthreonam . The following clinical findings were obtained: The clinical efficacy rate of 30 cases was 100%; excellent in 16, good in 14 cases . All 2 patients with gonorrheal urethritis caused by PPNGs were cured with the treatment . No subjective side effects were found.

Postgrad Med J, 1984 Oct, 60(708), 691 - 2
Asymptomatic gonorrhoea in a male patient; Chattopadhyay B et al.; A case of asymptomatic gonorrhoea in a male patient is described . Failure to isolate Neisseria gonorrhoea from his wife possibly demonstrates inhibitory effect of Candida albicans in vivo on the former organism.

J Med Microbiol, 1984 Oct, 18(2), 271 - 6
Comparison of microscopy, culture and enzyme immunoassay (Gonozyme) for the detection of Neisseria gonorrhoeae in urogenital specimens; Sobczak H et al.; Urogenital specimens of male patients and female prostitutes were examined for gonorrhoea in a gonococcal antigen enzyme immunoassay (Gonozyme), by microscopic examination of stained smears and by bacterial culture . Out of 18 male patients, 14 showed positive reactions (all 14 by Gonozyme and by microscopy, but only eight by culture also) . The sensitivity and specificity of Gonozyme was 100% in reference to microscopy . The predictive value for a positive test and for a negative test was 100% . The sensitivity of Gonozyme in reference to culture was also 100%, but the specificity was only 40%, because of the low yield of positive cultures . The predictive value for a positive test was 57% and for a negative test 100% . Out of 189 female prostitutes, 41 (22%) had a positive reaction in at least one test (Gonozyme, microscopy and culture were positive in 10; Gonozyme and culture in three; Gonozyme and microscopy in 14; Gonozyme alone in 11; culture alone in three) . The sensitivity of Gonozyme was 100% and specificity 92% in reference to microscopy . The predictive value for a positive test was 63% and for a negative test 100% . In reference to culture, the sensitivity was 81% and specificity 86% . The predictive value for a positive test was 34% and for a negative test 98% . In prostitutes, the rate of asymptomatic infections was 14%, if one assumed that all Gonozyme-positive results were truly positive . Gonozyme proved to be the most sensitive method for screening female patients . To discriminate possibly false positive reactions, Gonozyme-positive specimens should be corroborated, preferably by bacterial cultivation.

J Clin Microbiol, 1984 Oct, 20(4), 828 - 30
Comparison of microdilution and agar dilution procedures for testing antibiotic susceptibility of Neisseria gonorrhoeae; Shapiro MA et al.; Studies were run in parallel to compare the broth microdilution method and the chocolate agar dilution method for testing antibiotic susceptibility of Neisseria gonorrhoeae . Six clinically relevant drugs were tested against 23 clinical isolates of N . gonorrhoeae, including several penicillinase-producing, as well as multiply resistant, strains . Results showed that the MIC obtained by the two methods were not significantly different . The microdilution method appears to be a more sensitive system for discriminating penicillinase activity . The microdilution system is a more expedient method for screening new antibacterial agents and is more readily adaptable to new automated equipment.

J Clin Microbiol, 1984 Oct, 20(4), 680 - 3
Evaluation of Gonochek-II as a rapid identification system for pathogenic Neisseria species; Welborn PP et al.; The Gonochek-II test kit (E-Y Laboratories, San Mateo, Calif.) may be used to rapidly identify (within 30 min) Neisseria gonorrhoeae, Neisseria meningitidis, Neisseria lactamica, and Branhamella catarrhalis . The kit consists of oxidase swabs, chromogenic substrates, and EY-20 reagent (diazonium salt derivative) . A beta-lactamase tube is also included . Fifty-two clinical isolates were tested from cervical (22 isolates), urethral (13), throat (11), rectal (5), and urine (1) sources . All strains were oxidase-positive, gram-negative diplococci isolated on Thayer-Mayer plates incubated at 35 degrees C in 5% CO2 for 18 to 24 h . Each strain was tested by Gonochek-II, RapID NH (Innovative Diagnostics, Decatur, Ga.), and conventional rapid carbohydrate utilization . Forty-four isolates of N . gonorrhoeae and six N . meningitidis were identified . Only two isolates tested (4%) were identified as species other than these two . Gonochek-II outperformed all other methods for identification of N . gonorrhoeae from cervical and urethral areas . N . meningitidis strains were correctly identified in all cases . Ease and rapidity of the procedure, coupled with a small inoculum requirement and reliable results, led us to favor Gonochek-II for routine identification of pathogenic Neisseria species.

J Clin Microbiol, 1984 Oct, 20(4), 641 - 3
Modified enzyme immunoassay for detecting Neisseria gonorrhoeae antigens; Papasian CJ et al.; A commercial modification of an enzyme immunoassay (EIA) (Gonozyme; Abbott Laboratories, North Chicago, Ill.) for detection of Neisseria gonorrhoeae antigens was compared with conventional culturing . Specimens from males and females were collected at a sexually transmitted disease clinic; additional female specimens were collected at an obstetrics and gynecology clinic . EIA sensitivity and specificity for males were 100 and 98.6%, respectively (68 negative, 34 positive, 1 false-positive, and 0 false-negative) . EIA sensitivity and specificity for female sexually transmitted disease clinic patients were 74.4 and 95.7%, respectively (66 negative, 29 positive, 3 false-positive, and 10 false-negative) EIA sensitivity and specificity for obstetrics and gynecology clinic patients were 100 and 99.2%, respectively (6 positive, 119 negative, 1 false-positive, and 0 false-negative) . In female patients from whom multiple swab specimens were collected, the sequence of specimen collection and subsequent EIA analysis affected sensitivity.

J Adolesc Health Care, 1984 Oct, 5(4), 272 - 6
Perihepatitis (Fitz-Hugh--Curtis syndrome) . A review and case presentation; Ris HW; Perihepatitis, or Fitz-Hugh--Curtis syndrome (FHC), is a complication of pelvic inflammatory disease (PID) . Although though in the past Neisseria gonorrhoeae was thought to be the only etiological agent, recent data indicate that chlamydia trachomatis can produce the syndrome . Because cervical cultures frequently fail to demonstrate the presence of C . trachomatis, the serologic microimmunofluorescence antibody test is essential to diagnosis; the antibody titer in FHC syndrome is markedly higher than in PID without FHC syndrome . The classic presenting symptom of perihepatitis is severe right upper quadrant abdominal pain . If unnecessary diagnostic and surgical procedures are to be avoided, the FHC syndrome in the sexually active young woman must be included in the differential diagnosis of abdominal pain irrespective of its location . To illustrate the diagnosis and management of the FHC syndrome caused by C . trachomatis, a case of a 16-year-old adolescent female is presented.

Br J Vener Dis, 1984 Oct, 60(5), 316 - 8
Activity of ciprofloxacin against genital tract pathogens; Hart CA et al.; The in vitro activity of the quinolone carboxylic acid, ciprofloxacin, against a variety of genital tract pathogens was examined . Each of 35 isolates of Neisseria gonorrhoeae, including some beta-lactamase producing strains and strains resistant to tetracycline, was inhibited at a concentration of 0.01 mg/l . Most (13 of 20) strains of Gardnerella vaginalis were inhibited at 1 mg/l but three isolates had minimum inhibitory concentrations (MICs) of 8 mg/l or more . Each of seven strains of Chlamydia trachomatis was completely inhibited at a concentration of 2 mg/l . Prolonged (72 hours) exposure of the chlamydiae to ciprofloxacin was required for inhibition at this concentration.

Br J Vener Dis, 1984 Oct, 60(5), 302 - 5
Serogrouping Neisseria gonorrhoeae: correlation of coagglutination serogroup WII with homosexually acquired infection; Reid KG et al.; With coagglutination reagents prepared against W antigens, 205 clinical isolates of Neisseria gonorrhoeae were classified into three serogroups WI, WII, and WIII . Of 195 strains isolated from patients who acquired their infection in the Edinburgh area, 85 (44%) belonged to serogroup WI and 110 (56%) to serogroup WII . Serogroup WII accounted for 90% of all isolates from homosexual men and for 34% and 47% of isolates from heterosexual men and women respectively (p less than 0.001) . In homosexual men serogroup WII predominated regardless of the anatomical site from which the strain was isolated, and accounted for 94% of rectal, 90% of urethral, and 81% of pharyngeal isolates.

Br J Vener Dis, 1984 Oct, 60(5), 298 - 301
Stable serum resistance of Neisseria gonorrhoeae as an epidemiological marker; Lavitola A et al.; Using a simple and rapid microassay, we tested 100 strains of Neisseria gonorrhoeae isolated from 81 patients (41 men and 40 women) for their sensitivity to killing by normal human serum (NHS) . The reproducibility of the test was good when the bactericidal end points were taken as the dilution of fresh NHS that killed more than 95% of the test organisms . The bactericidal end points of strains isolated either from different anatomical sites or from sexual partners correlated well with the levels of sensitivity to serum of corresponding isolates, as well as with auxotypes . When the strains were not highly resistant to killing by NHS, this marker gave a precise definition of each strain and permitted the differentiation of isolates belonging to common auxotypes.

J Bacteriol, 1984 Oct, 160(1), 288 - 93
Mutagenesis of Neisseria gonorrhoeae: absence of error-prone repair; Campbell LA et al.; The lethal and mutagenic effects of various mutagens on Neisseria gonorrhoeae were investigated . Lethality studies demonstrated that N . gonorrhoeae was relatively sensitive to ethyl methanesulfonate, UV light, and methyl methanesulfonate . Although N . gonorrhoeae was readily mutated by ethyl methanesulfonate and N-methyl-N'-nitro-N-nitrosoguanidine for the three genetic markers assayed, no increase in the mutation frequency was observed for any of the selective markers after UV irradiation or methyl methanesulfonate treatment . These results suggest that N . gonorrhoeae lacks an error-prone repair mechanism.

Infect Immun, 1984 Oct, 46(1), 176 - 81
Anaerobic growth of Neisseria gonorrhoeae coupled to nitrite reduction; Knapp JS et al.; A total of 204 Neisseria gonorrhoeae strains, including 39 penicillinase-producing strains, representing 64 distinct auxotype and serovar classes were tested for their ability to grow anaerobically with nitrite as a terminal electron acceptor . All strains grew anaerobically with subtoxic concentrations of nitrite, and all penicillinase-producing strains produced beta-lactamase when grown anaerobically . Nitrite reductase was produced constitutively under aerobic conditions in the absence of nitrite, and cytochrome oxidase was produced constitutively under anaerobic conditions . Strains could not grow anaerobically with sulfite as a terminal electron acceptor . Strain NRL 905 grew anaerobically in broth medium containing nitrite at a rate comparable to its growth rate under aerobic conditions . The feasibility and significance of in vivo anaerobic growth of N . gonorrhoeae is discussed.

Am J Clin Pathol, 1984 Oct, 82(4), 461 - 5
Detection of Neisseria gonorrhoeae in cervical swabs using the Gonozyme enzyme immunoassay . Clinical evaluation in a university family planning clinic; Nachamkin I et al.; PIP: The authors performed a prospective, clinical evaluation of the Gonozyme assay in a family planning clinic population . 1588 female patients were screened for gonococcal infection using culture and Gonozyme assay . 109 patients were culture positive (6.9% disease prevalence) . The sensitivity and specificity of the Gonozyme assay in this setting was 87.2% and 89.1% respectively . The predictive value of a positive and negative test, given a disease prevalence of 6.9%, was 37.2% and 98.9%, respectively . The false positive and false negative rate was 10.9% and 12.8% respectively . The authors prospectively followed patients with true positive and false positive Gonozyme results . The Gonozyme test showed an 83% correlation with test of cure cultures and, thus, should not be used for test of cure analysis . False positive Gonozyme tests could not be explained on the basis of cross-reacting bacteria or detection of vancomycin sensitive gonococci . Results suggest that the Gonozyme test should not be used in lieu of culture in a clinical setting with a similar population . author's modified

Hautarzt, 1984 Oct, 35(10), 512 - 6
{Gardnerella vaginalis infection--another sexually transmitted disease}; Hartmann AA et al.; The Gardnerella vaginalis infection of the urogenital tract, an STD, is of clinical importance in females and of epidemiological importance in males . Females suffer from vulvovaginitis amine colpitis, with a bad-smelling grey vaginal discharge with a pH of 5.0-5.5, which contains "clue cells" . The urethra of males is often asymptomatically infected . The identification of G . vaginalis is time-consuming and requires a lot of material . Isolation and identification of G . vaginalis can not yet be made in the routine examination of outpatients suffering from urogenital tract infections . If the diagnosis is based on signs such as bad-smelling grey discharge containing "clue cells", and the increase in pH about 20% false-positive and 20% false-negative results will be obtained . If G . vaginalis is isolated, simultaneous infections with further agents such as Chlamydia trachomatis, Neisseria gonorrhoeae etc., Trichomonas vaginalis, Candida species and HSV 2 should be excluded . Metronidazole (1 g/day for 5 days) is the drug of first choice in G . vaginalis infection.

J Clin Microbiol, 1984 Oct, 20(4), 802 - 5
Enzyme immunoassay for detection of pneumococcal antigen in cerebrospinal fluid; Yolken RH et al.; A solid-phase immunoassay utilizing horse antiserum against the C polysaccharide of Streptococcus pneumoniae and biotinylated rabbit antibodies to type-specific pneumococcal polysaccharides was developed to detect pneumococcal antigens in human body fluids and in broth cultures . Pneumococcal antigen could be detected in broth cultures of serotypes of S . pneumoniae containing as little as 10(2) to 10(3) organisms per ml . The assay system detected pneumococcal antigen in all 25 cerebrospinal fluid specimens obtained from patients with documented pneumococcal meningitis . There were no positive reactions noted in specimens from patients infected with Neisseria meningitidis group A or from patients without evidence of bacterial infection . The solid-phase enzyme immunoassay utilizing these reagents is a sensitive and specific assay for the immunodetection of a wide range of pneumococcal antigens.

Sex Transm Dis, 1984 Oct-Dec, 11(4 Suppl), 404 - 6
Single-dose treatment of uncomplicated gonorrhea in men with intramuscular and oral thiamphenicol; Panikabutra K et al.; Each of 200 men with uncomplicated gonococcal urethritis was randomly assigned to a group receiving one of two therapeutic regimens . Group A received 2 g of spectinomycin intramuscularly . Group B received 2.5 g of thiamphenicol, with 500 mg administered intramuscularly just after oral administration of 2 g . Of the 89 patients in group A who completed the study, 32 were infected with penicillinase-producing Neisseria gonorrhoeae, 49 with non-penicillinase-producing N . gonorrhoeae, and eight with gonococcal strains not tested for penicillinase production . Infection was cured in all 89 patients . Of the 91 patients in group B who completed the study, 33 were infected with penicillinase-producing N . gonorrhoeae, 54 with non-penicillinase-producing N . gonorrhoeae, and four with gonococcal strains not tested for penicillinase production . Infection was cured in 86 (94.5%) of the 91 patients . Thus, the single-dose regimen of thiamphenicol was effective against uncomplicated infections caused by either penicillinase-producing or non-penicillinase-producing strains of N . gonorrhoeae.

