Neisseria

J Clin Microbiol, 1984 Mar, 19(3), 347 - 50
Validity of an enzyme immunoassay for detection of Neisseria gonorrhoeae antigens; Papasian CJ et al.; An enzyme immunoassay (EIA; Gonozyme, Abbott Laboratories) for the antigenic detection of Neisseria gonorrhoeae in endocervical or urethral specimens was evaluated . EIA results were compared with results of conventional culture tests for N . gonorrhoeae . Specimens from 208 males (113 culture positive) and 252 females (72 culture positive) were tested . The sensitivity and specificity of EIA for specimens from males were 97.3 and 95.8%, respectively . The sensitivity and specificity of EIA for specimens from females were 79.2 and 87.2%, respectively.

Infect Immun, 1984 Mar, 43(3), 994 - 9
Monoclonal antibody that recognizes an outer membrane antigen common to the pathogenic Neisseria species but not to most nonpathogenic Neisseria species; Cannon JG et al.; A hybridoma derived from a mouse immunized with gonococcal outer membranes produced an antibody, designated H.8, that bound to all strains of Neisseria gonorrhoeae and N . meningitidis tested, and to N . lactamica and N . cinerea, but only rarely to other nonpathogenic Neisseria species . Studies with the gonococcal strain used in production of the antibody showed that the antibody bound to a surface-exposed, protease-sensitive, and heat-modifiable outer membrane antigen that we believe is distinct from previously described gonococcal outer membrane proteins.

Infect Immun, 1984 Mar, 43(3), 839 - 45
Conservation of peptide structure of outer membrane protein-macromolecular complex from Neisseria gonorrhoeae; Hansen MV et al.; The structural conservation of an outer membrane protein of Neisseria gonorrhoeae called OMP-MC (outer membrane protein-macromolecular complex) was investigated by determining the isoelectric point and amino-terminal amino acid sequence of the protein and by using high-performance liquid chromatography for comparative tryptic peptide mapping . The 76,000-dalton subunits generated by reduction and alkylation of the native 800,000-dalton complex from six test strains focused in ultrathin gels as bands of restricted heterogeneity at an approximate pI of 7.6 . Dansyl chloride labeling indicated that all strains shared glycine as the amino-terminal amino acid . Sequence analysis of OMP-MC from two strains revealed no amino acid differences within the first 11 residues . Dual-label peptide maps revealed an extremely high degree of conservation of peptide structure . The results indicate that (i) OMP-MCs isolated from various strains of N . gonorrhoeae share structural homology and (ii) the 800,000-dalton complex is a homopolymer composed of 10 to 12 apparently identical 76,000-dalton subunits.

Rev Infect Dis, 1984 Mar-Apr, 6(2), 181 - 8
The significance of nongonococcal, nonmeningococcal Neisseria isolates from blood cultures; Feder HM Jr et al.; Nongonococcal, nonmeningococcal neisseriae are part of the normal respiratory flora and infrequently cause disease . These organisms include Neisseria lactamica, Neisseria mucosa, Neisseria sicca, Neisseria flavescens, Neisseria subflava , Neisseria perflava , Neisseria flava , and Branhamella catarrhalis (previously classified as Neisseria catarrhalis) . Blood cultures positive for these bacteria have been associated with serious infections, including endocarditis, septicemia, and meningitis . In a retrospective survey of a 10-year period, 1970-1980, eight patients were identified at Hartford Hospital (Hartford, Conn.) whose blood cultures were positive for nongonococcal, nonmeningococcal neisseriae . In four patients, the neisseria blood isolates were associated with serious infections: two with endocarditis, one with sepsis, and one with meningitis . In four other patients, the neisseria blood isolates were contaminants.

J Clin Microbiol, 1984 Mar, 19(3), 338 - 41
Use of the API NeIdent system for identification of pathogenic Neisseria spp . and Branhamella catarrhalis; Janda WM et al.; The API NeIdent system (Analytab Products, Plainview, N.Y.) was evaluated for identifying Neisseria spp . and Branhamella catarrhalis commonly isolated from clinical specimens . The system identified 90% of 303 Neisseria gonorrhoeae isolates, 71% of 113 Neisseria meningitidis isolates, and 63% of 16 Neisseria lactamica isolates but failed to identify any of 22 B . catarrhalis isolates . Testing of gonococcal strains of various auxotypes revealed no relationship between nutritional requirements and NeIdent profile numbers . With the Neisseria species, interpretation of the cinnamaldehyde-coupled beta-naphthylamine reactions was difficult and resulted in profile numbers not listed in the Profile Register . Positive resazurin-glucose reactions resulted in unlisted numbers for all B . catarrhalis strains . Inconsistent results were also obtained when 62 N . gonorrhoeae isolates were tested more than once on the strip . In all cases, profile variability and failure to identify these organisms were related to the beta-naphthylamide substrate tests . Expansion of the data base and modification of the substrate formulations or their interpretive criteria may increase the reliability of the NeIdent system for identifying Neisseria spp . and B . catarrhalis.

N Engl J Med, 1984 Mar 1, 310(9), 545 - 9
Effect of treatment regimens for Neisseria gonorrhoeae on simultaneous infection with Chlamydia trachomatis; Stamm WE et al.; We evaluated the effect of treatment of gonorrhea on simultaneous Chlamydia trachomatis infection by randomly assigning 293 heterosexual men and 246 heterosexual women with gonorrhea to receive one of the following treatment regimens: (1) 4.8 million units of aqueous procaine penicillin plus 1 g of probenecid, (2) nine tablets of trimethoprim-sulfamethoxazole daily for three days, or (3) 500 mg of tetracycline four times a day for five days . Among the men, gonococcal infection was cured in 99 per cent given penicillin plus probenecid, 96 per cent given trimethoprim-sulfamethoxazole, and 98 per cent given tetracycline . Among the women, only 90 per cent given tetracycline were cured, in contrast to 97 per cent given penicillin plus probenecid and 99 per cent given trimethoprim-sulfamethoxazole . Chlamydial infection, present in 15 per cent of the men and 26 per cent of the women, was cured in 30 of 32 patients given trimethoprim-sulfamethoxazole and 27 of 29 given tetracycline, but in only 10 of 23 given penicillin plus probenecid . Among chlamydia-positive patients, postgonococcal urethritis in men and cervicitis in women occurred more often in patients given penicillin plus probenecid . Salpingitis developed in 6 of 20 women given penicillin plus probenecid, but in only 1 of 26 given trimethoprim-sulfamethoxazole and in none of 24 given tetracycline . We conclude that the use of penicillin plus probenecid alone for gonorrhea in heterosexual patients carries an unacceptably high risk of postgonococcal chlamydial morbidity . Trimethoprim-sulfamethoxazole and tetracycline were highly effective against both pathogens and were well tolerated in men, but both drugs caused frequent side effects in women . The failure of tetracycline to cure gonorrhea in 10 per cent of women argues against its use alone; treatment with penicillin followed by tetracycline has been recommended for further trial.

JAMA, 1984 Feb 3, 251(5), 620 - 5
Establishing the cause of genitourinary symptoms in women in a family practice . Comparison of clinical examination and comprehensive microbiology; Berg AO et al.; We conducted a prospective study comparing the diagnostic yield of standard clinical examinations and of comprehensive microbiological studies in establishing the etiology of genitourinary (GU) symptoms and the prevalence of GU tract infections in 204 women seen in a university-based family practice . Two thirds were initially seen with GU symptoms and one third were seen for routine examinations . In each case we obtained demographic and historical information, a physical examination, and a variety of laboratory tests, including research procedures not commonly available . Diagnoses considered were urinary tract infection and sterile pyuria; trichomonal, yeast, and nonspecific vaginitis; and GU tract infection with Neisseria gonorrhoeae, Chlamydia trachomatis, or herpes simplex virus . Using strategies commonly employed in practice, we reached a diagnosis in only 34% of symptomatic women, a figure rising to 66% when selected, nonroutine laboratory examinations were added.

Br J Obstet Gynaecol, 1984 Feb, 91(2), 182 - 6
An assessment of pre-operative microbial screening on the prevention of post-abortion pelvic inflammatory disease; Mills AM; Five hundred women were examined for lower genital tract infection before vaginal termination of pregnancy . Pre-operatively, Neisseria gonorrhoeae was isolated from nine women (1.8%); five of eight male partners also had gonorrhoea . All the women with gonorrhoea were treated at least 48 h pre-operatively with ampicillin and probenicid; three of them had symptoms of pelvic infection pre-operatively and one had symptoms postoperatively . Of these women, 120 (24%) had a follow-up examination within 47 days of abortion; 15 (3%) required an evacuation of retained products of conception and only 12 (2%) had mild suspected pelvic infection . Screening for Neisseria gonorrhoeae and treatment pre-operatively prevented pelvic infection in a further eight patients.

J Rheumatol, 1984 Feb, 11(1), 3 - 8
Arthritis in rabbits induced by killed Neisseria gonorrhoeae and gonococcal lipopolysaccharide; Goldenberg DL et al.; Intraarticular injections of viable N, gonorrhoeae, killed N . gonorrhoeae or gonococcal lipopolysaccharide (LPS) in rabbits' knees caused an acute, polymorphonuclear synovitis with abscess formation 24-72 h after the injection . At 5-7 days, a mononuclear infiltration with synovial lining cell hyperplasia developed, which in some rabbits persisted for one month . Gonococcal LPS, in amounts of 5 micrograms or greater, always caused a marked synovitis indistinguishable from that produced by viable N . gonorrhoeae . Gonococcal outer membrane protein used as a control in these experiments caused no or minimal synovitis in concentrations 50-fold higher than those used in the LPS inoculation experiments . These studies should provide a model to investigate the role of LPS in the arthritis associated with gonococcal infection.

J Infect Dis, 1984 Feb, 149(2), 175 - 83
Serum sensitivity of Neisseria gonorrhoeae: the role of lipopolysaccharide; Shafer WM et al.; A lipopolysaccharide (LPS) mutant (FA5100) of a serum-resistant strain of Neisseria gonorrhoeae (FA19) was found to be highly sensitive to the bactericidal activity of normal human serum (NHS) . Both strain FA5100 and an unrelated serum-sensitive clinical isolate (F62) were killed by NHS via the classical complement pathway since killing required C2 and Ca++ . However, the fact that only strain FA5100 was sensitive to human hypogammaglobulinemic and cord serum suggested that this strain might activate the classical complement pathway in the absence of antibody . Anticomplementary concentrations of LPS from strain FA5100 inhibited the bactericidal activity of NHS against either strain FA5100 or strain F62 . However, concentrations of LPS from strain FA5100 that exhibited marginal anticomplementary behavior also inhibited the killing of strain F62 by NHS . The ability of LPS from strain FA5100 to inhibit the bactericidal activity of NHS against strain FA5100 and to activate complement was reduced by treatment with mild alkali . However, alkali-treated LPS from strain FA5100 still inhibited the bactericidal activity of NHS against strain F62.

J Clin Microbiol, 1984 Feb, 19(2), 218 - 20
Isolation of Neisseria gonorrhoeae on selective and nonselective media in a sexually transmitted disease clinic; Bonin P et al.; To assess the practical significance of reported increases in the prevalence of vancomycin-susceptible strains of Neisseria gonorrhoeae on isolation of this organism, antibiotic-free chocolate agar (CA), modified Thayer-Martin medium (MTM), and a vancomycin-free selective medium (VFSM) were compared in a sexually transmitted disease clinic . Among 326 cervical gonococcal infections detected in a comparison of CA with MTM, 92.0% were detected on CA, compared with 98.2% on MTM (P less than 0.001) . Similarly, among 306 cervical infections detected in a comparison of MTM and VFSM, 95.8% of infections were detected with VFSM, compared with 98.4% for MTM (P = 0.10) . For 1,632 urethral infections in men, all three media were equivalent, with none detecting fewer than 98% of the infections . Compared with a single inoculation, dual inoculation of MTM increased the diagnostic yield by 1.5% for 206 urethral infections and 2.4% for 83 cervical infections . In our clinic population, MTM is superior to CA or VFSM for the diagnosis of genital gonococcal infections, especially in women . The increased yield that accrued from inoculation of both MTM and either of the other media was not sufficiently high to warrant routine use of this practice in our clinic.

Br J Vener Dis, 1984 Feb, 60(1), 31 - 8
Interaction between Trichomonas vaginalis and other pathogenic micro-organisms of the human genital tract; Street DA et al.; Trichomonas vaginalis organisms were mixed with suspensions of Neisseria gonorrhoeae, Mycoplasma hominis or Chlamydia trachomatis to allow ingestion of these micro-organisms by the trichomonads . Culture studies indicated that gonococci and mycoplasmas were ingested and that the number of intracellular viable organisms decreased rapidly, most gonococci being killed within six hours and all mycoplasmas within three hours . Electron microscopy revealed phagocytic uptake and destruction of these two micro-organisms within the trichomonads, gonococcal degradation being associated with lysosomal enzyme activity . There was no evidence from cultural or electron microscopy studies that C trachomatis organisms persisted in mixed culture with T vaginalis.

Br J Vener Dis, 1984 Feb, 60(1), 23 - 8
Epidemiology of PPNG infections in Amsterdam: analysis by auxanographic typing and plasmid characterisation; Ansink-Schipper MC et al.; In January 1981 the incidence of penicillinase producing Neisseria gonorrhoeae (PPNG) strains in Amsterdam had increased to 18% of all new cases of gonorrhoea . Auxanographic typing in combination with plasmid determination of 729 PPNG strains showed that in 1981 the predominant and endemic types were those with the Africa plasmid and transfer factor which were non-requiring and inhibited by phenylalanine . In 1982 proline requiring strains with the Asia plasmid and transfer factor increased after being imported and spread by prostitution . Four different plasmid patterns and 12 auxotypes were distinguishable . Unusual auxotypes of both African and Asian plasmid types are frequently imported, some disappearing soon after their introduction into Holland but others providing an opportunity to trace sources and contacts . Prostitution and the biological properties of PPNG strains seem to play an important role in their spread . Only 2.6% of them were isolated from homosexual men . In areas where PPNG strains are prevalent, auxotyping is an important tool in their surveillance.

Arch Intern Med . 1984 Feb;144(2):391.
Gonococcal inguinal lymphadenitis; DeHertogh DA et al.; Neisseria gonorrhoeae is an unusual cause of inguinal lymphadenitis . We describe herein a male patient with no evidence of urogenital or extragenital gonococcal infection who had bacteriologically proved lymphadenitis secondary to N gonorrhoeae . We were unable to elucidate the pathogenesis of this entity, but concluded that urethral, rectal, and pharyngeal cultures for gonorrhea should be included in the evaluation of sexually active persons with adenitis of uncertain etiology even in the absence of urogenital or extragenital symptoms or findings.

J Med Microbiol, 1984 Feb, 17(1), 45 - 52
Chemotaxis of human polymorphonuclear leukocytes toward Neisseria gonorrhoeae; Rank EL et al.; Chemoattractive properties of Neisseria gonorrhoeae were studied by measuring leukocyte migration in agarose gel . Human serum albumin (0.5%) was present in the gel and normal human serum was excluded from all components of the assay . Viable cell populations and lysates of colonial types F62T1, F62T2 and F62T3 induced migration of polymorphonuclear leukocytes . Chemotactic activity of the lysate was not altered by heating at 100 degrees C for 10 min and was retained in the 12 100 g supernatant fraction of the heated lysate . Fractionation of the supernate by Sephadex G-100 chromatography showed that the chemotactic activity was associated primarily with an absorbance peak at 280 nm of relatively low mol . wt . The chemotactic activity of this fraction was lost after dialysis and the peak was no longer present in the Sephadex G-100 elution profile of the dialysed supernate . The gonococcal leukotaxins were sensitive to digestion by trypsin, pronase and amyloglucosidase, but insensitive to treatment with RNAase, DNAase or lipase at pH 5.7-7.1.