Sex Transm Dis, 1984 Oct-Dec, 11(4 Suppl), 386 - 90
Comparison of thiamphenicol and spectinomycin in the treatment of uncomplicated gonorrhea in men; Kim JH; Thiamphenicol (2.5 g perorally) was compared with spectinomycin (2.0 g im) in the treatment of uncomplicated gonococcal urethritis in men . Patients were selected on the basis of cultures positive for Neisseria gonorrhoeae and were randomly assigned to one of the treatment regimens . Test-of-cure cultures were done three to five days after treatment . Beta-lactamase activity of every isolate was tested . In the group treated with thiamphenicol, 152 patients were followed; 63 (41.4%) failed to be cured, while the spectinomycin regimen gave a cure rate of greater than 95% . Penicillinase-producing strains gave a greater rate of failure than non-penicillinase-producing strains . The strains of N . gonorrhoeae isolated in Seoul had high minimal inhibitory concentrations of various antibiotics . About 48% of strains had a MIC of greater than or equal to 2 micrograms of thiamphenicol/ml . Hematologic examinations, repeated on days 0, 3-5, 10, and 30 of treatment, revealed no appreciable toxicity following the thiamphenicol regimen.

Sex Transm Dis, 1984 Oct-Dec, 11(4 Suppl), 382 - 5
Thiamphenicol in the treatment of gonococcal infections: a comparative trial with penicillin and spectinomycin; Tupasi TE et al.; The efficacy of thiamphenicol for treatment of uncomplicated gonococcal infection was compared with that of penicillin and spectinomycin in 370 women confined in the clinic to preclude reinfection before evaluation of treatment . Thiamphenicol (2.5 g perorally) was highly effective against beta-lactamase-producing Neisseria gonorrhoeae, but the failure rate in infections with non-beta-lactamase-producing N . gonorrhoeae was high . This rate was not, however, significantly higher than that for beta-lactamase-producing strains . The failure rate with thiamphenicol was significantly higher than that with spectinomycin (2 g im) in the treatment of infections due to beta-lactamase-producing N . gonorrhoeae but was essentially similar to that observed with aqueous procaine penicillin G (4.8 X 10(6) units im) plus probenecid (1 g perorally) among non-beta-lactamase-producing N . gonorrhoeae . Therefore thiamphenicol may be used as an alternative therapy for gonorrhea, especially for infections due to beta-lactamase-producing strains.

Sex Transm Dis, 1984 Oct-Dec, 11(4 Suppl), 373 - 5
Introductory address: gonorrhea today; Stolz E; The counterattack to the resurgence of one of the commonest infectious diseases, gonorrhea, still consists of epidemiologic measures, correct clinical and microbiological diagnosis, and effective treatment . Few antibiotics effective against Neisseria gonorrhoeae fulfill the criteria of the World Health Organization (i.e., the antibiotic should be effective, safe, free from side effects, capable of aborting simultaneously acquired or coexisting infection with Treponema pallidum or Chlamydia trachomatis, should entail a low incidence of postgonococcal urethritis, and should not be the sole antibiotic used for other, more serious conditions) . Therefore, current attention is focused on the use of thiamphenicol for the treatment of uncomplicated urogenital, rectal, and oropharyngeal gonorrhea caused by both beta-lactamase-producing and non-beta-lactamase-producing Neisseria gonorrhoeae.

Antimicrob Agents Chemother, 1984 Oct, 26(4), 608 - 9
In vitro activities of the spectinomycin analog U-63366 and four quinolone derivatives against Neisseria gonorrhoeae; Peeters M et al.; The in vitro activities of the new spectinomycin analog U-63366 and four new quinolone derivatives, rosoxacin, norfloxacin, ofloxacin, and ciprofloxacin, were compared with those of penicillin, tetracycline, thiamphenicol, cefotaxime, ceftriaxone, and spectinomycin against 222 beta-lactamase-negative and 25 beta-lactamase-positive Neisseria gonorrhoeae strains . U-63366 was more active than spectinomycin, inhibiting 90% of the strains at a concentration of 2 mg/liter . Among the quinolone derivatives, ciprofloxacin was the most active compound in vitro (90% MIC, 0.002 mg/liter), followed by ofloxacin (90% MIC, 0.008 mg/liter), norfloxacin (90% MIC, 0.015 mg/liter), and rosoxacin (90% MIC, 0.03 mg/liter).

Scand J Immunol, 1984 Oct, 20(4), 291 - 7
Factor I deficiency and C3 nephritic factor: immunochemical findings and association with Neisseria meningitidis infection in two patients; Teisner B et al.; The complement system was examined in two patients with systemic Neisseria meningitidis infections, both of whom had reduced or nondetectable CH50 as analysed by both pathways . C3 measured by conventional technique revealed 19% anti-C3c-reactive protein in the plasma of patient 1 and 3% in patient 2 . Patient 1 had circulating C3b but no detectable C3c, C3d, or C4d, whereas patient 2 had normal levels of C3c and C4d and strongly elevated levels of C3d . Factor B analysis revealed no demonstrable native factor B and small amounts of Bb in patient 1 and normal concentration of native factor B plus trace amounts of Bb in patient 2 . The depletion of C3 in both patients was due to uncontrolled activation caused by complete factor I deficiency (patient 1) and circulating C3 nephritic factor (patient 2) . Both parents of patient 1 had factor I concentrations below (mean-2 SD) that seen in normal healthy individuals (n = 20) . Circulating immune complexes (IC) were demonstrated in patient 1 only, whereas serum from both patients had strongly reduced capacity to solubilize preformed IC.

J Clin Microbiol, 1984 Oct, 20(4), 742 - 6
Evaluation of Gonozyme, an enzyme immunoassay for the rapid diagnosis of gonorrhea; Manis RD Jr et al.; A new indirect enzyme immunoassay (EIA), Gonozyme (Abbott Laboratories), was assessed for rapid detection of gonococcal antigens . A correlation of optic density (OD) readings by EIA with colony counts of serial dilutions of Neisseria gonorrhoeae ATCC 19424 disclosed that EIA detected 10(3) CFU/ml at OD readings of 0.1 to 0.3, that EIA consistently detected greater than or equal to 10(4) CFU/ml at OD readings of 0.6 to 1.3, and that concentrations of greater than or equal to 10(5) CFU/ml were associated with OD readings of greater than or equal to 2.0 . The clinical usefulness of Gonozyme was evaluated by comparing results of EIA with those of Gram stain (GS) and culture for N . gonorrhoeae from urethral and endocervical swabs obtained prospectively in 886 randomly selected patients attending a clinic for sexually transmitted diseases . The patients evaluated included 83 female contacts of men with gonorrhea and 56 patients seen at the clinic for test of cure . In tests with 295 males, the sensitivities of GS and EIA were 91.3 and 97.1%, respectively, and both tests had specificities of greater than 96% . In tests with 591 females, the sensitivities of GS and EIA were 51.4 and 96.4%, respectively (P less than 0.0001, Z proportionality test), and the specificities were 98.7 and 86.5%, respectively (P less than 0.0001) . In tests with 61 females and 3 males, EIA was positive, whereas GS and cultures were negative for N . gonorrhoeae . Gonozyme is a highly sensitive method for rapid detection of gonococcal antigens . EIA is comparable to GS for males and more sensitive though less specific than GS for females . Possible reasons for the lower specificity of EIA for females are discussed . Due to its high negative predictive value for female contacts, EIA offers an alternative to epidemiological treatment of contacts before culture results.

Infect Immun, 1984 Oct, 46(1), 202 - 12
Analyses of gonococcal lipopolysaccharide in whole-cell lysates by sodium dodecyl sulfate-polyacrylamide gel electrophoresis: stable association of lipopolysaccharide with the major outer membrane protein (protein I) of Neisseria gonorrhoeae; Hitchcock PJ; The lipopolysaccharide (LPS) of Neisseria gonorrhoeae whole-cell lysates and proteinase K-digested lysates was examined and compared with purified homologous LPS by a method which preferentially stains LPS in polyacrylamide gels . The silver-stained profile of gonococcal LPS in the proteinase K-digested lysate was similar to that of homologous purified LPS; however, the LPS profile in whole-cell lysates was much smaller than that of digested lysates or purified LPS . Conditions of solubilization did not affect these differences . Since it is known that LPS migrates in a unique fashion in second-dimension electrophoresis, the location of LPS in the whole-cell lysates was probed by second-dimension sodium dodecyl sulfate-polyacrylamide gel electrophoresis with a variety of stains and radiolabels . Results from these experiments indicated a stable and reproducible association of LPS with proteins ranging between 23,000 to 36,000 in Mr, in particular major outer membrane protein I . In addition to staining with the silver method, which preferentially stains LPS, the putative LPS was resistant to digestion by proteinase K, did not stain with Coomassie brilliant blue, and was not labeled extrinsically with 125I (Iodogen method) or intrinsically with {35S}methionine . Analysis of two-dimensional gels by immunoblotting with rabbit antisera prepared from protein I bands removed from a polyacrylamide gel revealed the presence of antigens in the same area of the gel (below proteins that were 23,000 to 36,000 in Mr) . Antibodies to constituents which migrated below the diagonal were essentially removed by adsorption of antisera with purified LPS, as were antibodies to homologous LPS and LPS in proteinase K-digested whole-cell lysates . Immunoblotting with a monoclonal antibody specific for LPS demonstrated reactivity of the antibody with LPS and with the protein I band . On the basis of these data, we conclude that protein I and perhaps other proteins in the whole-cell lysate are stably associated with LPS; this complex is resistant to dissociation in sodium dodecyl sulfate at high temperature (approximately 100 degrees C) but does, for unknown reasons, dissociate with electrophoresis in the second dimension . The association of LPS with protein antigens in sodium dodecyl sulfate-polyacrylamide gels adds another dimension of complexity to analysis of these antigens by immunoelectroblotting . Furthermore, the tight association of LPS with the major outer membrane protein I may alter the nature of the immune response generated by "purified" protein I vaccine antigens . The possible role of protein-LPS complexes in the pathogenesis of gonorrhea is discussed.

Proc Natl Acad Sci U S A, 1984 Oct, 81(19), 6110 - 4
Pilus genes of Neisseria gonorrheae: chromosomal organization and DNA sequence; Meyer TF et al.; We have mapped two regions of the Neisseria gonorrheae genome, pilE1 and pilE2, which are involved in pilus expression . When the cells are in the piliated P+ state, these two loci carry sequences necessary for pilin production . A silent locus, pilS1, also maps near pilE1 and pilE2 . pilS1 contains structural gene information but lacks pilus promoter sequences . The pilus gene sequences in pilE1 and pilE2 are identical in strain MS11.

Sex Transm Dis, 1984 Oct-Dec, 11(4 Suppl), 379 - 81
Comparative study of treatment of uncomplicated gonorrhea with thiamphenicol and cefotaxime; Notowicz A et al.; Results of treatment of uncomplicated urogenital gonorrhea caused by penicillinase- and non-penicillinase-producing Neisseria gonorrhoeae were compared . In The Hague treatment consisted of thiamphenicol (2.5 g given orally), whereas the treatment in Rotterdam was cefotaxime (1 g given im) . All isolates were tested for production of penicillinase and sensitivity to cefotaxime and thiamphenicol . Special attention was given to possible hematological effects of treatments with thiamphenicol . Of 55 patients treated with thiamphenicol, 87.3% were cured; however, all of 55 patients treated with cefotaxime were cured . The frequency of postgonococcal urethritis among male patients was 34.1% after thiamphenicol and 39.5% after cefotaxime treatment . The only adverse effect seen after cefotaxime treatment was a rash (2%) . After treatment with thiamphenicol, 10.9% of patients had diarrhea . No significant changes in hematologic tests were seen after treatment with thiamphenicol . There was a remarkable and significant difference in sensitivity to thiamphenicol between the two treatment groups; this fact could point to the importance of specific local factors in comparison of different treatments for gonorrhea.

Sex Transm Dis, 1984 Oct-Dec, 11(4), 314 - 7
A comparison of penicillin G plus a beta-lactamase inhibitor (sulbactam) with spectinomycin for treatment of urethritis caused by penicillinase-producing Neisseria gonorrhoeae; Crider SR et al.; When combined with penicillin, sulbactam, a beta-lactamase inhibitor with weak intrinsic antibacterial activity, produces a marked synergistic effect in vitro against penicillinase-producing Neisseria gonorrhoeae . We compared a regimen of aqueous procaine penicillin G, sulbactam, and probenecid with spectinomycin for the treatment of uncomplicated gonococcal urethritis . Of 101 patients receiving the penicillin-sulbactam regimen, 97 (97%) were cured of their infection, as were 87 (95%) of 92 patients who received spectinomycin . Fifty per cent of patients were infected with penicillinase-producing N . gonorrhoeae; 43 (94%) of 46 treated with the penicillin-sulbactam regimen were cured as compared with 47 (92%) of 51 treated with spectinomycin . Neither regimen was associated with serious adverse effects . The results show that aqueous procaine penicillin G given with sulbactam and probenecid is an effective alternative for single-session therapy of urethritis caused by penicillinase-producing N . gonorrhoeae.

Acta Pathol Microbiol Immunol Scand {B}, 1984 Oct, 92(5), 271 - 8
Restriction endonuclease fingerprinting of chromosomal DNA of Neisseria gonorrhoeae; Falk ES et al.; Twenty gonococcal isolates representing different serovars of the protein IA & IB serogroups, as determined by co-agglutination with monoclonal antibodies, were investigated by the restriction enzyme (RE) technique with Hind III enzyme . The patterns resulting from RE digestion and subsequent electrophoresis of the DNA fragments in gel consisted of 40-45 bands . Eight RE patterns were observed among ten of the protein IA strains representing three serovars with an identical pattern for three strains of the same serovar with positive epidemiology . Seven RE patterns were observed among ten of the protein IB strains representing five serovars with identical patterns for each of three pairs with available positive epidemiology for two of them . Seven samples from the same bacterial clone extracted and digested separately showed identical band patterns . The genetic stability was illustrated by identical patterns through 41 passages in vitro and by the same band pattern of the various virulent and avirulent colony morphology variants of a particular gonococcal strain . The results show that RE analysis of the gonococcal DNA genome is well suited as an adjunct to phenotypic markers in epidemiological studies of gonorrhoea.

J Clin Microbiol, 1984 Oct, 20(4), 687 - 90
Differentiation of Neisseria gonorrhoeae from other Neisseria species by use of the restriction endonuclease HaeIII; Torres AR et al.; We used the restriction endonuclease HaeIII to differentiate Neisseria gonorrhoeae from other Neisseria species and Branhamella catarrhalis . A total of 16 clinical isolates and four American Type Culture Collection strains of N . gonorrhoeae were resistant to HaeIII digestion, whereas 17 isolates and four American Type Culture Collection strains from eight different bacterial species were susceptible . This resistance was not caused by an enzyme inhibitor . We propose that protection of the HaeIII recognition sequence by methylation is the mechanism of resistance since N . gonorrhoeae DNA became susceptible to digestion when passed in Escherichia coli as part of a plasmid clone.

Br J Vener Dis, 1984 Oct, 60(5), 331 - 6
Sexually transmitted diseases among randomly selected attenders at an antenatal clinic in The Gambia; Mabey DC et al.; PIP: 100 randomly selected attenders of a free government antenatal clinic in Bakau, Gambia, were examined between November 1981 and February 1982, to discover the prevalence of a variety of sexually transmitted diseases (STDS) . The age, tribal origin, and obstetric history of each patient were recorded . Patients were asked specifically about the presence of lower abdominal pains, vaginal discharge, and pain on passing urine . A vaginal speculum was passed and specimens were taken for Trichomonas vaginalis, Candida albicans, Neisseria gonorrhea, Chlamydia trachomatis, and Herpesvirus hominis . An abnormal vaginal discharge was noted on examination in 67 patients; only 24 of these patients had complained of discharge . The prevalence of infection was 35% with Candida abicans, 32% with Trichomonas vaginalis, 6.9% with Chlamydia trachomatis, 6.7% with Neisseria gonorrhea, and 0% with Herpesvirus hominis . IgG antibodies to H hominis type I were present . At a titre of at least 1.16 in 94% of women tested and to type II in 52.9% tested . author's modified

Br J Vener Dis, 1984 Oct, 60(5), 306 - 8
Antimicrobial susceptibility of Neisseria gonorrhoeae isolated in Durban, South Africa; Coovadia YM et al.; One hundred and forty clinical isolates of Neisseria gonorrhoeae were screened for production of penicillinase by the intralactam strip method and chromogenic cephalosporin test . Minimum inhibitory concentrations (MICs) of penicillin, ampicillin, tetracycline, cefoxitin, cefuroxime, cefotaxime, sulphamethoxazole-trimethoprim (ratio 19/1), and spectinomycin, were measured for 100 strains by the agar dilution method . Seven (5%) of the 140 isolates were identified as penicillinase producing N gonorrhoeae (PPNG) . The MICs of penicillin for the seven PPNG strains ranged from 0 X 25 mg/1 to 2 mg/1 . Of the 93 non-PPNG strains, 80 (86%) were fully susceptible to penicillin with MICs ranging from 0 X 0037 mg/1 to 0 X 06 mg/1 and 13 (14%) were of intermediate penicillin resistance with MICs greater than or equal to 0 X 125 mg/1 . Of the 100 isolates tested, 86% were fully susceptible to tetracycline with MICs of less than 1 mg/1 . No spectinomycin resistant strains were encountered in this study . All gonococcal strains were susceptible to the cephalosporins tested as well as to sulphamethoxazole-trimethoprim.

Sex Transm Dis, 1984 Oct-Dec, 11(4 Suppl), 366 - 70
Susceptibility of Neisseria gonorrhoeae to rifampicin and thiamphenicol: correlation with protein I antigenic determinants; Bygdeman SM et al.; Tests of susceptibility to thiamphenicol and rifampicin were done for 85 strains of Neisseria gonorrhoeae, including 28 beta-lactamase-producing and three spectinomycin-resistant isolates . Strains were serogrouped by co-agglutination with 14 monoclonal antibodies that are specific for different antigenic determinants on protein I of the gonococcal outer membrane . Thus the isolates could be classified into one of the serogroups WI, WII, or WIII and could be subgrouped further into several serovars . The minimal inhibitory concentration (MIC) of thiamphenicol ranged between 0.125 and 4.0 micrograms/ml and that of rifampicin between 0.016 and 4.0 micrograms/ml . All isolates with a MIC of rifampicin of greater than or equal to 0.5 microgram/ml had a MIC of thiamphenicol of greater than or equal to 2.0 micrograms/ml . Decreased susceptibility (thiamphenicol MIC, greater than or equal to 1.0 microgram/ml; rifampicin MIC, greater than or equal to 0.5 microgram/ml) to both drugs was correlated with serogroup WII specificity and also correlated with strains that belonged to serovars characterized by a positive reaction with the WII monoclonal antibody 2G2.

Med J Aust, 1984 Sep 15, 141(6), 337 - 8
Association of genital adenovirus infection with urethritis in men; Harnett GB et al.; Adenoviruses were isolated from the urethral swabs of 129 male patients in an STD clinic . After exclusion of patients with Chlamydia trachomatis or Neisseria gonorrhoea infections, 85 of the remaining 120 patients had urethritis, compared with 28 men with urethritis detected in a control group which was closely matched for age, sex, and date of specimen collection . This statistically significant difference suggests that genital adenovirus infection may be a cause of urethritis in some male patients.

Philos Trans R Soc Lond B Biol Sci, 1984 Sep 6, 306(1129), 419 - 30
Inherited complement deficiencies; Lachmann PJ; Isolated genetic deficiencies of individual components of the complementary system have been described in man for all the components of the classical pathway and the membrane attack complex as well as for Factor I, Factor H and properdin . It is only for Factor B and Factor D of the alternative pathway that homozygous deficiency states are not so far known . Complement deficiency states provide the most direct way of looking at the role of the complement system in vivo and emphasize the importance of complement in resistance to bacterial infection and in particular to infection with Neisseria . This association is not unexpected since in vitro studies have shown complement to be an efficient enhancer of phagocytosis and inflammation . The particularly frequent occurrence of neisserial infection may be ascribed to the ability of these organisms to survive in phagocytic cells so that the plasma cytolytic activity provided by complement is needed to kill them . On the other hand the strong association between complement deficiencies and immune-complex diseases--especially systemic lupus erythematosus--was unexpected and seems paradoxical in view of the large part played by complement in the pathogenesis of immune complex mediated tissue damage . The paradox can be explained in part by the necessity for an intact complement system in the solubilization and the proper handling of immune complexes . It is also likely that complement deficiency can allow the persistence of low virulence organisms that produce disease solely by an immune complex mechanism . Recently described deficiencies of complement receptors and their effects in vivo are described.

Southeast Asian J Trop Med Public Health, 1984 Sep, 15(3), 360 - 3
Rifampicin-erythromycin combination for the treatment of gonococcal urethritis in men; Desudchit P et al.; A total of 184 men with uncomplicated gonococcal urethritis were treated with a single oral dose of rifampicin 900 mg and erythromycin stearate 1 gm . The cure rate on day 3 was 95.1%, 175 were cured and 9 failed (4.9%) . Of all the Neisseria gonorrhoeae isolated, 86 were PPNG (46.7%) . There was no difference in failure rate among patients with PPNG or with non-PPNG . With the exception of self-limited gastrointestinal disturbance, side effects were minimal . The value of this combination for the treatment of uncomplicated gonococcal urethritis in men is promising and deserves further study.

Rev Infect Dis, 1984 Sep-Oct, 6(5), 669 - 88
Epidemiology of venereal urethritis: comparison of gonorrhea and nongonococcal urethritis; McCutchan JA; Gonorrhea (GU) and nongonococcal urethritis (NGU), the commonest sexually transmitted diseases in men, are endemic at high levels in most regions of the world, despite effective methods of diagnosis and treatment . NGU is a milder disease with a longer incubation period and longer duration of symptoms before treatment . Although Chlamydia trachomatis and Ureaplasma urealyticum appear to account for a majority of NGU cases, the cause of approximately 20% of cases remains unknown . NGU is about twice as common as GU in Western countries, and on the basis of national statistics from Great Britain, its incidence has been thought to be increasing more rapidly . However, data from individual clinics suggest that incidence of both diseases has remained stable over the past decade . The increased incidence of NGU in Great Britain over the past decade probably results from increased recognition or reporting . Marked socioeconomic and racial differences in both relative incidence of and susceptibility to NGU and GU have been found repeatedly but are unexplained . Men appear to transmit GU to women more efficiently than vice versa . Neisseria gonorrhoeae appears to be more infectious than C . trachomatis for both men and women, but interpretation of differences in susceptibility and transmission is hindered by ignorance of natural and acquired immunity to these agents . Of the several important time intervals in chains of transmission of venereal urethritis, only incubation periods and iatrotropic intervals for GU and NGU and the posttreatment period of infectivity for GU are known.

J Clin Microbiol, 1984 Sep, 20(3), 577 - 8
Efficacy of an enzyme immunoassay with uncentrifuged first-voided urine for detection of gonorrhea in males; Rudrik JT et al.; An enzyme immunoassay (Gonozyme; Abbott Laboratories, North Chicago, Ill.) for detection of Neisseria gonorrhoeae antigens was used to screen 184 urethral or uncentrifuged first-voided urine or both specimens from males and 78 cervical specimens . When compared with culture, the sensitivity and specificity of Gonozyme for cervical and urethral specimens were comparable to those in published reports . The sensitivity and specificity for urine specimens were 91.6 and 97.9%, respectively.

Int J Epidemiol, 1984 Sep, 13(3), 344 - 6
Chemoprophylaxis and gonococcal infections in prostitutes; Goh CL et al.; The influence of chemoprophylaxis on gonorrhoea has not been reported recently . 777 prostitutes were interviewed and checked for evidence of chemoprophylaxis . The study showed that chemoprophylaxis does reduce the risk of gonococcal infections and that those who took penicillin chemoprophylaxis had a higher risk of Penicillinase producing Neisseria gonorrhoeae (PPNG) infections compared to those who took non-penicillin chemoprophylaxis and those who did not take any prophylaxis.

J Infect Dis, 1984 Sep, 150(3), 397 - 401
Conjugation of plasmids of Neisseria gonorrhoeae to other Neisseria species: potential reservoirs for the beta-lactamase plasmid; Genco CA et al.; The discovery that penicillinase production in Neisseria gonorrhoeae was plasmid mediated and the spread of the beta-lactamase encoding plasmids in gonococcal isolates since 1976, raise the possibility that a nonpathogenic indigenous bacterium could serve as a reservoir for these plasmids . We initiated studies to define the ability of commensal Neisseria species and Branhamella catarrhalis strains, as well as strains of the pathogen Neisseria meningitidis, to serve as recipients in conjugation with Neisseria gonorrhoeae . We found that with N . gonorrhoeae as the donor, 3 of 5 Neisseria cinerea, 2 of 5 Neisseria flava, 0 of 1 Neisseria flavescens, 1 of 3 Neisseria subflava, 0 of 6 B . catarrhalis, 0 of 7 Neisseria lactamica, 1 of 5 Neisseria mucosa, 1 of 7 Neisseria perflava/sicca, and 0 of 13 N . meningitidis strains gave detectable conjugation frequencies (greater than 10(-8) . N . cinerea was the only species found to maintain the gonococcal conjugal plasmid (pLE2451) . A N . cinerea transconjugant containing pLE2451 was observed to transfer both the beta-lactamase plasmid and pLE2451 to N . gonorrhoeae at high frequency.

J Infect Dis, 1984 Sep, 150(3), 389 - 96
Isolates of Neisseria meningitidis from different sites in the same patient: phenotypic and genomic studies, with special reference to adherence, piliation, and DNA restriction endonuclease pattern; Kristiansen BE et al.; Neisseria meningitidis was isolated from the throat, blood, and cerebrospinal fluid of six patients and from the throat and blood of two patients . All 22 isolates were of serogroup B, serotype 15, and sodium dodecyl sulfate-polyacrylamide gel electrophoresis type IV . Isolates from a single patient always possessed identical DNA restriction endonuclease patterns; this observation strongly suggested genomic identity . In spite of this apparent genomic identity, however, significant differences in piliation and adherence were observed among isolates from different sites in the same patient . Isolates from the throat were significantly more piliated (P less than .001) and adhered to human buccal epithelial cells in vitro in significantly higher numbers (P less than .001) than did isolates from the blood and the cerebrospinal fluid of the same patient . These results indicate that phase shift occurs in N . meningitidis in vivo.

Afr J Med Med Sci, 1984 Sep-Dec, 13(3-4), 151 - 4
Susceptibility of penicillinase-producing Neisseria gonorrhoeae in Ibadan to cefoxitin; Ogunbanjo BO et al.; The minimum inhibitory concentration (MIC) of fourteen strains of penicillinase-producing Neisseria gonorrhoeae (PPNG) isolated in Ibadan to cefoxitin has been determined and compared with that of other antibiotics, viz . penicillin, ampicillin, thiamphenicol, spectinomycin, erythromycin and oxytetracycline . All the strains show high-level resistance to penicillin and ampicillin and the MIC of cefoxitin ranged from 0.5 to 16.0 micrograms/ml, with 71% of the strains having an MIC of 1.0 microgram/ml or less . The data suggest that cefoxitin may be a useful alternative to spectinomycin in the treatment of uncomplicated gonococcal infections, due to either PPNG or non-PPNG strains . However, further experiments and in vitro studies are indicated.

J Antimicrob Chemother, 1984 Sep, 14 Suppl B, 291 - 3
Cefotaxime in the treatment of gonorrhoea caused by beta-lactamase-producing Neisseria gonorrhoeae; Barlow D et al.; Of 118 patients infected with beta-lactamase producing Neisseria gonorrhoeae treated with cefotaxime 0.5 g, 95 returned for at least one assessment . There were no failures to eradicate genital or rectal infection, but three of four patients with pharyngeal infection failed to respond.

Lancet, 1984 Aug 11, 2(8398), 333 - 7
Prevalence of six sexually transmitted disease agents among pregnant inner-city adolescents and pregnancy outcome; Hardy PH et al.; 115 pregnant girls aged 13-17 years were investigated during the third trimester for endocervical infection with six sexually transmissible microorganisms . Specimens from 21 patients destroyed the tissue cell monolayers for propagation of Chlamydia trachomatis, but 11 were no longer toxic when recultured after freezing or with additional antimicrobial agents; Trichomonas vaginalis was present in 76% of the toxic specimens . C trachomatis was recovered from 37% of 105 specimens . T vaginalis was recovered from 34% of the 115 subjects, candida from 38%, Mycoplasma hominis from 70%, and Ureaplasma urealyticum from 90% . Neisseria gonorrhoeae was cultured from 1 of 12 girls infected earlier in pregnancy . T vaginalis infection, alone or with C trachomatis or candida, was associated with low gestational age and low birthweight . C trachomatis and candida infections alone had no effect on pregnancy outcome.