J Exp Med, 1984 Feb 1, 159(2), 452 - 62
Purification and partial characterization of the opacity-associated proteins of Neisseria gonorrhoeae; Blake MS et al.; Gonococci, grown on agar, frequently give rise to opaque colonies . This opacity phenotype is associated with the presence of one or more outer membrane proteins of approximately 28,000 mol weight . These proteins are included within a class of proteins named proteins II . A method is described to isolate and purify the opacity-associated proteins from Neisseria gonorrhoeae . This method uses high concentrations of calcium and a zwitterionic detergent at pH 4.0 . Under these conditions proteins II are readily solubilized from the outer membrane . Further purification is achieved by ion exchange and molecular sieve chromatography in the presence of the zwitterionic detergent . The opacity-associated proteins are very basic with isoelectric points varying between 9.0 to 10.0 . Further evidence for their basic nature is their behavior on ion exchange chromatography and their amino acid composition.

Urol Clin North Am, 1984 Feb, 11(1), 65 - 81
Acute pelvic inflammatory disease; Eschenbach DA; PIP: This discussion of acute pelvic inflammatory disease (PID) -- usually a spontaneous infection that occurs among sexually active, menstruating, nonpregnant women -- covers: pathophysiology; microbial etiology (gonorrhea, chlamydia, genital mycoplasmas, and aerobic and anerobic bacteria); epidemiology (number of sexual partners, age, IUDs, previous PID, previous gonorrhea, untreated male sexual contacts, and perihepatitis associated with PID); diagnosis (physical examination, laboratory examination, culdocentesis, examination of the male partner, cultures, and ultrasonography); treatment; and sequelae (recurrent PID, infertility, ectopic pregnancy, and pain) . The majority of infections are caused by bacteria and a polymicrobial bacterial infection is common . Neisseria gonorrhea, Chlamydia trachomatis, and a wide variety of aerobic and anerobic bacteria are most frequently isolated from women with PID . Primary PID is usually and acute infection in which organisms ascend into the uterus and fallopian tubes from the cervix . Chronic active infections are unusual except in neglected cases and in Actinomyces infection, but sterile chronic inflammatory adhesions are common residuals of acute infection . Except for women who have an IUD in place or the 15% who have had uterine instrumentation, spontaneous PID is almost totally confined to women who are sexually active . There is a much higher PID rate among younger than older women . Women who use an IUD for contraception are at least 2-4 times more likely to develop PID than nonusers . Women who have had PID are twice as likely to develop the infection as those who have never had it . A history of a prior uncomplicated gonococcal infection is more common among women with PID than among women without disease . Untreated males with urethral N . gonorrhea and possibly with C . trachomatis infection are an important source of infection both for the initial and for recurrent episodes of PID . Abdominal pain is the most common symptom although the pain may be mild or even absent in at least 5% of patients with PID verified by laparoscopy . In patients who have overt PID, it is possible to establish the diagnosis with reasonable certainty by a combination of history, physical examination, Gram stain of cervical secretions, culdocentesis, and examination of the male sexual partner . Adequate treatment of salpingitis includes an assessment of the severity of the infection, administration of appropriate antibiotics, employment of other health measures, close patient follow-up, and treatment of the male sexual patner . 25% of women with 1 episode of salpingitis develop a subsequent episode .

Urol Clin North Am, 1984 Feb, 11(1), 55 - 64
Nongonococcal urethritis; Bowie WR; Nongonococcal urethritis is a frequent genital infection, in most cases caused by Chlamydia trachomatis or Ureaplasma urealyticum . Diagnosis requires demonstration of urethritis and exclusion of Neisseria gonorrhoeae infection . Preferred treatment is seven days of tetracycline hydrochloride or doxycycline, to both the patient and partners . Physical sequelae are infrequent but include epididymitis and Reiter's syndrome.

Br J Vener Dis, 1984 Feb, 60(1), 29 - 30
Treating gonococcal urethritis in men: oral amoxycillin potentiated by clavulanate compared with intramuscular procaine penicillin; Latif AS et al.; In a study of 121 men with uncomplicated gonococcal urethritis, 64 were treated orally with a single dose of 3 g amoxycillin and 250 mg of the specific beta-lactamase inhibitor, clavulanic acid, and 57 with a single intramuscular injection of 2.4 MU procaine penicillin . After seven days, six (9.4%) patients treated with amoxycillin and clavulanic acid were still culture positive for Neisseria gonorrhoeae, compared with 26.3% of those treated with procaine penicillin.

Urol Clin North Am, 1984 Feb, 11(1), 45 - 53
Gonococcal urethritis; Harrison WO; Gonorrhea continues to maintain its position as the most common reportable infectious disease in the United States . Penicillin is still the antibiotic of choice for the treatment of uncomplicated gonococcal urethritis in most of the United States, but the increasing incidence of penicillinase-producing Neisseria gonorrhoeae (PPNG) in many areas of the world necessitates a reconsideration of standard therapy . In addition to penicillin resistance, the gonococcus is also developing resistance to spectinomycin and tetracycline, which further complicates the choice of therapy.

Infect Immun, 1984 Feb, 43(2), 706 - 9
Analysis of the antigen specificity of the human serum immunoglobulin G immune response to complicated gonococcal infection; Hook EW 3rd et al.; The antigen-specific basis of human serum immunoglobulin G antibody response to complicated gonococcal infection was studied in 13 patients by using the Western blot technique for transfer of proteins from sodium dodecyl sulfate-polyacrylamide gels to nitrocellulose paper . Of 13 patients (8 with disseminated gonococcal infection, 4 with pelvic inflammatory disease, 1 with gonococcal epididymitis), 12 reacted with protein I antigens and 9 with lipopolysaccharide (LPS) . Sera from eight patients reacted with both protein I and LPS, whereas sera from four reacted only with protein I, and one sera reacted with LPS alone . One serum with antibody to both protein I and LPS by Western blot analysis was tested for bactericidal activity before and after adsorption of antibody to LPS . Removal of antibody to LPS reduced the bactericidal titer of this serum from 1:100 to 1:50, indicating that antibody to both antigens may be bactericidal for Neisseria gonorrhoeae.

J Infect Dis, 1984 Feb, 149(2), 166 - 74
Antigenic variation during infection with Neisseria gonorrhoeae: detection of antibodies to surface proteins in sera of patients with gonorrhea; Zak K et al.; Neisseria gonorrhoeae were cultured from the urethra of male patients and from the cervix and urethra of female contacts . Isolates from a given group of individuals were of the same strain but differed considerably in terms of the molecular weight of both protein II and pili . Radioimmunoprecipitation assays showed that most patients produced serum antibodies to protein I . Antibodies to pili, when present, showed limited cross-reactivity with the different pili produced by a single strain . Antibodies to protein II were highly specific, reacting with only one of the protein II-types produced by a single strain; this observation suggested that the host immune response may be an important factor in antigenic variation . Several sera also contained antibodies to a common surface protein with a molecular weight of 43,000 that was present in all strains tested.

Microbios, 1984, 41(160), 99 - 106
The oral ecology of patients with severe Sjögren's syndrome; MacFarlane TW; An investigation of the commensal microflora, salivary flow rate, pH, and the degree of atrophy of the oral mucosa in ten patients with severe Sjogren's syndrome and ten control subjects, revealed a number of differences . The numbers of Streptococcus salivarius, Neisseria pharyngis, Veillonella species and Micrococcus mucilagenosus isolated from patients with Sjogren's syndrome were significantly reduced, while the numbers of Candida spp . and Staphylococcus aureus were significantly increased when compared with control subjects . In addition the salivary pH of the Sjogren's group was significantly reduced and the degree of mucosal atrophy increased compared with controls.

Sex Transm Dis, 1984 Jan-Mar, 11(1), 34 - 5
Cutaneous gonococcal abscess: a case report; Fiumara NJ et al.; A 29-year-old man was diagnosed as having a gonococcal abscess of the prepuce and urethritis . Such abscesses, caused by fetal monitoring during labor of a mother infected with Neisseria gonorrhoeae, have been observed on the scalp of newborns . If antibiotic treatment is to be effective, these abscesses must be excised and drained.

Sex Transm Dis, 1984 Jan-Mar, 11(1), 24 - 7
A comparison of rosoxacin with ampicillin and probenecid in the treatment of uncomplicated gonorrhea; Cohen AI et al.; Rosoxacin, a beta-lactamase-resistant, pyridyl quinolone derivative with in vitro activity against Neisseria gonorrhoeae, was compared to an oral regimen of ampicillin plus probenecid for the treatment of uncomplicated gonococcal infection . Fifty-seven patients were evaluated for the effectiveness of the two antibiotics . Thirty (97%) of 31 patients receiving rosoxacin were cured of their infection as were 25 (96%) of 26 patients who received the oral regimen of ampicillin plus probenecid . Both drug regimens were associated with a significant number of side effects . Of the ampicillin-treated group, 29% had diarrhea and/or abdominal cramping . Of the rosoxacin-treated patients, 52% had reactions classified as central nervous system effects; these included headaches, dizziness, euphoria, and drowsiness.

Sex Transm Dis, 1984 Jan-Mar, 11(1), 18 - 23
Urinary tract infection among women attending a clinic for sexually transmitted diseases; Wong ES et al.; The symptoms, signs, and laboratory findings for 69 women who were seen at a sexually transmitted disease (STD) clinic and who had acute urinary tract infection (UTI) were compared with those for women who had vaginitis, gonorrhea, or chlamydial infection . Escherichia coli and Staphylococcus saprophyticus were the two most common causes of acute cystitis in this population and accounted for 62 (90%) of 69 infections . Forty-three percent of the women had positive tests for antibody-coated bacteria (ACB), an observation implying renal infection although symptoms of upper tract infection were infrequent . Frequency, urgency, dysuria, and suprapubic tenderness were significantly associated with cystitis, whereas vaginal discharge and vulvar itching were associated with vaginitis . There was, however, considerable overlap in symptoms among the four groups of women, and their accurate differentiation required objective information based upon pelvic examination, examination of vaginal fluid, and urinalysis . In the absence of vaginitis on wet mount and mucopurulent cervicitis on examination, pyuria, as determined by examination of centrifuged urine, had an 88% sensitivity, 76% specificity, 61% positive predictive value, and 93% negative predictive value for acute UTI . Because of the high prevalence of positive ACB tests and the possibility that infection with Chlamydia trachomatis and/or Neisseria gonorrhoeae may be mistaken for cystitis, we prefer a five- to seven-day course of antibiotics over single-dose therapy for treatment of patients with possible UTI in the setting of an STD clinic.

Obstet Gynecol, 1984 Jan, 63(1), 81 - 4
Chlamydia trachomatis isolation in a symptomatic university student population; Wiesmeier E et al.; In a study of 638 women attending a University Student Health Service outpatient gynecologic clinic, their symptoms were either lower genital tract infection or a history of suspected exposure to sexually transmitted diseases . Forty-two (6.6%) harbored Chlamydia trachomatis, four (0.8%) Neisseria gonorrhoeae, and one (0.2%) both of these organisms . Chlamydia-positive patients were more likely to be using a contraceptive method, have multiple partners, and have partners with symptoms of urethritis (P = .05) . The Chlamydia-positive patients were no more likely to have increased or abnormal vaginal discharge than were controls . Of the women harboring Chlamydia trachomatis, only one of 36 (3%) of those who were available for follow-up at one to eight weeks posttreatment was still infected with the organism.

Rev Chil Obstet Ginecol, 1984, 49(2), 84 - 7
{Gonococcal infection in pregnancy}; Donoso E et al.; PIP: 256 pregnant women were studied for the presence of Neisseria gonorrhea in the endocervical canal of the uterus . Those who had positive cultures also had cultures taken from the rectum and the pharynx before administering treatment . 7 days after treatment, control cultures were taken to confirm the effectiveness of the therapy . The cultures were taken at the Diagnostic Center of the Catholic University of Chile . The treatment consisted of two intramuscular doses of a mixture of clemizol penicillin (400,000 IU) and penicillin sodium (3,600,000 IU) . The prevalence of endocervical infection for gonorrhea amounted to 4 cases (1.56%) . They presented bacteria in the rectum and one of them presented bacteria in the pharynx . All cultures were negative 7 days after treatment . There were significantly fewer first-trimester pregnancy cases (58) compared to second-trimester (90) and third-trimester (108) cases . There were 116 primiparas and 140 multiparas . As to the couples, 65.6% of the female population and 61.3% of the male population was concentrated in the 21-30 age group . 87.9% of the population was married; 11.3% was single; and 0.8% was widowed . 48.9% of the pregnant women were exclusively housewives; 23.9% were employed in technical or university professions; 7.4% were engaged in commerce; 3.9% were employees; 4.7% were students; and 1.9% were laborers . Their average age was 26.4 years, while the average age of the healthy population was 26.7 years .

G Batteriol Virol Immunol, 1984 Jan-Jun, 77(1-6), 9 - 18
Effects of different bacterial endotoxins on the drinking behaviour of the rat; Foca' A et al.; Endotoxins of Pasteurella multocida, Pseudomonas aeruginosa, Neisseria gonorrhoeae, and Shigella sonnei, when given in a single intravenous injection in the rat, showed antidipsogenic effects on drinking behaviour stimulated by 48 h water deprivation, or by intracerebroventricular injection of carbachol (250 ng) . In water deprived rats, the antidipsogenic effect was dose related . When drinking was induced by carbachol, endotoxins showed a very long-lasting inhibition . The effect was neither a consequence of behavioural alterations, nor due endotoxin peripheral vasodilatating properties.

Bull Soc Pathol Exot Filiales, 1984, 77(5), 617 - 27
{Epidemiologic approach to gonococcal infections in Senegal through the study of auxotypes}; Buisson Y et al.; 287 strains of Neisseria gonorrhoeae isolated in Dakar during a 26 months period (April 1981-May 1983) were sent to Pasteur Institute of Paris for auxotyping . They are distributed in (+): 56%, (PRO-): 21%, (ARG-): 13%, and nine minor auxotypes to the exclusion of (AHU-) . Auxotypes distribution according to the sex, the kind of samples and the race do not give proof of significant difference . Monthly distribution shows an endemic circulation of auxotypes (+) and (PRO-), as well as an unstability of auxotype (ARG-) that was prevailing in early months . 22 strains of penicillinase-producing Neisseria gonorrhoeae (among which the first strains isolated in Senegal) belong to auxotypes (+), (PRO-) and (PRO-, ARG-) . This distribution does not differ from that of non-producer strains . Gonococcal auxotyping provides an useful epidemiologic marker in order to search after the source of a contamination, to discern a failure of the treatment from a later infection and, on a wide plan, to survey the resistant strains spreading.

Scand J Infect Dis, 1984, 16(3), 267 - 70
Virulence markers in patient and carrier strains of Neisseria meningitidis; Holten E et al.; Patient and carrier strains of Neisseria meningitidis from 2 different periods were compared with respect to serogroups, serotypes and sensitivity to sulphadiazine . The majority of 249 patient strains were resistant to sulphadiazine, and belonged to the groups A, B or C . The group B and C strains were mainly type 15/16 and 2, respectively . In contrast, most of the 400 carrier strains belonged to serotypes other than 2 or 15/16, or were non-typable, and most strains were sensitive to sulphadiazine . Among the resistant group B and C carrier strains there were more type 2 and 15/16 strains than would have been expected from the average . The virulence markers: serogroup A, B and C, serotype 2 and 15/16, and resistance to sulphadiazine, coexist in more carrier strains than would be expected if the distribution of these markers was random.