Aust N Z J Obstet Gynaecol, 1984 Aug, 24(3), 217 - 8
Relationship between contraceptive method and vaginal flora; Peddie BA et al.; PIP: Increase in the number of positive cultures for fungi of bacteria taken from vaginal or cervical swabs, in oral contraceptive (OC) users was assessed . Women attending a family planning center in Christchurch, New Zealand, had a vaginal or cervical swab taken prior to a cervical smear . The swabs were placed in transport media and then cultured on brain-heart infusion agar with added chloramphenicol for Candida albicans isolation and modified Thayer-Martin agar and blood agar for Neisseria gonorrhoea . The presence of Trichomonas vaginalis was ascertained by examining a wet preparation and by culture onto Trichomonas medium . Other aerobic bacteria were isolated from the blood agar plates and identified using standard techniques . The culture results from 1002 consecutive swabs were assessed . There was no difference in the rates of infection with C . albicans between the different contraceptive groups . Similarly, there were no differences when the OC group was subdivided into those with either standard dose, low dose, or no estrogen content . When a similar analysis was carried out for the isolation of Gram positive cocci, the groups differed significantly due largely to the high rate of isolation of Gram positive cocci from women using IUDs . The patients also differed signifficantly in the rate of infection with Gram negative bacilli . To limit the number of multiple comparisons, the diaphragm and IUD groups were compared; the isolation rate of Gram negative bacilli was significantly higher in the diaphragm group . The isolation rate of Gram negative bacilli from women using IUDs or condoms was significantly higher than in those women using OCs . T . vaginalis was isolated from 1 woman who had never used contraceptives, 2 who were not using them at the time the swabs were taken, 7 taking OCs, and 1 using condoms . N . gonorrhoea was isolated from 3 women using 3Cs and 1 using an IUD . OC use was not associated with an increased incidence of cervical or vaginal infection by C . albicans, T . Vaginalis, N . gonorrhoea, or by any bacterial species . The highest rate of isolation of Gram-positive cocci was seen in women using IUDs .

Zh Mikrobiol Epidemiol Immunobiol, 1984 Aug, (8), 41 - 4
{Sputum microflora in acute pneumonia based on the data from a quantitative study}; Kondratenko GP et al.; In this work the data obtained in the quantitative investigations of sputum samples from 106 miners having acute pneumonia are presented . These investigations were carried out twice at the peak of the disease to determine the possible infective agent . The virological study of nasal impression smears by immunofluorescence and the serological study of paired sera made it possible to establish the viral and bacterial nature of the disease in 12% of cases . The expediency of the quantitative investigations of sputum, carried out twice, in combination with the study of the biological properties of opportunistic microorganisms was shown . Streptococcus pneumoniae proved to play the most important etiological role in the appearance of acute pneumonia in miners . This infective agent was detected in 82% of patients by the inoculation of sputum samples in "diagnostic" dilutions (10(-5) and higher) . The associations of pneumococci with staphylococci, hemolytic bacteria and Neisseria were found to be capable of playing a significant role in the development of acute inflammation in pulmonary tissue, especially in those cases when these associations were isolated from highly diluted sputum (10(-5)).

Antimicrob Agents Chemother, 1984 Aug, 26(2), 192 - 5
Influence of inoculum size on comparative susceptibilities of penicillinase-positive and -negative Neisseria gonorrhoeae to 31 antimicrobial agents; Hall WH et al.; The effects of two inoculum sizes (10(4) and 10(6) CFU) on the MICs of 20 beta-lactam antibiotics, 4 aminoglycosides, and 7 other antimicrobial agents were compared for 102 unselected strains of Neisseria gonorrhoeae (26 penicillinase positive and 76 penicillinase negative), with three replicates for each test . The method was agar plate dilution on Mueller-Hinton agar supplemented with 1% hemoglobin and 1% IsoVitaleX . For penicillinase-positive strains, a large inoculum (10(6) CFU) increased the MIC greater than or equal to 16-fold for benzylpenicillin, piperacillin, azlocillin, and mezlocillin and increased the MIC greater than or equal to 8-fold for ampicillin, cefoperazone, ceftazidime, cefonicid, and cefamandole . The inoculum size had little or no influence on MICs of any antimicrobial agent for penicillinase-negative strains . For penicillinase-positive strains, the most active antibiotics (MIC, less than or equal to 0.001 microgram/ml) were the new cephalosporins: cefotaxime, ceftazidime, ceftizoxime, ceftriaxone, and cefmenoxime . For penicillinase-negative strains, the most active antibiotics were piperacillin, ceftriaxone, ceftizoxime, and cefmenoxime (MIC, less than or equal to 0.001 microgram/ml), closely followed by ceftazidime, moxalactam, azlocillin, mezlocillin, and cefuroxime.

Infect Immun, 1984 Aug, 45(2), 453 - 7
Characterization of Neisseria gonorrhoeae protein II phase variation by use of monoclonal antibodies; Black WJ et al.; The protein II (P.II) outer membrane proteins of Neisseria gonorrhoeae, which have been implicated in gonococcal pathogenesis, have been previously shown to undergo a type of phase variation in which expression of any of several different forms of the proteins may be switched on or off . We identified six electrophoretically distinct forms of P.II proteins (designated P.IIa through P.IIf) within strain FA1090, and we isolated colonial variants of FA1090 that expressed only one of the six different P.II protein forms . Two monoclonal antibodies that bound specifically and differentially to P.II proteins were produced . One antibody bound to proteins P.IIb and P.IId and was bactericidal for all colonial variants expressing P.IIb . The second antibody bound to P.IIa and was bactericidal for colonial variants expressing P.IIa . P.II protein profiles of survivors of antibody killing indicated that multiple P.II protein species may be expressed on a single bacterium and that P.II protein switching in the gonococcus is nonrandom.

Infect Immun, 1984 Aug, 45(2), 410 - 6
Identification of an iron-regulated 37,000-dalton protein in the cell envelope of Neisseria gonorrhoeae; Mietzner TA et al.; We examined the outer membrane proteins which appear during the growth of Neisseria gonorrhoeae F62 in complex medium supplemented with 25 microM Desferal mesylate, a potent iron chelator . Outer membranes were prepared by Sarkosyl extraction and analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis . Several higher-molecular-weight (74,000 to greater than 94,000) proteins increased under iron-limiting conditions . In addition we observed the appearance of an iron-regulated protein with an apparent molecular weight of 37,000 . This protein comigrated with the gonococcal protein I under normal Laemmli gel conditions . By increasing the ionic strength of the lower gel buffer, separation of protein I and the 37,000-dalton iron-regulated protein occurred . The 37,000-dalton protein stained poorly with Coomassie blue . However, when a silver stain was used, the protein appeared as a major component of the gonococcal outer membrane . Production of this 37,000-dalton protein was suppressed by the addition of iron to the medium . An iron-regulated protein with a similar molecular weight was observed in four clinical isolates and in an additional laboratory strain . Peptide mapping indicated that the 37,000-dalton protein was distinct from protein I and was identical between strains of the WI and WII serogroups.

Br J Vener Dis, 1984 Aug, 60(4), 238 - 40
Cefoperazone (Cefobid) for treating men with gonorrhoea caused by penicillinase producing Neisseria gonorrhoeae; Kim JH et al.; The recent emergence of spectinomycin resistant penicillinase producing Neisseria gonorrhoeae (PPNG) and the high prevalence of PPNG strains among the gonococcal isolates in Seoul represent a grave challenge to the programme for controlling sexually transmitted disease (STD) . Fifty men with uncomplicated gonococcal urethritis caused by PPNG strains were treated with a single intramuscular injection of 1 g cefoperazone . Forty two patients were followed up . All patients recovered including three who became reinfected and required further treatment . Two patients (4.8%) developed postgonococcal urethritis (PGU) . The MIC90 of cefoperazone measured by an agar dilution susceptibility test was 0.12 mg/l.

Br J Vener Dis, 1984 Aug, 60(4), 226 - 30
Penicillin sensitivity of gonococci in Australia: development of Australian gonococcal surveillance programme . Members of the Australian Gonococcal Surveillance Programme; Analysis of immune responses in genital tracts of mice immunised with purified ribosomal fractions of Neisseria gonorrhoeae; Immunisation of ddY mice with the purified ribosomal fraction of Neisseria gonorrhoeae was found to protect against intravaginal challenge with homologous organisms . This protection correlated with the presence of bactericidal antibody to purified ribosomal fraction in serum as well as in vaginal secretions . Analysis of the vaginal fluids from control mice and those immunised with purified ribosomal fraction showed that the enhanced elimination of gonococci in immune mice might be because of an early response of leucocytes generated by the reaction mediated by antibody and complement . Absorption studies showed that there was at least one major protective antigen in purified ribosomal fraction, other than cell surface substances such as lipopolysaccharide, outer membrane proteins, and pili . Bactericidal assays mediated by antibody and complement showed that matched samples of serum and vaginal fluid from immune mice had comparable gonococcidal activity, which was augmented by the effect of progesterone . Although delayed hypersensitivity was produced in immune mice that were resistant to N gonorrhoeae, the exact role of cellular immunity could not be clarified in this study . These results suggest that antibody to purified ribosomal fraction plays a major part in protection against gonococcal infection in the genital tract, and that such protection may entail both cellular immunity and hormonal changes.

Br J Vener Dis, 1984 Aug, 60(4), 231 - 4
Rosoxacin in the treatment of uncomplicated gonorrhoea in men; Panikabutra K et al.; Between 3 January and 4 March 1983 we treated 200 male patients diagnosed as having uncomplicated gonococcal urethritis with one of two regimens . They were divided into two groups and randomly assigned to treatment with either 2 g spectinomycin administered intramuscularly (group A) or 300 mg rosoxacin by mouth (group B) . Of 187 isolates tested for the production of beta-lactamase, 101 (54%) were penicillinase producing Neisseria gonorrhoeae (PPNG) strains . All 81 cases followed in group A (spectinomycin) were cured, compared with 88.5% (77 out of 87) of the patients followed in group B (rosoxacin) . We concluded that rosoxacin at a dosage of 300 mg administered orally was fairly effective in the treatment of gonococcal urethritis in men caused by both PPNG and non-PPNG strains.

N Engl J Med, 1984 Jul 19, 311(3), 137 - 40
Treatment of penicillin-resistant Neisseria gonorrhoeae with oral norfloxacin; Crider SR et al.; Norfloxacin, an orally administered quinoline carboxylic acid that is structurally related to nalidixic acid, has been shown to be highly active in vitro against penicillinase-producing Neisseria gonorrhoeae . Ninety-two men with culture-proved gonococcal urethritis, 46 per cent with penicillinase-producing N . gonorrhoeae, and 27 per cent with non-penicillinase-producing N . gonorrhoeae that was resistant to penicillin were given either 1200 mg of norfloxacin divided into two equal oral doses four hours apart (59 patients) or 2 g of spectinomycin intramuscularly (33 patients) . All patients in both treatment groups were cured . No adverse reactions were reported in either group . We conclude that a two-dose, single-day regimen of orally administered norfloxacin is effective therapy for uncomplicated urethritis caused by penicillin-resistant strains of N . gonorrhoeae.

JAMA, 1984 Jul 13, 252(2), 247 - 50
Evaluation of an enzyme immunoassay for detection of Neisseria gonorrhoeae in an adolescent population; Demetriou E et al.; We compared a modified procedure of Gonozyme , an enzyme immunoassay for detection of gonococcal antigen in urogenital specimens, with bacterial culture for Neisseria gonorrhoeae in a hospital-based adolescent clinic . In 839 patients studied, prevalence of urogenital gonorrhea by culture was 14.3% . The sensitivity of the immunoassay was 90.0%, and the specificity was 98.1%; predictive values for a positive and a negative test result were 88.5% and 98.3%, respectively . Gonozyme was highly accurate in 57 males studied; sensitivity, specificity, and predictive values were 100% . In 782 females, sensitivity was 87.5%, specificity was 98.0%, positive predictive value was 85.7%, and negative predictive value was 98.2% . Patients with false-negative immunoassay results had lower colony counts on culture . Gonozyme is an acceptable substitute for culture in males and in females with intermediate or high prevalence of gonorrhea . Results can be available within three hours.

Sex Transm Dis, 1984 Jul-Sep, 11(3), 156 - 8
Infections in sexual contacts and associates of children with gonorrhea; Alexander WJ et al.; The productivity of gonorrhea case-finding among persons epidemiologically associated with children infected with Neisseria gonorrhoeae was examined . During a 33-month period, 36 cases of gonococcal infection in children prompted the examination of 244 individuals who were identified as either sexual contacts, household associates, or nonhousehold associates . Overall, we found an infection rate of 18.4% among 244 persons associated with cases of gonococcal infection in children . Of 21 sexual contacts examined, ten (47.6%) had gonorrhea . Of 223 persons associated with the childhood cases of gonorrhea, 21 (16%) of household associates and 14 (15.2%) of nonhousehold associates were found to have gonorrhea . Associates aged greater than or equal to 30 years who were not named as sexual contacts had a risk of infection significantly lower than that of younger persons examined . These results emphasize that gonorrhea screening prompted by reports of cases in children should not be limited to those persons identified as sexual contacts or household members.

Sex Transm Dis, 1984 Jul-Sep, 11(3), 137 - 47
Decision analytic approach to the management of gonorrhea contacts; Turshen IJ et al.; We used a combination of decision analytic and modeling techniques in constructing a model for study of the management of an asymptomatic woman presenting to a sexually transmitted disease clinic as a contact of a man with gonorrhea . Total cost (physical, emotional, and economic) is expressed in units of dysutility . Initially the probabilities and "costs" of anogenital gonorrhea, incubating syphilis, carriage of the agents of nongonococcal urethritis, and coincident pharyngeal gonorrhea are considered; complications and sequelae are then accounted for . The best strategy is to culture for Neisseria gonorrhoeae, treat immediately with tetracycline, and follow up sexual partners if the culture is positive . Dysutility values calculated for the strategies of just treating with standard regimens of tetracycline, procaine penicillin, or amoxicillin are 288, 310, and 560, respectively . Sensitivity analyses show that the most important factors in determining optimal strategy are the probabilities and costs associated with the patient's carriage of the agents of nongonococcal urethritis . In order for this decision to change, the dysutility value for nongonococcal urethritis would have to decrease to 17% of our best estimate, or the overall prevalence of nongonococcal urethritis would have to be reduced to 16% of our best estimate.

Biull Eksp Biol Med, 1984 Jul, 98(7), 84 - 6
{Protein spectra and phospholipid composition of cholinoreceptor-enriched membranes from rat skeletal muscles after sensitization}; Ado AD et al.; The effect of neisserial sensitization on the protein spectra and phospholipid composition of acetyscholine receptor-rich membrane fragments was investigated in rat skeletal muscles . The sensitization led to substantial changes in the protein spectrum of the cell membranes of the skeletal muscles with high receptor activity in respect to choline . The phospholipid composition of the membranes was found to experience profound transformations . A considerable increase was noted in the content of sphingomye lin and phosphatidylcholine together with a marked drop in the content of phosphatidylethanolamine, phosphatidylinosite and phosphatidylserine.

Ann Microbiol (Paris), 1984 Jul-Aug, 135B(1), 3 - 11
Sulphur nutrition and metabolism in various species of Neisseria; Le Faou A; Most Neisseria strains are able to grow with sulphate as a unique source of sulphur . Nevertheless, a cysteine requirement was present in a few strains of N . meningitidis and in 30% of N . flava strains isolated in our laboratory . All strains of N . gonorrhoeae exhibited such a requirement . In every strain tested, the need for cysteine (which can be satisfied by thiosulphate) was linked to the lack of sulphite-reducing-activity . The implications of these findings for the taxonomy and identification of Neisseria are discussed.