Sex Transm Dis, 1984 Jan-Mar, 11(1), 32 - 3
Etiology of acute epididymitis presenting in a venereal disease clinic; Kristensen JK et al.; Sixteen patients aged 19-42 years and suffering from acute epididymitis were investigated . In twelve patients evidence of acute epididymitis developed without premonitory urethral symptoms . The only microbiologic finding for ten patients was Chlamydia trachomatis; both C . trachomatis and Neisseria gonorrhoeae were isolated from four patients . Two patients, who had recently had antibiotic treatment, harbored neither of these microorganisms . These observations indicate that C . trachomatis must be considered a dominant cause of acute epididymitis in the younger age groups . This fact has implications for the choice of treatment (erythromycin or tetracycline) and the investigations and treatment of sexual contacts.

Mol Cell Biochem, 1984, 59(1-2), 165 - 71
Characterization and inhibition of dihydrofolate synthetase from Neisseria gonorrhoeae; Pongsamart S et al.; Dihydrofolate synthetase (EC 6.3.2.12) from N . gonorrhoeae was isolated and enzyme characteristics were determined . The purified enzyme was found quite stable when stored at -60 degrees C . About 50% of the enzyme activity was destroyed within 6 weeks when kept at 4 degrees C . Maximum velocity was observed at pH 9.3 . The enzyme required a monovalent cation, K+ or NH4+, and divalent cation, Mg2+ or Mn2+, for its function . ATP at 5 mM concentration gave maximum activity . Km values for dihydropteroate and L-glutamate at pH 9.3 were 3.5 X 10(-5) M and 6.5 X 10(-4) M, respectively . Patterns of product inhibition by dihydrofolate were found to be non-competitive with respect to dihydropteroate, having a Ki value of 5.1 +/- 0.8 X 10(-4) M, and competitive with respect to L-glutamate, having a Ki value of 6.2 X 10(-4) M.

Mol Gen Genet, 1984, 193(3), 561 - 3
A DNA excision repair system for Neisseria gonorrhoeae; Campbell LA et al.; The removal of pyrimidine dimers from deoxyribonucleic acid of ultraviolet irradiated cultures of Neisseria gonorrhoeae can not be readily ascertained by using radioactively labeled thymidine precursors . However, by adapting the alkaline agarose gel technique of Achey et al . (Photochem Photobiol 29, 305-310, 1979), it was possible to demonstrate that this human pathogen does possess an active excision repair system that functions on pyrimidine dimers.

Clin Ther, 1984, 6(2), 193 - 7
Cefoperazone for urethritis due to penicillinase-producing Neisseria gonorrhoeae; Kim JH et al.; Thirty-two men infected with penicillinase-producing Neisseria gonorrhoeae were treated with a single intramuscular dose of 0.5 gm of cefoperazone . Of the 29 patients who were followed up, only two (7%) failed to recover; seven patients (26%) had postgonococcal urethritis . The MICs of cefoperazone were 0.03 microgram/ml (three strains), 0.06 microgram/ml (11), 0.12 microgram/ml (nine), 0.25 microgram/ml (one), and 0.5 microgram/ml (one).

J Infect, 1984 Jan, 8(1), 70 - 83
Epidemiology of penicillinase-producing Neisseria gonorrhoeae in Liverpool from 1977 to 1982; Arya OP et al.; After the 1976 outbreak of penicillinase-producing Neisseria gonorrhoeae (PPNG) infections had been controlled, less than 1 per cent of cases of gonorrhoea in Liverpool in 1977 and 1978 were caused by PPNG . Thereafter the steady increase in PPNG infections to 5.6 per cent of all cases in 1982 was associated with marked changes in epidemiological pattern, plasmids and auxotypes . In 1976 nearly all PPNG infections were acquired by young black males living in the inner city from women frequenting clubs; the PPNG were all of the African 3.2 megadalton (MD) plasmid type and of arginine-requiring auxotype . Between 1977 and 1982 female patients were increasingly ship girl prostitutes associating with seamen who constituted more than 50 per cent of the male patients . These men and other travellers introduced PPNG into Liverpool from the Far East and West Africa . In 1978 PPNG of the Asian type with 4.4 MD plasmid with or without 24.5 MD transfer plasmids were isolated in Liverpool where in 1979 all PPNG carried 4.4 MD and 24.5 MD plasmids . In 1982 strains of the 'new' African type with 3.2 and 24.5 MD plasmids were isolated as were PPNG of the Asian type that had been acquired in West Africa . Auxotyping of the 1982 isolates showed that none were arginine-requiring but three other types were identified: proline-requiring: proline-arginine-requiring; non-requiring . For the control of PPNG, a strategy based on constant vigilance, appropriate diagnostic procedures, rapidly effective treatment and determined contact tracing is needed.

Dermatologica, 1984, 168(2), 67 - 72
In vitro susceptibility of recent isolates of Neisseria gonorrhoeae to cephalosporins of different generations and penicillin G: a comparative evaluation; Korting HC; 98 recent clinical isolates of Neisseria gonorrhoeae (96 nonpenicillinase-producing N . gonorrhoeae (NPPNG) and 2 penicillinase-producing N . gonorrhoeae (PPNG) strains) were tested for their antibiotic susceptibility using the agar dilution test . The antibiotics examined all belonged to the beta-lactam group: penicillin G represented the penicillins, cephalothin, cefazolin, cefotiam, cefmenoxime and ceftizoxime represented the different groups of cephalosporins . In the in vitro tests cephalothin and cefazolin proved less active than penicillin G, cefotiam a bit more and both cefmenoxime and ceftizoxime much more active . These last three antibiotics should become promising alternatives to penicillin in the therapy of gonorrhea caused either by NPPNG or PPNG strains.

JOGN Nurs, 1984 Jan-Feb, 13(1), 9 - 12
Sexually transmitted diseases and pregnancy; Osborne NG et al.; The association of adverse pregnancy outcome with Treponema pallidum, Neisseria gonorrhoeae and herpes simplex infections is well known and specific recommendations for management have been formulated . However, other agents that are not so well known can be transmitted sexually and threaten an otherwise healthy pregnancy . These agents are discussed in order to make the nurse more aware of related maternal and fetal diseases.

J Clin Microbiol, 1984 Jan, 19(1), 63 - 7
Characterization of Neisseria cinerea, a nonpathogenic species isolated on Martin-Lewis medium selective for pathogenic Neisseria spp; Knapp JS et al.; An asaccharolytic, gram-negative, oxidase-positive diplococcus was isolated on Martin-Lewis medium from the cervix of a patient attending an arthritis clinic at Seattle Public Health Hospital, Seattle, Wash . This strain, NRL 32165, did not produce detectable acid from glucose, maltose, sucrose, fructose, mannitol, or lactose in either cystine Trypticase agar (BBL Microbiology Systems, Cockeysville, Md.) or modified oxidation-fermentation medium and was identified presumptively as a glucose-negative Neisseria gonorrhoeae strain, but was identified later as Neisseria cinerea on the basis of its biochemical reactions . Nitrate was not reduced, nitrite (0.001%, wt/vol) was reduced, and polysaccharide was not produced from sucrose . Proline, arginine, and cystine-cysteine were required for growth on defined medium . Strain NRL 32165 did not react with antigonococcal protein I monoclonal antibodies and did not produce immunoglobulin A protease . In DNA:DNA homology studies with N . gonorrhoeae NRL 8038 (F62) and N . cinerea type strain NRL 30003, strain NRL 32165 showed 95% homology relative to N . cinerea and 44% homology relative to N . gonorrhoeae . Thus, the identity of strain NRL 32165 was confirmed as N . cinerea (von Lingelsheim 1906) Murray 1939 . Of all Neisseria spp., N . cinerea is most likely to be misidentified as a glucose-negative N . gonorrhoeae strain.