Sex Transm Dis, 1984 Jul-Sep, 11(3), 131 - 6
The co-existence of genital Mycoplasma and Neisseria gonorrhoeae isolated from the male urethra; Alfa MJ et al.; Ureaplasma urealyticum and Mycoplasma hominis, separately or together, were co-isolated along with 34 of 102 strains of Neisseria gonorrhoeae cultured from urethral swabs from men with urethritis . For approximately half of the N . gonorrhoeae strains, the mycoplasma(s) persisted for at least five passages on agar medium . U . urealyticum was isolated in 31 of the 34 instances . No association between particular serotype(s) of U . urealyticum or auxotypes of N . gonorrhoeae was identified . The auxotypes of the N . gonorrhoeae isolates were not altered by the presence of U . urealyticum . To screen cultures of N . gonorrhoeae for the presence of genital mycoplasmas, we recommend direct microscopy of growth on agar: for M . hominis, after the colony epifluorescence test, and, for U . urealyticum, after the urease spot test.

J Infect Dis, 1984 Jul, 150(1), 71 - 9
Immune response of infants and children to disseminated infections with Neisseria meningitidis; Griffiss JM et al.; Acute- and convalescent-phase sera from 34 children and 10 young adults were studied to determine if, at what age, and to which antigens of Neisseria meningitidis they respond during disseminated disease . Seven children older than two years of age who were infected with group C or Y strains developed significant increases in both binding and bactericidal antibody . Children infected with group B strains infrequently (eight {31%} of 26) had measurable increases in serum antibody to this capsular polysaccharide; response was meager when it did occur, was unrelated to age, and was considerably poorer than that of young adults, of whom 80% responded . Convalescent-phase sera from all children contained bactericidal antibody . Binding capacity for group B polysaccharide accounted for only 35% of the bactericidal activity in convalescent-phase sera of children infected with group B strains . Bactericidal antibody in the sera of children who did not respond to capsular polysaccharides was often to a lipooligosaccharide antigen.

J Infect Dis, 1984 Jul, 150(1), 49 - 56
A bacterial respiratory burst: stimulation of the metabolism of Neisseria gonorrhoeae by human serum; Cohen MS et al.; Exposure of Neisseria gonorrhoeae to human serum causes an immediate increase in metabolism, including a fourfold increase in O2 consumption and {14C}adenine uptake and a threefold increase in glucose consumption . These effects were detected at a serum concentration of 1.0% and were maximal at 20% . Serum-stimulated gonococcal metabolism was inhibited by KCN but was not affected by heating or boiling of serum . Dialysis of serum with membrane tubing having a molecular weight exclusion of 3,500 eliminated stimulation of O2 consumption and reduced incorporation of {14C}adenine . Addition of lactate, pyruvate, or cysteine to dialyzed serum had no effect on bacterial metabolism . One in vitro ramification of this observation was demonstrated when gonococci, serum, and polymorphonuclear neutrophils (PMNs) were incubated in an O2 monitor . Under these conditions O2 consumption by bacteria stimulated by serum confounded interpretation of results and would be expected to reduce the O2 concentration in the suspension available for microbicidal metabolism by PMNs.

J Infect Dis, 1984 Jul, 150(1), 44 - 8
Serological classification of Neisseria gonorrhoeae with use of monoclonal antibodies to gonococcal outer membrane protein I; Knapp JS et al.; Identification of strain-specific markers on Neisseria gonorrhoeae that are capable of differentiating gonococci into a large number of distinct classes could facilitate analysis of patterns of gonorrhea transmission and application of gonorrhea control measures . A panel of 12 monoclonal antibodies to gonococcal outer membrane protein IA (PrIA) and IB (PrIB) was used to classify 1,433 strains serologically in a worldwide survey . Eighteen PrIA and 28 PrIB serovars were identified, and a nomenclature is proposed . Gonococcal strains were classified further by auxotyping . Auxotyping and serotyping served to classify the 1,433 isolates into 107 unique auxotype/serovar classes . Dual classification by auxotype and serovar can be used to identify epidemiologically related gonococcal infections in order to test the effectiveness of innovative, focused measures to control gonorrhea.

EMBO J, 1984 Jul, 3(7), 1595 - 601
IgA protease of Neisseria gonorrhoeae: isolation and characterization of the gene and its extracellular product; Halter R et al.; Gonococcal virulence is thought to rely on multiple characteristics including the production of an extracellular protease specific for human IgA1 . Using a sensitive filter assay we have isolated an Escherichia coli clone which harbours the gene of Neisseria gonorrhoeae MS11 IgA protease on a multicopy number plasmid . This clone secrets IgA protease activity to an extent similar to that of the parental MS11 strain . By exonucleolytic digestion of the cloned insert we obtained a fragment of 4.6 kb which could not be shortened further without loss of IgA protease expression . Compared with the cloned IgA protease gene from N . gonorrhoeae F62, this minimal gene segment shows marked differences in the arrangement of restriction sites . We suppose that these differences determine strain-specific variations of N . gonorrhoeae IgA proteases and also affect the secretory properties of the enzyme when produced in E . coli . A novel purification procedure developed for IgA protease of N . gonorrhoeae allowed us to correlate the enzyme activity with a distinct protein band in SDS acrylamide gels . By comparison with the enzyme prepared from the E . coli clone, we identified a 105-kd protein as the extracellular form of gonococcal IgA protease.

Biochem Pharmacol, 1984 Jul 1, 33(13), 2101 - 7
Kinetics of methotrexate binding to dihydrofolate reductase from Neisseria gonorrhoeae; Baccanari DP et al.; The kinetics of methotrexate inhibition of dihydrofolate reductase from Neisseria gonorrhoeae have been investigated . Methotrexate was shown to be a tight-binding inhibitor (Kt = 13 pM) competitive with dihydrofolate . However, "stoichiometric" or "pseudoirreversible" inhibition could not be demonstrated . Progress curves of inhibited assays quickly attained steady state regardless of the order of substrate addition, indicating that methotrexate association and dissociation processes were rapid . Kinetic techniques were used to measure the rate of methotrexate dissociation from the enzyme-NADPH-methotrexate ternary complex . At 30 degrees, the first-order off-rate constant (koff) was calculated to be 0.56 min-1 . This value is approximately 40-fold greater than the dissociation rate constant of methotrexate for Escherichia coli dihydrofolate reductase . At lower temperatures, progress curves of methotrexate-inhibited gonococcal enzyme assays displayed marked increases in both curvature and the time to reach steady state . At 9 degrees, the methotrexate dissociation rate was slow enough (koff = 0.04 min-1) so that initial velocities of the reaction could be measured, and under these conditions methotrexate inhibition was shown to be "stoichiometric".

Infect Immun, 1984 Jul, 45(1), 133 - 8
Ceruloplasmin and regulation of transferrin iron during Neisseria meningitidis infection in mice; Letendre ED et al.; The role of ceruloplasmin (ferroxidase I; EC 1.16.3.1) in iron metabolism during experimental Neisseria meningitidis infection was investigated . Plasma ceruloplasmin activity was found to increase greatly in mice during the convalescence phase of iron-controlled infection and after a plasma hypoferremia had occurred . Ceruloplasmin activity-deficient animals became hypoferremic as a result of an impaired release of iron from the reticuloendothelial system as shown by impaired return of reticuloendothelial system-processed heme iron in these mice . Hypoferremia in ceruloplasmin activity-deficient mice was associated with an increased resistance to N . meningitidis infection, an effect reversed readily by ceruloplasmin supplementation or iron addition . This evidence implicated ceruloplasmin activity as an important component in the regulation of the plasma transferrin iron pool and suggested that an important role of additional ceruloplasmin as an acute-phase protein might be related to the requirement of additional transferrin iron . This study also provided further evidence of the importance of transferrin iron and host hypoferremia in bacterial infection.

Sex Transm Dis, 1984 Jul-Sep, 11(3), 173 - 81
Epididymitis, orchitis, and related conditions; Krieger JN; Epididymitis is the most common intrascrotal inflammation . Retrograde ascent of pathogens is the usual route of infection . Nonspecific bacterial epididymitis is caused by various aerobic bacteria, is frequently associated with anatomic abnormalities, and represents the most common type of epididymitis in older men . Sexually transmitted epididymitis is usually caused by Chlamydia trachomatis or Neisseria gonorrhoeae and represents the most frequent cause of acute scrotal swelling in men younger than 35 years of age . Underlying urologic abnormalities are uncommon in patients with sexually transmitted epididymitis . Systemic infections and trauma are unusual causes of epididymitis . Orchitis is less common than epididymitis . Blood-borne dissemination is the major route of testicular infection . With the exception of viral diseases, genitourinary tract infections seldom involve the testis primarily . Mumps is the most frequent cause of viral orchitis . Pyogenic orchitis usually results from an inflammatory process in the epididymis . Systemic dissemination of granulomatous infections may occasionally cause orchitis.

J Bacteriol, 1984 Jul, 159(1), 312 - 20
Arrangement of pili in colonies of Neisseria gonorrhoeae; Todd WJ et al.; The morphology and arrangement of pili in the P++ colony phenotype of Neisseria gonorrhoeae were examined by a variety of electron microscopic techniques . The apparent structure and organization of gonococcal pili varied depending upon the method of specimen preparation . Pili as thin, individual, unbranched structures were demonstrated by negative staining and in sections of epoxy-embedded specimens . Pili forming thick structures which branch, subdivide, and rejoin to form an irregular lattice were demonstrated in specimens processed by the critical-point drying method and by rapid freezing and low temperature sublimination . We propose that in gonococcal colonies of the P++ phenotype, pili exist as individual threadlike structures only on the bacterial surfaces; as the pili leave the bacterial surfaces, they form thick bundles which branch, subdivide, and rejoin to form a supporting framework interconnecting the colony members . This arrangement of pili is usually disrupted by the commonly used method of negative staining and cannot be clearly detected within epoxy-embedded specimens . These data are summarized in a model depicting the organization of pili in the P++ colony phenotype of N . gonorrhoeae.

Sex Transm Dis, 1984 Jul-Sep, 11(3), 152 - 5
Susceptibility of different auxotypes of Neisseria gonorrhoeae to norfloxacin, cefotaxime, cefuroxime, and erythromycin; Noble RC et al.; Isolates of Neisseria gonorrhoeae from 150 patients attending a venereal disease clinic were examined for their susceptibility to four antibiotics (norfloxacin, cefotaxime, cefuroxime, and erythromycin) by a plate-dilution method . The isolates were also characterized by gonococcal auxotyping . The most frequent auxotypes were nonrequiring, 50%; Pro-, 16.7%; Pro-, Arg-, (Orn*), Ura-, 10.7%; Arg-, Hyx-, Ura-, 12.7%; and a miscellaneous group consisting of 10% of the isolates . Norfloxacin was the most active of the antibiotics; all of the isolates were inhibited by less than or equal to 0.06 microgram/ml . The Arg-, Hyx-, Ura- group of isolates was the most susceptible of the auxotypes to antibiotics . In the present study N . gonorrhoeae of the Arg-, Hyx-, Ura- auxotype fell into two groups with respect to erythromycin, one highly susceptible and one less susceptible . The results of the present study provide further evidence that the nutritional requirements of gonococci are associated with their response to certain antibiotics.

Eur J Biochem, 1984 Jun 15, 141(3), 513 - 9
Structure of the capsular antigen of Neisseria meningitidis serogroup H; van der Kaaden A et al.; The capsular polysaccharide of Neisseria meningitidis serogroup H is composed of the following repeating unit, Gro = glycerol; (formula; see text) Partial O-acetylation of the D-Galp moieties is found for C-2 (21%) and C-3 (57%) . The structural elucidation of the biopolymer is based on sugar analysis, methylation analysis, partial acid hydrolysis, using gas-liquid chromatography/mass spectrometry studies, and NMR spectroscopy with 1H, 13C and 31P.

J Dermatol Surg Oncol, 1984 Jun, 10(6), 451 - 4
International dermatosurgery: genitoperineal cyst of the median raphe; Sanchez-Conejo-Mir J et al.; Canals and cysts are not rare embryonic malformations of the male genitoperineal median raphe . These patients usually consult dermatovenereologists . They normally remain asymptomatic for a long period, but secondary infections, caused by Neisseria gonorrheae , may occur . Surgical excision is the treatment of choice.

Am J Dis Child, 1984 Jun, 138(6), 562 - 4
Prevalence of Chlamydia trachomatis cervical infection in female adolescents; Golden N et al.; To determine the prevalence of infection with Chlamydia trachomatis in young girls with the same socioeconomic background from New York City, 186 sexually active female adolescents (age range, 12 to 17 years; mean age, 15.5 years) were screened . One third of the patients were pregnant . Papanicolaou smears, endocervical cultures for C trachomatis and Neisseria gonorrhoeae, and syphilis serologic tests were obtained prospectively . Chlamydia trachomatis was isolated from 10.2% of the subjects, and N gonorrhoeae was isolated from 9.7% of the subjects; 3.2% of the subjects had syphilis . At least one sexually transmitted disease was found in 17.2% of the subjects . Eight (44%) of 18 patients with N gonorrhoeae also harbored Chlamydia . The high rate of multiple infection should have significant implications with regard to treatment . High isolation rates of C trachomatis and other sexually transmitted pathogens suggested that routine screening may be warranted in even the very young, sexually active female adolescent, and especially in pregnant girls.

South Med J, 1984 Jun, 77(6), 800 - 1
Adult gonococcal ophthalmia; Baker FJ et al.; It is important to consider Neisseria gonorrhoeae as a possible pathogen in any case of purulent conjunctivitis . Gram stains and cultures should be obtained and appropriate therapy initiated immediately to reduce the potential for severe and irreversible complications.

Nurse Pract, 1984 Jun, 9(6), 34, 39 - 47, 67
Assessment and management of vaginitis and cervicitis; Smith LS et al.; This article presents the assessment, management, client education, and psychosocial considerations related to trichomoniasis, candidiasis, Gardnerella vaginitis, and cervicitis due to Chlamydia trachomatis and Neisseria gonorrhea . The physiology of the vagina, approach to the history and physical exam, specimen collection, and laboratory diagnosis are included . Recommended treatment regimens and preventive behaviors are discussed in detail . The psychosocial impact to the client of having a discharge which may be a sexually transmitted disease is discussed.

Acta Pathol Microbiol Immunol Scand {B}, 1984 Jun, 92(3), 165 - 70
Activity of bacteriocin-like agents from Neisseria meningitidis on strains isolated from patients and carriers; Jyssum K et al.; Strains of Neisseria meningitidis isolated from patients were more often completely insensitive to five bacteriocin-like agents than carrier strains, but no particular bacteriocin type could be associated with patient strains . Two genetically distinct types of insensitivity could be separated by transformation . Insensitivity to four bactericidal agents (from the strains P201, P213, P241 and 99/79) was caused by one common genetic marker whereas insensitivity to a bacteriostatic agent (from the strain 77/79) was caused by another . Insensitivity to the bactericidal agents was more often found among strains belonging to serogroup B than among strains belonging to other groups . But group B strains from patients were more often insensitive than similar strains from carriers . Insensitivity to the bacteriostatic agent seemed evenly distributed among strains of various serogroups . All insensitive patient strains tested showed reduced binding/destruction of inhibitor, indicating that resistance and not tolerance is associated with patient strains.