Acta Otolaryngol Suppl, 1984, 407, 40 - 2
Pathogenicity of Branhamella catarrhalis; Schreiner A; Branhamella catarrhalis--a Gram-negative diplococcus--differs biochemically from other Neisseriaceae and possesses a specific protein with antigenic properties . Although scattered cases of meningitis and endocarditis have been reported since 1907, B . catarrhalis has been considered a non-pathogenic, pharyngeal commensal . However, relatively recent reports have shown B . catarrhalis to play a significant role in the etiology of otitis media and bronchopulmonary infections . Some reports also indicate a pathogenic role in sinusitis and longstanding cough in children, and in acute laryngitis in adults . B . catarrhalis is susceptible to co-trimoxazole, erythromycin, cephalosporins and tetracyclines . Most strains are also susceptible to penicillin, but the frequency of beta-lactamase producing B . catarrhalis has increased from 4% to 25% during the last six years (Sweden) . First choice antibiotics in infections with penicillin-resistant strains would be erythromycin and co-trimoxazole.

Sex Transm Dis, 1984 Jan-Mar, 11(1), 30 - 1
Ceftizoxime (FK-749) is effective therapy for urethritis caused by penicillinase-producing Neisseria gonorrhoeae; Harrison WO et al.; Fifty-five men with culture-proved gonococcal urethritis caused by either penicillin-sensitive or penicillinase-producing Neisseria gonorrhoeae were treated with 1 g of ceftizoxime given intramuscularly . All patients were cured, including 26 (47%) with penicillinase-producing strains . Patients experienced no local or systemic side effects and tolerated the injection of ceftizoxime well . These results show that ceftizoxime is an effective alternative to either spectinomycin or cefoxitin in treatment of uncomplicated gonococcal urethritis caused by penicillin-resistant bacteria.

Antimicrob Agents Chemother, 1984 Jan, 25(1), 7 - 9
Resistance trends of Neisseria gonorrhoeae in the Republic of Korea; Piziak MV et al.; Penicillinase-producing Neisseria gonorrhoeae has increased in the Far East to the point that penicillin can no longer be recommended as the drug of choice, mandating a change to spectinomycin . As part of an ongoing surveillance of antibiotic susceptibilities, minimal inhibitory concentrations of penicillin, tetracycline, spectinomycin, trimethoprim-sulfamethoxazole, cefoxitin, ceftriaxone, cefotaxime, and moxalactam were determined . A disturbing, steady increase in resistance to spectinomycin was documented.

Can J Microbiol, 1984 Jan, 30(1), 52 - 6
Inhibition of anion transport in human erythrocytes by pilated Neisseria gonorrhoeae; Wiseman GM et al.; Pilated gonococci added to human erythrocytes apparently bind to polypeptide band 3 and inhibit chloride-bicarbonate exchange across the membrane in contrast with nonpilated organisms . Known covalent inhibitors of anion transport (4,4'-diisothiocyano-2,2'-disulphonic acid stilbene and alpha-cyano-4-hydroxycinnamic acid) inhibit chloride efflux from erythrocytes and also reduce hemagglutination titres, strongly suggesting that band 3 is the major host-cell receptor involved in all interaction between gonococci and erythrocytes . In studies of other cell species, however, band 3 prepared from human erythrocytes inhibited adherence of pilated gonococci to human foreskin and HeLa cells, but was without effect in human buccal, Vero, and mouse L cells.

Microbios, 1984, 41(164), 73 - 9
Nmel, a restriction endonuclease from Neisseria meningitidis; Sparling R et al.; A restriction endonuclease, Nmel, present in Neisseria meningitidis was partially purified by passing through a blue 2-cross linked agarose column; no contaminating nucleases remained detectable . This enzyme cleaved phage lambda, adenovirus type 2 and phi x 174 DNA but did not cleave SV40 DNA . It had an absolute requirement for Mg2+ for its activity and was inhibited by high concentrations of NaCl or MgCl2 . Nmel activity was completely abolished after 1 h of incubation at 65 degrees C . S-adenosyl-L-methionine and ATP had no effect on its activity suggesting that Nmel is a type II restriction endonuclease enzyme . It is the first report of a restriction enzyme present in N . meningitidis.

Chemotherapy, 1984, 30(6), 366 - 72
Repeated exposition to subinhibitory concentrations of antibiotic in vitro readily decreases susceptibility of Neisseria gonorrhoeae to rifampicin, but not to new cephalosporins and penicillin G; Korting HC et al.; Repeated subcultivation of Neisseria gonorrhoeae in the presence of subinhibitory concentrations of antibiotic has turned out as a reliable model to predict the low potential for development of resistance with respect to the beta-lactam antibiotic penicillin . Before large-scale introduction of the new cephalosporins we exposed 5 N . gonorrhoeae strains of different susceptibility to penicillin repeatedly to subinhibitory concentrations of cefotiam, ceftizoxime, rifampicin and penicillin G incorporated into chocolate agar . each time the most resistant representatives of a strain were propagated, on the whole 25 times . While resistance to rifampicin increased readily (all strains became relatively resistant, MIC = 4 micrograms/ml), the same was not true of the cephalosporins . Although their susceptibility decreased, too, no strain acquired partial or even total resistance (final MIC less than or equal to 0.128 with cefotiam and ceftizoxime) . The cephalosporins thus rather parallelled penicillin G which hardly induced any increase of resistance . Thus, a quick loss of clinical efficacy need not be feared after large-scale introduction of the new cephalosporins into the therapy of gonorrhea.

Chemotherapy, 1984, 30(5), 322 - 7
Susceptibility of Neisseria gonorrhoeae to ceftizoxime in vitro and in vivo; Korting HC et al.; Ceftizoxime - a new beta-lactamase-resistant cephalosporin - was tested for its potential efficacy in the cure of uncomplicated gonorrhea . While more than a half of the 102 freshly isolated Neisseria gonorrhoeae strains examined was partially or totally resistant to penicillin (MIC greater than or equal to 0.06 microgram/ml), most of these strains proved highly susceptible to ceftizoxime (as well as cefotaxime) . The MIC90% amounted to 0.004 micrograms/ml, while serum levels after the intramuscular application of as little as 0.5 g exceed 1 microgram/ml for more than 6 h . The clinical results were excellent . 105 male or female patients suffering from uncomplicated gonorrhea were treated with a single intramuscular application of 1 g of ceftizoxime . 61 of them reattended our clinic twice for follow-up . All of them were cured . Anaphylactic shock or rashes were not observed . Thus, we consider the intramuscular application of 1 g of ceftizoxime as a reliable and safe treatment for uncomplicated gonococcal urethritis and cervicitis.

Chemotherapy, 1984, 30(5), 277 - 82
Plasma and skin blister fluid levels of cefotiam and cefmenoxime after single intramuscular application of 1 g in gonorrhea; Korting HC; To predict the clinical efficacy of a new antibiotic in uncomplicated gonorrhea, data pertinent to its pharmacokinetics in man are needed . Before starting clinical trials on cefotiam and cefmenoxime, 1 g of each antibiotic was administered intramuscularly as a single dose to 5 healthy volunteers . Both blood and skin blister fluid samples (obtained by suction and cantharides blistering) were repeatedly taken . Peak plasma levels amounted on average to 24.8 and 48.2 micrograms/ml, respectively . 6 h after dose still average plasma concentrations of 3.4 and 6.52 micrograms/ml were found . Suction blister fluid levels essentially paralleled plasma levels, whereas cantharides blister fluid levels increased and decreased more slowly than plasma levels . Cefotiam penetrated more readily into suction blister fluid than cefmenoxime as obtained from area ratios . Thus, the chosen dosage regimens considered apt for gonorrhea led to high initial as well as long-standing drug levels . And this does not only hold true for the plasma . Facing their good in vitro activity on Neisseria gonorrhoeae, cefotiam and cefmenoxime well deserve further studies in this field including clinical trials.