J Clin Microbiol, 1984 Jun, 19(6), 949 - 51
Cost-effective method of triple-site culturing for Neisseria gonorrhoeae; Gartner T et al.; The efficacy of the use of a single modified Thayer-Martin triplate versus that of three separate modified Thayer-Martin plates for the recovery of Neisseria gonorrhoeae from pharyngeal, anal, and genital sites were studied . A total of 98 males and 74 females who showed intracellular gram-negative diplococci on genital Gram stain were studied . Of 172 patients, 164 had gonorrhea at one or more sites . In the first group of 45 males and 21 females, a single swab from each site was used to inoculate randomly both a standard plate (100 mm in diameter) and one-third of a triplate . In the second group of 53 males and 53 females, two swabs were used for collection from each site . One of each pair of swabs was randomly inoculated onto a standard plate and a triplate . There was no significant difference between the results obtained by inoculation with single swabs and those obtained by inoculation with two swabs . There were no significant differences between the positivity rates obtained with the triplate and those obtained with three standard plates used at each site . Cost (39% that of three separate plates) and acceptance by clinic and laboratory personnel make the triplate method an economical, accurate, and effective triple-site screening system.

J Clin Microbiol, 1984 Jun, 19(6), 893 - 5
Comparison of Transgrow and Gonozyme for the detection of Neisseria gonorrhoeae in mailed specimens; Martin R et al.; The Transgrow culture system and Gonozyme (Abbott Laboratories, North Chicago, Ill.), an enzyme-linked immunosorbent assay procedure, were compared by examining 510 patients (320 females, 190 males) from whom duplicate genital swabs were obtained for the diagnosis of Neisseria gonorrhoeae infection . Both Transgrow and the Gonozyme swabs were mailed to the laboratory . Clinical, epidemiological, and laboratory data for the 30 specimens for which there were discrepancies were evaluated to determine the probability of gonorrhea . At the same time, Gonozyme was compared to on-site Thayer-Martin cultures from 258 of the 510 patients, with a 93% agreement . When sensitivity and specificity were calculated on the basis of clinical, epidemiological, and on-site laboratory data, Gonozyme had a sensitivity of 95% and a specificity of 99% . Transgrow culture was considered to have a 100% specificity and a sensitivity of 69% . Gonozyme appeared to be a superior method for the diagnosis of gonorrhea by means of mailed specimens.

Antimicrob Agents Chemother, 1984 Jun, 25(6), 767 - 9
Identification of an envelope mutation (env-10) resulting in increased antibiotic susceptibility and pyocin resistance in a clinical isolate of Neisseria gonorrhoeae; Shafer WM et al.; A mutation (env-10) conferring increased susceptibility to drugs, dyes, and detergents was detected in a clinical isolate of Neisseria gonorrhoeae . In certain strains, env-10 also affected susceptibility to pyocins . This mutation was phenotypically similar to but genotypically distinct from previously described env mutations.

Antimicrob Agents Chemother, 1984 Jun, 25(6), 676 - 82
Probenecid: antibacterial action against Neisseria gonorrhoeae and interaction with benzylpenicillin; Catlin BW; Neisseria gonorrhoeae strains were used in an investigation of the antibacterial action of probenecid and its interaction with benzylpenicillin . The growth of 112 routine isolates was inhibited by probenecid at concentrations of 100 to 500 micrograms/ml incorporated in agar . Additive or synergistic effects of benzylpenicillin-probenecid combinations were graphically illustrated in gradient plates . In agar dilution tests with a resistant gonococcal strain, the MICs of benzylpenicillin alone and probenecid alone were 0.8 and 500 micrograms/ml, respectively; in contrast, the MICs of combinations of benzylpenicillin and probenecid were 0.45 and 75 micrograms/ml and 0.3 and 150 micrograms/ml, respectively . High concentrations of probenecid in broth were bactericidal . Probenecid alone at 50 to 100 micrograms/ml had little antibacterial effect, but in combination with an appropriate concentration of benzylpenicillin, it produced reductions of CFU in 6 h that were 100 to 300 times that produced by benzylpenicillin alone . Thus, in addition to its well-known pharmacological effects, probenecid potentiates the in vitro action of benzylpenicillin for gonococci . I suggest that synergism contributes to the beneficial effect of the benzylpenicillin-probenecid regimen for the treatment of gonorrhea . Furthermore, synergism may explain the reduction in the ratio of partially benzylpenicillin-resistant N . gonorrhoeae strains to benzylpenicillin-susceptible strains that occurred in the United States between 1972 and 1978.

Br J Vener Dis, 1984 Jun, 60(3), 161 - 3
Two dose Augmentin treatment of acute gonorrhoea in men; Lim KB et al.; We studied 192 men with acute gonococcal urethritis, 97 of whom received two oral doses of Augmentin (amoxycillin 3 g and clavulanic acid 250 mg) separated by a four hour interval; the remaining 95 received 2 g kanamycin in a single intramuscular injection . Of the patients treated with Augmentin, 93 (95.9%) were cured, which was significantly more than the 83 (87.4%) patients treated with kanamycin . Augmentin was equally effective in the treatment of penicillinase producing Neisseria gonorrhoeae (PPNG) and non-PPNG infections, the cure rates for which were 96.6% and 95.6% respectively.

Br J Vener Dis, 1984 Jun, 60(3), 157 - 60
Treatment of uncomplicated gonorrhoea with rosoxacin (acrosoxacin); Lim KB et al.; An open study was designed primarily to evaluate the efficacy of rosoxacin in the treatment of gonorrhoea caused by penicillinase producing Neisseria gonorrhoeae (PPNG) and non-PPNG strains . A total of 199 patients (99 men and 100 women) satisfactorily completed follow up examinations, 50 men and 50 women having received rosoxacin 300 mg orally and the remainder having received kanamycin 2 g intramuscularly . Rosoxacin achieved an overall cure rate of 94% (96.7% for PPNG and 90% for non-PPNG strains) . In patients treated with kanamycin the overall cure rate was 89.9% (92.7% for PPNG and 83.3% for non-PPNG strains) . A correlation between treatment failures and minimum inhibitory concentrations (MICs) of rosoxacin was noted in non-PPNG strains but not in PPNG strains . Side effects which were mild and self limiting were noted in 15 of 100 patients treated with rosoxacin . The high failure rates associated with non-PPNG strains requiring MICs of 0.125 mg/l and the observation of a substantial rise in the MICs for isolates after treatment is of concern . Otherwise, rosoxacin in a single dose of 300 mg appears to be safe and effective for the treatment of uncomplicated gonorrhoea.

Br J Vener Dis, 1984 Jun, 60(3), 151 - 3
Induction by human serum of resistance to serum in Neisseria gonorrhoeae: A clinical survey of patients with gonorrhoea; Martin PM et al.; Serum from 74 female and 170 male patients with gonorrhoea and from 72 male and 123 female controls was tested for its ability to induce in gonococci resistance to complement mediated killing by human serum . We confirmed two findings of a previous survey: firstly, a higher percentage of serum samples from women suffering their first infection than from female controls induced high resistance; secondly, no serum sample taken from infected women with complications (mainly salpingitis) induced high resistance . The number of serum samples from female patients with repeat infection was too small for conclusions to be drawn . In men, however, there were no significant differences between patients and controls, or between patients with first or repeat infection, in the percentage whose serum induced high resistance . The pattern of these results on the induction of resistance to serum correlates with the general clinical aspects of gonococcal infections; namely, wide clinical differences in symptoms in women contrasting with a more uniform pattern in men.

Br J Vener Dis, 1984 Jun, 60(3), 147 - 50
Penicillinase producing Neisseria gonorrhoeae in Zurich, Switzerland; Eichmann AR et al.; Of 1031 consecutive isolates of Neisseria gonorrhoeae examined before 31 July 1982, 30 strains showed beta-lactamase activity . All the penicillinase producing N gonorrhoeae (PPNG) strains were imported, 23 of them from South East Asia . One PPNG strain was identified as coming from Antigua and one from Chile, the first PPNG strains to be reported from these two countries . In 28 strains, the minimum inhibitory concentration (MIC) of penicillin was greater than or equal to 4.0 mg/l, and 15 strains were insensitive to tetracycline (MIC greater than or equal to 2.0 mg/l) . Four strains were less sensitive to spectinomycin (MIC = 30 mg/l), while the remaining 26 were highly sensitive to this antibiotic . The African plasmid was found in only one strain (that originating from Antigua), and all other PPNG strains contained the Asian plasmid . Twenty PPNG strains contained the resistance plasmid together with the transfer plasmid . Auxotype determination showed that 18 PPNG strains were prototrophic whereas 11 were proline requiring.

Br J Vener Dis, 1984 Jun, 60(3), 141 - 6
Epidemiology of PPNG infections in the Netherlands: analysis by auxanographic typing and plasmid identification; Ansink-Schipper MC et al.; We carried out auxanographic typing and plasmid identification on 1380 isolates of penicillinase producing Neisseria gonorrhoeae (PPNG) isolated in the Netherlands in 1982 and found four plasmid patterns and 24 auxotypes with noticeable local or regional variations . Among 756 strains harbouring the 3 X 2 megadalton (Mdal) resistance plasmid ("African" type), with or without the 24 Mdal transfer plasmid, 667 (88%) were non-requiring and inhibited by phenylalanine . This type was endemic in most of the cities or regions we studied . Twenty methionine requiring PPNG strains were found, all harbouring the 3.2 and 24 Mdal plasmid; virtually all of them were isolated or contracted in the region of Groningen . The predominant (443 (71%) auxotype among the 624 PPNG strains containing the 4.5 Mdal plasmid ("Asian" type) (with or without the 24 Mdal plasmid) was proline requiring . This auxotype (with the 4.5 Mdal and 24 Mdal plasmid) caused an outbreak in Amsterdam, and in Groningen replaced the local methionine requiring auxotype which had the 3.2 Mdal and 24 Mdal plasmids . Many auxotypes with the 4.5 Mdal plasmid, and requiring proline only, or proline and isoleucine, circulated in the Hague . Spread of imported strains by prostitution played an important part in the epidemiology of infection with PPNG strains.

J Med Microbiol, 1984 Jun, 17(3), 353 - 6
Absence of bactericidal antibodies against Group-I lipopolysaccharide determinants of Neisseria gonorrhoeae during human infection; Blackwell CC et al.; None of 34 sera from patients with gonorrhoea contained antibodies bactericidal for strains of Neisseria gonorrhoeae with Group-I lipopolysaccharide (LPS) . All contained antibodies against a strain with Group-II LPS, as do sera from uninfected controls . The absence of Group I-LPS antibodies in infected humans contrasts with previous findings that mice immunised with strains from either of the LPS groups produced bactericidal antibody to Group I . Our hope that detection of antibodies to Group-I strains would provide a screening test for gonorrhoea was, therefore, not realised.

Infect Immun, 1984 Jun, 44(3), 565 - 8
Proteins IA and IB exhibit different surface exposures and orientations in the outer membranes of Neisseria gonorrhoeae; Barrera O et al.; Exposure of whole gonococci to proteinase K resulted in cleavage of protein I (P.I) of the organism in situ . P.I subunits in the P.IB group were cleaved into two membrane-associated fragments, whereas P.IA subunits were cleaved by proteinase K to yield a single membrane-associated fragment slightly smaller in apparent size than the intact P.IA subunit . These data suggest that P.IA and P.IB subunits are quite different in their surface exposures and orientations in the gonococcal outer membrane; P.IB subunits likely have both termini buried in the membrane, whereas P.IA subunits have one of their termini exposed on the surface of the organism.

Br J Vener Dis, 1984 Jun, 60(3), 154 - 6
The activity of rosoxacin, fosfomycin, cefotiam, and spectinomycin on beta-lactamase producing Neisseria gonorrhoeae; Dickgiesser N et al.; We measured the activity of rosoxacin, fosfomycin, cefotiam, and spectinomycin against 51 isolates of beta-lactamase producing Neisseria gonorrhoeae, all of which were susceptible to each drug at sufficient concentrations . The development of strains of penicillinase producing N gonorrhoeae (PPNG) which are resistant to spectinomycin can therefore be avoided, as there are alternative drugs.

Rev Esp Fisiol, 1984 Jun, 40(2), 227 - 30
Toxicity of an algal mucopolysaccharide for Escherichia coli and Neisseria meningitidis strains; Criado MT et al.; Several bacterial strains of clinical significance have been tested to assess the toxic effect of a lectin-like algal mucopolysaccharide from Fucus vesiculosus on their growth . The toxic effect of the mucopolysaccharide has been found to be exerted only on Escherichia coli and Neisseria meningitidis strains . The degree of toxicity, measured by the effect on the growth of the bacteria, is variable depending on the strains of E . coli tested, whereas with N . meningitidis the results obtained indicate homogeneity between the strains, without significative variations among different serotypes even in the same serogroup.

Cell, 1984 Jun, 37(2), 447 - 56
Opacity determinants of Neisseria gonorrhoeae: gene expression and chromosomal linkage to the gonococcal pilus gene; Stern A et al.; In N . gonorrhoeae, the expression of pilus and opacity (Op) proteins can be switched on and off and a single cell apparently has a whole repertoire of genes to express many serologically distinguishable protein types . We describe the isolation of several different Op genes and of nonexpressing gene equivalents, all derived from isogenic gonococcal variants . In the E . coli host, Op proteins identical with those made in the respective N . gonorrhoeae strain are produced . The Op genes map near the pilus expression locus . Genomic blotting experiments with an Op gene probe reveal complex hybridization patterns but little heterogeneity among the genes of Op variants . It appears that colonial variation involving the Op protein of N . gonorrhoeae is based on minor sequence alterations, in contrast to the pilus variation system, in which changes in the expression can be evoked by substantial genomic rearrangements.

S Afr Med J, 1984 May 26, 65(21), 835 - 7
The emergence of penicillinase-producing strains of Neisseria gonorrhoeae in Durban; Coovadia YM et al.; Gonorrhoea was diagnosed in 179 (87%) of 206 Black males who presented with urethritis at a sexually transmitted disease clinic at the King Edward VIII Hospital, Durban . Penicillinase-producing strains of Neisseria gonorrhoeae were detected in 7 (5%) of 140 gonococcal isolates, and a further 13 strains were relatively resistant to penicillin . Microscopic examination of Gram-stained smears provided a rapid presumptive diagnosis of gonorrhoea in 162 cases . The modified Thayer-Martin medium proved marginally superior to chocolate agar for the isolation of N . gonorrhoeae from urethral exudates . The causation and laboratory diagnosis of urethritis in males and the antibiotic susceptibility pattern of the gonococcal isolates are discussed.

Br Med J (Clin Res Ed), 1984 May 5, 288(6427), 1349 - 52
Urethral syndrome: a self limiting illness; O'Dowd TC et al.; Thirty nine adult women who were not pregnant and had the urethral syndrome in a general practice underwent detailed microbiological investigations . Patients monitored their own symptoms, and those with persisting symptoms were entered into a randomised controlled trial of treatment with doxycycline and placebo . Chlamydia trachomatis and Neisseria gonorrhoeae were not isolated and fastidious organisms were not causally associated with the urethral syndrome . Treatment with doxycycline showed no benefit; each episode of the urethral syndrome was short and self limiting and there were no recurrences in a median observation period of 12 months.

Am Rev Respir Dis, 1984 May, 129(5), 876 - 8
Branhamella catarrhalis pneumonia and immunoglobulin abnormalities: a new association; Diamond LA et al.; A case of Branhamella catarrhalis pneumonia in a patient with multiple myeloma is reported . With the inclusion of this case, 5 of 17 (29.4%) reported cases of Branhamella pneumonia or empyema have occurred in patients with underlying diseases associated with immunoglobulin abnormalities . This strong clinical association suggests that qualitatively and quantitatively normal immunoglobulins are important host defense mechanisms in preventing infection with this pathogen . The sputum Gram stain demonstrating kidney-shaped gram-negative diplococci may be an early clue to the diagnosis, as well as an initial guide to empiric therapy, and may help the laboratory isolate and identify this pathogen, which, because of its morphologic resemblance to Neisseria, is frequently reported as "normal flora".

J Gen Microbiol, 1984 May, 130 ( Pt 5), 1303 - 6
Alteration of pyocin-sensitivity pattern of Neisseria gonorrhoeae is associated with induced resistance to killing by human serum; Winstanley FP et al.; A laboratory-grown strain of Neisseria gonorrhoeae, selected in vivo, BS4 (agar), is susceptible to complement-mediated killing by fresh human serum but is relatively resistant to killing by human phagocytes . It can be induced to serum resistance by incubation with a small molecular weight fraction of guinea pig serum . The serum-susceptible and induced-resistant forms show differences in pyocin sensitivity tests . This indicates either differences in the structure of their lipopolysaccharides or masking of some determinant(s) . The pyocin sensitivity pattern of BS4 (agar) is only slightly different from that of a closely related strain, BSSH, which is more susceptible to killing by human phagocytes.

Infect Immun, 1984 May, 44(2), 306 - 14
Monoclonal antibody against a genus-specific antigen of Chlamydia species: location of the epitope on chlamydial lipopolysaccharide; Caldwell HD et al.; Monoclonal antibodies were prepared by the fusion of murine myeloma NS1 cells with spleen cells of BALB/c mice immunized with Formalin-killed elementary bodies of the Chlamydia trachomatis L2 serovar . The specificity of these monoclonal antibodies was determined with a solid-phase immunoassay in which HeLa 229 cells infected with C . trachomatis serovars D, G, H, I, L2 and the Chlamydia psittaci meningopneumonitis strain Cal-10 were used . An immunoglobulin G3 monoclonal antibody (L2I-6) was identified that reacted with both C . trachomatis- and C . psittaci-infected HeLa cells . The immunoreactivity of the genus-specific epitope was heat resistant (100 degrees C, 10 min) but was destroyed by sodium metaperiodate treatment . Further characterization of the chlamydial specificity of monoclonal antibody L2I-6 by microimmunofluorescence showed that it was reactive with all 15 C . trachomatis serovars and seven C . psittaci strains isolated from five different animal species . We undertook studies to identify the biochemical nature of the chlamydial component on which the genus-specific epitope was located . The immunoreactive component was isolated by hot phenol-water extraction of dithiothreitol-reduced chlamydial elementary bodies . The component was positive in the Limulus amoebocyte lysate test (results of Limulus amoebocyte lysate assay were identical with those of Salmonella typhimurium LT2 SAI 377 Re lipopolysaccharide {LPS}), contained 8.8% 2-keto-3-deoxyoctulosonic acid, was resistant to proteinase K, and possessed electrophoretic mobility and silver-staining characteristics in sodium dodecyl sulfate-polyacrylamide gel electrophoresis consistent with a rough LPS or glycolipid . On the basis of these findings, we conclude that the genus-specific epitope recognized by monoclonal L2I-6 is located on chlamydial LPS . We further characterized the antigenic properties of the chlamydial LPS epitope by examining the immunoreactivity of monoclonal antibody L2I-6 by immunoblotting analyses against isolated LPSs extracted from Neisseria gonorrhoeae, S . typhimurium, and Escherichia coli . Monoclonal antibody L2I-6 did not bind LPS of these organisms, demonstrating that the chlamydial genus-specific LPS epitope is apparently not shared by these gram-negative bacteria . We were able, however, to show that the chlamydial LPS does share antigenic determinants with LPS of gram-negative organisms . Polyclonal rabbit antisera raised against S . typhimurium Re LPS or lipid A showed intense immunological cross-reactivity with chlamydial LPS by immunoblotting.(ABSTRACT TRUNCATED AT 400 WORDS)

J Bacteriol, 1984 May, 158(2), 696 - 700
Cloning genes for proline biosynthesis from Neisseria gonorrhoeae: identification by interspecific complementation of Escherichia coli mutants; Stein DC et al.; DNA from Neisseria gonorrhoeae KH45 was partially digested with Sau3A and inserted into the BamHI site of the cloning vector pLES2 . After introduction into Escherichia coli JM83 by transformation, two different size classes of plasmids were isolated that could complement the proAB deletion of JM83 . These plasmids ( pLES4 and pLES7 ) were characterized by restriction endonuclease digestion . Southern hybridization demonstrated that the inserts had sequence homology . Various deletions of these plasmids were constructed that had lost the ability to complement the proA lesion of chi 463, the proB lesion of chi 340, or both (plasmids pLES9 , pLES8 , and pLES10 , respectively) . These deleted plasmids were introduced into a proline-requiring strain of N . gonorrhoeae, F62, with plasmids pLES4 , pLES7 , and pLES8 possessing the ability to correct the proline requirement of F62 . Further analysis indicated that the hybrid plasmids were stably maintained as plasmids in N . gonorrhoeae.

Presse Med, 1984 Apr 28, 13(18), 1133 - 6
{Epidemiological surveillance of beta-lactamase producing gonococci . I . Auxotyping of 83 strains isolated in France (May 1979-April 1983)}; Riou JY et al.; Ever since they appeared in France, in 1979, penicillinase-producing gonococci have been isolated with increasing frequency . From May, 1979 to April, 1983, eighty-three strains were studied at the Neisseria laboratory . While new resistances to antibiotics can be studied in any laboratory specialized in clinical bacteriology, tests devised for epidemiological purposes can only be performed in a specialized laboratory . This is the case with auxotyping by the Catlin technique . The distribution of auxotypes in a given region over a given period is fairly regular and some distributions are found in the same geographical areas . The fact that the distribution of auxotypes of 83 penicillinase-producing strains significantly differed from that of 594 strains isolated during the same period clearly shows that these strains are not implanted in France and can be regarded as imported . It is suggested that auxotyping should be used for the epidemiological surveillance of extension or implantation of these strains.

Sem Hop, 1984 Apr 5, 60(15), 1057 - 60
{Gonococcal and nongonococcal urethritis in the male . Apropos of 100 cases treated with doxycycline polyphosphate}; Privat Y et al.; After pointing out the epidemiological significance of sexually transmitted diseases, the authors report results in 100 male patients given doxycycline polyphosphate during 2 weeks for urethritis . Ten patients had post-gonococcal urethritis and twenty others had persistent urethritis afer a first treatment had failed . The association Chlamydia trachomatis-Staphylococcus albus was the most common bacteriologic finding . Staphylococcus aureus and Neisseria gonorrhea were demonstrated in 24 and 12 cases respectively . Ureaplasma urealyticum was found in only four instances . Clinical and bacteriological results show that doxycycline polyphosphate was effective in 92 out of 100 cases . Circumstances of the eight failures are analyzed specifically . Clinical tolerance was excellent in every case . Following confrontation with recent data from the literature, these results lead the authors to conclude that gonococcal and non-gonococcal urethritis is an indication of choice for doxycycline polyphosphate.

Antibiotiki, 1984 Apr, 29(4), 275 - 6
{Anaerobic bacteria from microbial foci in acute odontogenic inflammatory diseases}; Oleinik II et al.; Mixed microbial associations from purulent foci of 30 patients with odontogenic inflammatory diseases were studied . 18 specimens of the clinical material were subjected to three-fold investigation . Bacteroids, propionic bacteria and pentococci predominated in the mixed cultures . Nonpathogenic Neisseria, streptococci of the mitis-salivarius group and epidermal staphylococci were isolated from the facultative anaerobic flora . The anaerobic species were the most sensitive to the antibiotics used in the treatment of the patients.

Antimicrob Agents Chemother, 1984 Apr, 25(4), 494 - 6
Evaluation of Sch 29,482 in the eradication of Neisseria meningitidis from nasopharyngeal carriers; Pugsley MP et al.; Fifty-eight chronic carriers of Neisseria meningitidis were given 250 mg of Sch 29,482 or placebo orally every 6 h for 4 days . Although 22 of 29 subjects taking Sch 29,482 became culture negative while taking the drug, only five were culture negative 2 weeks posttherapy . There were no significant adverse reactions.

Br J Vener Dis, 1984 Apr, 60(2), 123 - 4
Preterm labour in association with Neisseria gonorrhoeae: case reports; Lacey CJ et al.; We describe two cases of spontaneous rupture of the membranes, followed by premature labour at 32 and 34 weeks' gestation, in association with gonococcal infection.

Sex Transm Dis, 1984 Apr-Jun, 11(2), 77 - 80
Serogrouping of Neisseria gonorrhoeae: correlation of serogroup with disseminated gonococcal infection; Sandstrom EG et al.; Gonococci can be divided into serogroups WI, WII, and WIII by coagglutination . To assess the clinical correlation of serogroups of gonococci, we studied isolates of gonococci from patients with disseminated and uncomplicated gonococcal infections in three cities in the United States . Strains of Neisseria gonorrhoeae belonging to serogroup WI represented 85 (84%) of 101 isolates from patients with disseminated gonococcal infection (DGI) and 68 (40%) of 168 isolates from patients with uncomplicated gonorrhea (P less than .001) . The auxotype Arg-, Hyx-, Ura- (AHU) represented 62 (61%) of 101 isolates from DGI and 54 (32%) of 168 isolates from uncomplicated infection (p less than .001); all AHU isolates were serogroup WI . Among other auxotypes, WI strains represented 25 (64%) of 39 isolates from patients with DGI and 14 (12%) of 114 from uncomplicated infections (P less than .001) . In Atlanta only, 13 (34%) of 38 isolates from DGI were AHU, but 31 (82%) were serogroup WI (P less than .001) . Thus gonococci of serogroup WI are associated with DGI in these cities of the United States, and this correlation appears to be independent of auxotype . Serogroup WI is correlated with serum resistance.

Sex Transm Dis, 1984 Apr-Jun, 11(2), 68 - 71
Incidence of disseminated gonococcal infection correlated with the presence of AHU auxotype of Neisseria gonorrhoeae in a community; Noble RC et al.; Strains of Neisseria gonorrhoeae requiring arginine, hypoxanthine, and uracil (AHU) may cause disseminated gonococcal infection (DGI) . A significant epidemiologic association was noted between the incidence of disseminated gonococcal infection and the presence of gonococci of the AHU auxotype in the community over a nine-year period . Thirty-nine patients with DGI were identified from hospital records of January 1974-December 1982 . During this interval, gonococcal isolates from patients in the community were collected at a venereal disease clinic and a hospital emergency room . The incidence of patients hospitalized for DGI dropped significantly after 1978 . The year of highest incidence of DGI was 1977, when there were 429 cases of DGI per 100,000 cases of uncomplicated gonorrhea; the incidence of gonococcal isolates of the AHU auxotype in that year was 26.3% . In contrast, this auxotype accounted for only 4.6% of gonococcal isolates in 1980, when the incidence of DGI had decreased to 58 cases per 100,000 cases of uncomplicated gonorrhea . When DGI and gonococci of the AHU auxotype from the community were ranked for incidence by year, a significant correlation between the two was found (P less than .001) . Thus the incidence of patients with DGI in the hospital reflected the presence of gonococci of the AHU auxotype in the community.

Antimicrob Agents Chemother, 1984 Apr, 25(4), 455 - 7
Rosoxacin in the therapy of uncomplicated gonorrhea; Romanowski B et al.; In this randomized, multicentered study, 157 males and 130 females with laboratory-confirmed, uncomplicated anogenital Neisseria gonorrhoeae infections were evaluated to determine the efficacy and safety of a single 300-mg oral dose of rosoxacin versus 3.5 g of ampicillin plus 1 g of probenecid . A total of 130 males and 101 females were evaluated . Rosoxacin cured 90.3% (P = 0.053) and 94.1% (P = 0.62), respectively, whereas ampicillin was effective in 98.5 and 98% of males and females, respectively . All 39 patients with anorectal infections were cured . One penicillinase-producing N . gonorrhoeae strain was isolated and was eradicated with rosoxacin . Of 212 pretreatment isolates tested, 201 were inhibited by 0.06 micrograms or less of rosoxacin per ml . The MICs of rosoxacin for the remaining 11 isolates ranged up to 0.5 micrograms/ml . The incidence of adverse effects was relatively high (29% for the rosoxacin group versus 18% for the ampicillin group), but none of the reactions required medical intervention nor did they result in serious sequelae.

Acta Pathol Microbiol Immunol Scand {C}, 1984 Apr, 92(2), 139 - 43
Interaction of human serum transferrin with Neisseria gonorrhoeae, demonstrated by agglutination and precipitation; Rod TO et al.; Human sera show non-immune precipitation with ultrasonically disrupted bacteria of the N . gonorrhoeae strain 8551 . A human serum was resolved by DEAE cellulose chromatography and immune absorption to isolate the serum component involved in the precipitation . Testing of the final product against antisera to various serum proteins and analysis by SDS-PAGE revealed only serum transferrin . This preparation and transferrin obtained commercially produced precipitation in agar gel against the gonococcal extract . The bacterium was agglutinated by transferrin in solution or when carried by latex particles, and particles sensitized with the bacterial extract were agglutinated by transferrin . Four out of 26 gonococcal strains examined showed reactivity with transferrin in the precipitation and agglutination tests.

J Clin Microbiol, 1984 Apr, 19(4), 558 - 60
Lipopolysaccharide banding patterns of Neisseria meningitidis and Neisseria gonorrhoeae; Parr TR Jr et al.; The lipopolysaccharides of Neisseria meningitidis and Neisseria gonorrhoeae were examined by electrophoresis after whole-cell lysis and proteinase K digestion . The banding patterns observed from clinical isolates and laboratory strains demonstrated lipopolysaccharide which included a small number of smooth high-molecular-weight molecules as well as the previously reported lower-molecular-weight rough lipopolysaccharide.