JAMA, 1983 Dec 23-30, 250(24), 3319 - 21
Spontaneous bacterial peritonitis caused by a viridans Streptococcus or Neisseria perflava; McCue JD; Eight patients had nine episodes of presumed spontaneous bacterial peritonitis (SBP) caused by commensal bacteria that usually inhabit the oropharynx, including Neisseria perflava and the viridans streptococci Streptococcus milleri, Streptococcus mitis, and Streptococcus sanguis . Nonpurulent ascites (ascitic fluid WBC count, less than 1,000/cu mm) was present in four episodes, possibly caused by either bacterial colonization or early peritonitis; purulent ascites was present in five episodes . None died of their infection, and three episodes remitted without treatment . Poor condition of gums and teeth may play a pathogenic role in SBP caused by these bacteria.

JAMA, 1983 Dec 16, 250(23), 3205 - 9
Risk of acquiring gonorrhea and prevalence of abnormal adnexal findings among women recently exposed to gonorrhea; Platt R et al.; We determined the conditions of 26 women who had recently been exposed to Neisseria gonorrhoeae . Infection was more common among women with more than one exposure (13/14) than among those with one exposure (6/12) . Gonococcal infection was significantly associated with the presence of findings on physical examination suggestive of upper genital tract inflammation . Nine of 19 infected women had such findings; no uninfected women did . Among infected women, the prevalence of abnormal physical findings was 47% +/- 23% (95% confidence interval) . These findings suggest that upper genital tract involvement is a common early complication of gonococcal infection.

J Rheumatol, 1983 Dec, 10(6), 985 - 6
Branhamella catarrhalis septic arthritis; Craig DB et al.; An adult with spontaneous septic arthritis due to Branhamella catarrhalis is described and the literature reviewed . B . catarrhalis is an organism similar to the Neisseria species and has been implicated in a variety of systemic infections . As it is frequently resistant to penicillin, cephamycins or third generation cephalosporins may be the empiric drugs of choice for infections caused by this organism.

Clin Orthop, 1983 Dec, (181), 115 - 7
Septic arthritis of the hip caused by Neisseria gonococcae; Rubinow A; In two patients septic monoarthritis of the hip was caused by Neisseria gonococcae . Treatment by parenteral penicillin in the first patient and oral erythromycin in the second resulted in complete recovery without residual loss of function in the affected hips . Gonococcal arthritis of the hip appears to respond favorably to appropriate antibiotic therapy, and immediate surgical drainage is probably unnecessary . This is in contrast to bacterial arthritis of the hip due to other organisms, for which surgical intervention and drainage are mandatory.

Antimicrob Agents Chemother, 1983 Dec, 24(6), 952 - 4
Antibiotic susceptibilities and auxotypes of Neisseria gonorrhoeae strains from women with pelvic inflammatory disease or uncomplicated infections; Jacques M et al.; The purpose of the present study was to compare the auxotypes and the minimal inhibitory concentrations of four antibiotics for 50 isolates from women with gonococcal pelvic inflammatory disease with those of 55 isolates from uncomplicated anogenital gonococcal infections . No significant differences in auxotype patterns and susceptibilities were found between isolates from the two groups.

J Clin Microbiol, 1983 Dec, 18(6), 1366 - 9
Amylase inhibits Neisseria gonorrhoeae by degrading starch in the growth medium; Gregory MR et al.; Highly purified salivary alpha-amylase inhibited the growth of fresh isolates of Neisseria gonorrhoeae on GC agar base medium supplemented with 2% IsoVitaleX (BBL Microbiology Systems) . Hydrolysis of starch in the medium by amylase resulted in a negative starch-iodine test . However, purified amylase did not inhibit gonococcal growth on agar plates that contained hemoglobin (chocolate agar) . This effect was not caused by inhibition of amylase, since amylase activity was the same in the presence or absence of blood products . Moreover, survival of N . gonorrhoeae in buffered saline was not affected by amylase . These results suggest that amylase inhibited the growth of N . gonorrhoeae on GC agar base plates by hydrolyzing starch.

Am J Obstet Gynecol, 1983 Dec 1, 147(7), 781 - 4
Gonococcal ventriculitis associated with ventriculoamniotic shunt placement; Bland RS et al.; Use of a ventriculoamniotic shunt to control fetal hydrocephalus is a new procedure . Early experience suggests possible benefit to the fetus . Complications have been rare . This report describes the first case of Neisseria gonorrhoeae central nervous system infection associated with a ventriculoamniotic shunt and the third case reported in a neonate . On the basis of this clinical experience, we recommend that the mother be monitored closely for cervical pathogens, that delivery be performed prior to amniorrhexis, and that culturing of the shunt and ventricular fluid be carried out at delivery.

Infect Immun, 1983 Dec, 42(3), 1034 - 40
In vivo degradation of gonococcal outer membrane proteins within human leukocyte phagolysosomes; Eaton LJ et al.; We previously showed in vitro hydrolysis of outer membrane proteins by lysosomal proteases and purified elastase . In this study we examined the in vivo relevance of the previous studies . Outer membranes were obtained from Neisseria gonorrhoeae type 3 (strain GC7) by LiCl2 extraction . Some preparations were labeled with 125I . Phagocytizable particles were prepared by coating latex beads with outer membranes, and polymorphonuclear leukocytes were allowed to phagocytize serum-opsonized particles . After homogenization of neutrophils, phagolysosomes were recovered by flotation through sucrose . Phagolysosomes were prepared for slab gel electrophoresis immediately or incubated further at 37 degrees C to allow continued degradation of outer membrane proteins . The principal protein (protein I) and minor proteins (proteins II) of outer membranes were hydrolyzed in whole neutrophils and in isolated phagolysosomes . Proteins II were more susceptible to hydrolysis than protein I . Hydrolytic products formed were nearly identical in vivo and in vitro . We also radiolabeled the surface-exposed proteins of live gonococci . Degradation of outer membrane proteins on the intact bacteria within neutrophil and monocyte phagolysosomes was shown . This indicates that our earlier in vitro model is relevant to in vivo hydrolysis of gonococcal outer membrane proteins.

Br J Vener Dis, 1983 Dec, 59(6), 364 - 8
Imported penicillinase producing Neisseria gonorrhoeae becomes endemic in London; Thin RN et al.; We review all cases of gonorrhoea caused by penicillinase producing Neisseria gonorrhoeae (PPNG) seen between 1976 and 1983 at the sexually transmitted disease (STD) clinic of this hospital, which accounted for 11% of all such cases reported in that period in the United Kingdom . While the overall incidence of gonorrhoea remained relatively stable in this clinic, that of PPNG rose to 4.4% of all such cases by 1982 . Until last year, 75% of these cases were imported, mainly from Nigeria and Ghana, but a marked change was seen in the second half of 1982, when 71% of cases were indigenous in origin . Casual partners and prostitutes in London were mentioned as the source of infection by 34% of patients, a much higher percentage than that seen previously . Such sources are notoriously difficult to trace and these figures show a very disturbing trend . Although rectal infection tends to be asymptomatic, PPNG was isolated in rectal cultures from two of five homosexuals and 19 of 26 women . There is therefore a risk that PPNG could spread rapidly through the homosexual population . We suggest that spectinomycin should no longer be the first drug of choice in the treatment of gonorrhoea caused by PPNG but should be replaced by the newer cephalosporins.