Am J Obstet Gynecol, 1984 Apr 1, 148(7), 915 - 28
Bacterial attachment to the chorioamniotic membranes; Galask RP et al.; Intra-amniotic infections are believed to result from bacteria of cervical and vaginal origin which gain access to the amniotic sac . The logical sequence in this process would be bacterial attachment to the maternal surface, followed by migration through the chorioamniotic membranes to the fetal surface . Fresh sterile chorioamniotic membranes were interposed between two arms of specially constructed incubation vessels . Bacteria (Escherichia coli, group B streptococci, or Neisseria gonorrhoeae) were inoculated into the arm (containing a basal salt medium) contiguous with the maternal surface . The arm contiguous with the fetal surface of the membrane contained pseudoamniotic fluid . At intervals up to 24 hours after inoculation, the membranes were removed, washed, fixed in glutaraldehyde, and examined by means of scanning and transmission electron microscopes . The ability of group B streptococci and E . coli to attach to and invade the chorioamniotic membranes was demonstrated by this technique . It appeared that group B streptococci had a greater capacity to attach and invade than did E . coli, whereas N . gonorrhoeae predictably failed to attach.

J Adolesc Health Care, 1984 Apr, 5(2), 120 - 3
Penicillinase-producing Neisseria gonorrhoeae infection in adolescent prostitutes in detention; Farrow JA et al.; In the first quarter of 1983, four (17%) of 24 cases of Neisseria gonorrhoeae infection diagnosed in female adolescent detainees in King County, Washington were caused by penicillinase-producing (PPNG) strains . Twelve (3%) of 397 reported cases of female gonorrhea in the rest of King County during this time were caused by PPNG strains (p less than 0.01) . All the detainees with PPNG infection were prostitutes . Their case histories are presented here . Three had signs and symptoms suggestive of pelvic inflammatory disease . In areas with endemic PPNG, all isolates of N . gonorrhoeae from female adolescent detainees should be tested for pencillinase production, and all prostitutes with genitourinary symptoms suggestive of gonorrhea should be treated with an antimicrobial resistant to pencillinase.

Br J Vener Dis, 1984 Apr, 60(2), 87 - 9
Differentiation of gonococcal and non-gonococcal neisseriae by the superoxol test; Young H et al.; We evaluated the superoxol (catalase) test as a means of differentiating gonococci from related species of organisms which were cultured from a variety of anatomical sites . An isolate was almost certainly not a gonococcus if it gave a negative superoxol test result, as all but one of 596 available gonococci gave positive test results . However, a proportion of the non-gonococcal neisseriae and isolates of Branhamella catarrhalis, also gave positive test results . The superoxol test is thus a useful addition to the techniques available for the characterisation of gonococci, but additional procedures are needed to confirm the identities of isolates giving positive results.

Am J Med, 1984 Apr, 76(4), 752 - 8
Neisseria subflava endocarditis . Case report and review of the literature; Pollack S et al.; Neisseria subflava is a rare cause of bacterial endocarditis . Only seven cases have been identified in the world literature if strict criteria as to organism classification and of endocarditis are applied to individual case reports . The first reported case in an intravenous drug user is described . In addition, findings on serial two-dimensional and M-mode echocardiography performed during and after the treatment period are presented . This patient's recovery with anti-microbial therapy alone despite evidence of aortic and significant mitral valve involvement is in accord with results of other antibiotic-treated cases.

Br J Vener Dis, 1984 Apr, 60(2), 95 - 8
Treatment of acute gonococcal urethritis in men with simultaneous infection with Chlamydia trachomatis; Csango PA et al.; Each of 201 men with symptoms and signs of acute urethritis was randomly assigned to one of two treatment regimens: ampicillin (2g) plus probenecid (1g), or sulphamethoxazole-trimethoprim (SMX-TMP) (sulphamethoxazole 1600 mg plus trimethoprim 320 mg) four tablets twice daily for two days . Before treatment Neisseria gonorrhoeae was isolated from 162 patients, while coexistent Chlamydia trachomatis was recovered from 42 (26%) men . After treatment N gonorrhoeae persisted in 11 (14.3%) of the 77 patients treated with ampicillin and probenecid and in three (3.5%) of the 85 treated with SMX-TMP (p less than 0.05), while C trachomatis persisted in four (16%) of the 25 men treated with SMX-TMP and in all 17 patients treated with ampicillin and probenecid . SMX-TMP was thus more effective than ampicillin in treating acute gonorrhoea in men and in eradicating concurrent C trachomatis infection.

Int J Clin Pharmacol Ther Toxicol, 1984 Apr, 22(4), 218 - 20
Plasma, cantharides blister fluid, and suction blister fluid levels of ceftizoxime after single intramuscular application for gonorrhea; Korting HC et al.; Following a single intramuscular application of 1 g ceftizoxime, levels of the drug were determined in plasma as well as in suction blister fluid (SBF) and cantharides blister fluid (CBF) . This regimen invariably led to both high and long-lasting plasma levels: 81 +/- 16 min post dose maximum plasma levels of 17.5 +/- 3.1 micrograms/ml were reached; 6 h post dose levels of 4.6 +/- 0.4 micrograms/ml were still found, i.e., 4375 and 1150 times, respectively, the MIC90% of Neisseria gonorrhoeae . The high plasma levels were parallelled by high concentrations in SBF, with peaks amounting to 8.4 +/- 1.0 micrograms/ml . Peak concentrations in CBF ranged from 8.1 to 15.7 micrograms/ml . Thus, the pharmacokinetic behavior of ceftizoxime given as a single intramuscular injection of 1 g explained the excellent clinical results of this regimen in uncomplicated gonorrhea.

Br J Vener Dis, 1984 Apr, 60(2), 90 - 1
Ceftizoxime in the treatment of uncomplicated gonorrhoea; Spencer RC et al.; A total of 74 men and 26 women with uncomplicated gonorrhoea were treated with ceftizoxime sodium 0.5 g intramuscularly . The cure rate was 99% and included successful treatment of four infections due to beta-lactamase producing organisms . The minimum inhibitory concentrations (MICs) of ceftizoxime in vitro were very much lower than those of penicillin and cefuroxime, and side effects were minimal . We conclude that ceftizoxime is effective against Neisseria gonorrhoeae in vivo and in vitro.

Am J Gastroenterol, 1984 Apr, 79(4), 280 - 2
Gonococcal perihepatitis: diagnostic and therapeutic value of laparoscopy; Cano A et al.; Two patients with pelvic and right hypochondrial pain and with purulent vaginal exudate in which Neisseria gonorrhoeae was isolated, are presented . Laparoscopy was used in both cases . A diagnosis of perihepatitis was made by demonstrating the typical adhesions in "violin string" shape and by obtaining clinical improvement after breaking up those adhesions . Our conclusion is that laparoscopy is a useful diagnostic and therapeutic procedure in young women with pain in the right upper quadrant of the abdomen and with signs of lower genital infection.

J Infect Dis, 1984 Apr, 149(4), 544 - 52
Electrophoretic and serological characterization of the lipopolysaccharide produced by Neisseria gonorrhoeae; Mintz CS et al.; Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) of purified lipopolysaccharide (LPS) from Neisseria gonorrhoeae resulted in the formation of multiple bands . Many of the bands consisted of LPS aggregates, which could be dissociated by treatment with 0.1 M NaOH or by addition of 4 M urea to the separating gel . The unaggregated LPS was usually found in one to three bands toward the bottom of the gels, a result suggesting that a long repeating O antigen is not present on gonococcal LPS . SDS-PAGE of LPS from different LPS serotypes of N gonorrhoeae indicated that structural heterogeneity exists . Antigenic analysis by enzyme-linked immunosorbent assay inhibition of gonococcal LPS extracted with phenol-chloroform-petroleum ether (PCP) and phenol-water revealed that PCP-extracted LPS contained substantially less serotype-specific antigen than did phenol-water-extracted LPS . These results suggest that the PCP and phenol-water methods extract different molecular species of LPS from N gonorrhoeae.

Med J Aust, 1984 Mar 3, 140(5), 268 - 71
Gonorrhoea in a Sydney house of prostitution; Donovan B; Seventy prostitutes were screened at their place of work, a Sydney house of prostitution, on a weekly basis over one year . Of these, 10% acquired new infections with gonorrhoea each week (53 episodes) . Clinical guidelines (symptoms, contact history, physical signs) were found to be unreliable, in this context, for predicting the isolation of Neisseria gonorrhoeae . Of the 39 women observed over one month or more, 17 (44%) acquired gonorrhoea within the first month . Stability of the place of work appeared to be associated with a lower isolation rate (5.5%) . Five asymptomatic, urethrally infected men (two clients, three boyfriends/husbands) were detected, and appeared to have an important role in the hyperendemicity of gonorrhoea in this environment.

Antimicrob Agents Chemother, 1984 Mar, 25(3), 375 - 6
Susceptibilities of bacterial and fungal urinary tract isolates to desferrioxamine; Lowy FD et al.; Desferrioxamine, a safe and effective iron chelator, was evaluated for its antibacterial and antifungal activity . The susceptibilities of 124 urinary tract isolates and 28 clinical isolates of Neisseria gonorrhoeae to desferrioxamine concentrations that are readily achievable in urine were determined . Of all isolates, 27% were inhibited by a concentration of less than or equal to 12.5 mM . Proteus mirabilis and N . gonorrhoeae isolates were particularly susceptible to the chelator . Desferrioxamine appears to have limited potential as an antibacterial agent.

JOGN Nurs, 1984 Mar-Apr, 13(2), 83 - 7
Unit dose erythromycin ophthalmic ointment for neonatal ocular prophylaxis; Bryant BG; Silver nitrate solution has been used since the 1880s for newborn prophylaxis against Neisseria gonorrhoeae ocular infections . Recommendations by the American Academy of Pediatrics and the Centers for Disease Control state that erythromycin and tetracycline ophthalmic products may serve as alternatives to silver nitrate solution . The selection of erythromycin ophthalmic ointment offers the advantage of antimicrobial activity against Chlamydia trachomatis and is not associated with the chemical conjunctivitis often seen with silver nitrate solutions . The only commercially available form of erythromycin ophthalmic ointment is a 3.5-gm tube . Repackaging the ointment into tuberculin syringes reduces the cost to the patient and provides the nurse with a more convenient method of administering the ointment to the neonate.

Pediatr Infect Dis, 1984 Mar-Apr, 3(2), 97 - 9
Vaginal Chlamydia trachomatis infection in children with sexual contact; Ingram DL et al.; To determine whether vaginal infections with Chlamydia trachomatis in children were associated with sexual contact, 50 children ages 1 to 12 years with a history of sexual contact and 34 children without such a history were studied . Vaginal, throat and rectal cultures for C . trachomatis and Neisseria gonorrhoeae were performed in all children . Three children with sexual contact and none of the children without a history of sexual contact had vaginal infections . The three infected children were asymptomatic and only one had had vaginal intercourse . None of the 10 children with a history of sexual contact and gonorrheal vaginitis had C . trachomatis isolated . Although C . trachomatis vaginal infections as detected by vaginal cultures are infrequent, we recommend that all girls being evaluated for sexual contact be routinely cultured for C . trachomatis so that those infected can be treated.

J Clin Lab Immunol, 1984 Mar, 13(3), 107 - 10
Binding of Neisseria gonorrhoeae by lectin-like receptors on human phagocytes; Kinane DF et al.; The adherence of gonococci to phagocytes was examined for the presence of "lectin-like" receptors capable of binding these bacteria . The data suggests such "lectin-like" receptors are present on PMN and monocytes that recognize sugars present in the gonococcal cell wall and that there are quantitative and qualitative differences in expression of these receptors . These findings may have importance in investigation of the interaction of gonococci with phagocytes and with the subsequent induction of immunity in the disease.

J Infect Dis, 1984 Mar, 149(3), 378 - 86
Ability of monomeric peptidoglycan fragments from Neisseria gonorrhoeae to damage human fallopian-tube mucosa; Melly MA et al.; Purified disaccharide peptide monomers obtained from Neisseria gonorrhoeae by enzymatic digestion of gonococcal peptidoglycan damaged the mucosa of human fallopian tubes in organ culture . Two peptidoglycan fragments were tested: a nonreducing, anhydromuramyl-containing monomer (the principal fragment shed by growing gonococci) and the analogous reducing, muramidase-derived monomer . The damage produced by either of these peptidoglycan monomers resulted in sloughing of ciliated cells from the mucosa and resembled the damage observed in active gonococcal infection and that produced by filter-sterilized toxic supernatant fluids from gonococcal-infected organ cultures . The minimal toxic dose of peptidoglycan monomers was 0.75 micrograms/ml . Neither lipopolysaccharide, sodium dodecyl sulfate, nor Triton X-100, possible contaminants from the monomer-purification procedures, was present in sufficient quantity to account for the damage . Both of the gonococcal peptidoglycan monomers may be present in vivo and thus may play a role in the pathogenesis of gonococcal infection.

J Clin Microbiol, 1984 Mar, 19(3), 399 - 403
Antigen detection for the diagnosis of gonorrhea; Stamm WE et al.; We compared the diagnostic value of an enzyme immunoassay method for detection of gonococcal antigen in genital secretions with culture results and direct Gram stain for Neisseria gonorrhoeae in 1,171 men and 723 women attending a sexually transmitted disease clinic . When compared with culture results in men, the immunoassay provided a sensitivity of 94% and a specificity of 98% and was essentially equivalent to the urethral Gram stain . The predictive value of a positive immunoassay was 97% in men with a urethral discharge in whom the prevalence of gonorrhea was 36%, and 30% in men without urethral discharge, who had a 2% prevalence of gonorrhea (P less than 0.001) . The sensitivity of the immunoassay was 95% in men with and 67% in men without urethral discharge (P less than 0.01) . In women, the immunoassay resulted in a sensitivity of 78% and a specificity of 98% compared with cervical culture and had a significantly better sensitivity than the cervical Gram stain (78 versus 48%, P less than 0.001) . Analysis of patients with discrepant culture and immunoassay results suggested that most culture-negative, immunoassay-positive patients probably did not have gonorrhea . After treatment, all but 1 of 59 originally culture- and immunoassay-positive patients became negative in both tests by 3 days . Results of the immunoassay were not affected by transport or by refrigeration for up to 30 days.

J Clin Microbiol, 1984 Mar, 19(3), 380 - 2
Rapid confirmatory identification of Neisseria gonorrhoeae with lectins and chromogenic substrates; Yajko DM et al.; A group of five tests utilizing wheat germ and soybean lectins and chromogenic substrates (orthonitrophenyl-beta-D-galactopyranoside, gamma-glutamyl-beta-naphthylamide, and prolyl-beta-naphthylamide derivatives) was used as a rapid (30-min) method for the identification of Neisseria gonorrhoeae . The rapid method agreed with Minitek test results for all 126 N . gonorrhoeae isolates and all 39 nongonococcal isolates tested . Soybean lectin was useful for the identification of rare strains (4 of 126) of N . gonorrhoeae which are not agglutinated by wheat germ lectin . The chromogenic substrates differentiate N . gonorrhoeae from Neisseria meningitidis, Neisseria lactamica, and other Neisseria species which may grow on Thayer-Martin or other selective media.

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