Jpn J Antibiot, 1983 Dec, 36(12), 3336 - 42
{Bacteriological and clinical evaluation of ceftizoxime in male gonorrheal urethritis}; Okazaki T; Forty-one male patients with gonorrheal urethritis were treated with ceftizoxime (CZX) administered concomitantly probenecid at the urological ward of Tokyo Metropolitan Taito Hospital during the period from October, 1982 to February, 1983, and clinically evaluated . Eighty strains of Neisseria gonorrhoeae isolated from the clinical specimens of these patients were bacteriologically studied . Of the 80 strains, 12(15%) were PPNG strains and the other 68 strains were non-PPNG strains . MICs of PCG to the 12 PPNG strains were 3.13 - 25 micrograms/ml and to the 68 non-PPNG strains were 0.0122 - 3.13 micrograms/ml . While MICs of CZX to the PPNG strains were less than or equal to 0.003 - 0.024 micrograms/ml and to the non-PPNG strains were less than or equal to 0.003 - 0.05 micrograms/ml . Those patients with gonorrheal urethritis were given a single 0.5 g intramuscular dose of CZX and a single 1 g oral dose of probenecid . The following clinical findings were obtained: The clinical efficacy rate of 41 cases was 98%; excellent in 24, good in 16, poor in 1 case . All 3 patients with gonorrheal urethritis caused by PPNGs were cured with the treatment . No subjective side effects were found.

J Am Acad Dermatol, 1983 Dec, 9(6), 815 - 39
Inherited disorders of complement; Guenther LC; Isolated complement component deficiencies are uncommon . Deficiencies of all eleven components and two inhibitors of the classical pathway have been described . Complete absence of the components of the alternative pathway has not been described . The consequences of a single defect in complement are often predictable from an understanding of the biologic activities associated with activation of the complement system . Deficiency of C1 esterase inhibitor gives rise to the disease, hereditary angioedema; deficiency of the early components of the classical pathway are associated with lupus erythematosus; C3 and C3 inactivator deficiencies with pyogenic infections; C5 dysfunction with Leiner's disease; deficiencies of the terminal components with recurrent Neisseria bacteremia; and C9 deficiency with normal health . The complement system and its associated biologic activities are reviewed . The present knowledge of the inherited complement deficiencies and associated diseases, with particular emphasis on the dermatologic manifestations, genetics, and diagnosis, is summarized.

J Infect Dis, 1983 Dec, 148(6), 1025 - 32
Gonococcal protein I-specific opsonic IgG in normal human serum; Sarafian SK et al.; Pooled normal human serum (NHS), as well as 10 individual NHS samples, markedly inhibited the reaction between monoclonal antibodies and their cognate epitopes on protein I of serum-sensitive, serum-resistant, and disseminated gonococcal infection-associated strains of Neisseria gonorrhoeae, as determined by ELISA inhibition . IgG was the immunoglobulin class responsible for the inhibition . Only the Fab fragment of IgG was inhibitory, making it likely that the IgG reacted specifically with protein I . After absorption with purified protein I, NHS did not inhibit the binding of a protein III-specific monoclonal antibody, thus excluding the possibility that protein III-specific antibodies in NHS masked epitopes on protein I . In addition, lipopolysaccharide-specific IgG in NHS did not appear to contribute to the inhibition of monoclonal antibody binding to protein I . The IgG from NHS was opsonic; opsonization was prevented by coating gonococci with the Fab fragment of protein I-specific monoclonal antibodies.

Infect Immun, 1983 Dec, 42(3), 980 - 5
Inhibition of Neisseria gonorrhoeae attachment to HeLa cells with monoclonal antibody directed against a protein II; Sugasawara RJ et al.; This study showed that a protein II (PII) of Neisseria gonorrhoeae FA1090 appeared to act as a mediator of attachment to HeLa cells . Two colony variants of FA1090 were selected . Both gonococcal variants were nonpiliated, but one contained a PII and the other did not . A monoclonal antibody (1090-10.1), which was directed against the PII, inhibited the apparent PII-mediated attachment to HeLa cells . Antibodies produced from clone 1035-4, which had no PII specificity, did not inhibit the attachment and were used as controls . Inhibition of gonococcal attachment by the 1090-10.1 monoclonal antibodies was demonstrated by fluorescent microscopy analysis . Monoclonal antibody 1090-10.1 appeared to cause agglutination of the PII-containing organism . To block the clumping caused by the PII-specific monoclonal antibodies, Fab fragments of goat anti-mouse IgG were incubated with gonococci and the 1090-10.1 monoclonal antibodies . The results showed that the goat anti-mouse IgG Fab fragments partially blocked the agglutination caused by the PII-specific monoclonal antibody . The effect of the 1090-10.1 antibodies on attachment was also determined by monitoring the HeLa cells with attached iodinated gonococci . The monoclonal antibody appeared to inhibit the PII-mediated attachment.

Ann Ophthalmol, 1983 Nov, 15(11), 1004, 1006 - 9
New issues in the prevention and treatment of ophthalmia neonatorum; Raucher HS et al.; We have recently seen two cases of ophthalmia neonatorum (ON) that illustrate a changing picture of this disease and raise a number of questions concerning optimal prophylaxis and treatment . Silver nitrate, which is the most widely used method for prevention of gonococcal ON, fails to prevent neonatal eye disease due to chlamydia . In addition, strains of gonococci which produce a penicillinase and are resistant to penicillin are becoming common in parts of the United States and Europe . Thus all gonococcal isolates must be tested for penicillinase production . The emergence of Chlamydia trachomatis as the most frequent cause of ON and the appearance of penicillin-resistant gonococci has led to new regimens for prophylaxis and therapy of neonatal ophthalmia . At our institution, we now use intramuscular penicillin and topical tetracycline ointment (1%) for eye prophylaxis . For initial therapy of gonococcal ON we recommend penicillin (systemic and topical) plus another antimicrobial with greater stability against the penicillinase of Neisseria gonorrhoeae.

J Clin Microbiol, 1983 Nov, 18(5), 1264 - 5
Gono Gen coagglutination test for confirmation of Neisseria gonorrhoeae; Lawton WD et al.; The Gono Gen (Micro-Media Systems, Inc., Potomac, Md.) coagglutination test was compared with the sugar utilization test and with a direct fluorescent antibody test for confirmation of Neisseria gonorrhoeae . Of 110 gonococcal clinical isolates, 109 were positive by the Gono Gen test . Of 57 nongonococcal gram-negative diplococci, all were negative by the Gono Gen test . We conclude that the Gono Gen test is sensitive and highly specific and provides a rapid method for the confirmation of N . gonorrhoeae.

J Clin Microbiol, 1983 Nov, 18(5), 1258 - 9
Ammonium bicarbonate as a replacement for carbon dioxide in Transgrow bottles for primary isolation of Neisseria gonorrhoeae; Potter LD et al.; Transgrow bottles with medium containing ammonium bicarbonate and Transgrow bottles gassed with 10% carbon dioxide performed equally well in detecting Neisseria gonorrhoeae in 434 clinical specimens . It appears that incorporation of ammonium bicarbonate into the medium increased the efficiency of the manufacturing process while maintaining the effectiveness of the medium.

J Clin Microbiol, 1983 Nov, 18(5), 1150 - 9
Five years of experience with a national external quality control program for the culture and identification of Neisseria gonorrhoeae; Griffin CW 3rd et al.; In response to a need for monitoring the proficiency of public health laboratories in isolating and identifying Neisseria gonorrhoeae, a national external quality control program was developed . Essentially, three types of freeze-dried samples, representing different levels of challenge for identification, were sent to laboratories for testing . The quality of the samples was confirmed by external reference laboratories, and stability of the samples was confirmed by thermal degradation tests before the samples were sent to laboratories enrolled in the program . By analyzing laboratory results, we identified common errors and chronic problems in testing samples . As a group, laboratories testing small numbers of actual patient specimens did not perform as well in the program as did laboratories testing large numbers of specimens; however, the performance of laboratories testing small numbers of specimens improved over time . Overall, laboratories experienced the most difficulty with samples containing N . gonorrhoeae mixed with other microbial species . Laboratories that performed confirmatory tests committed fewer errors than did laboratories that performed presumptive tests only, but the failure to use pure cultures of gonococci for inoculation of cystine tryptic digest agar appeared to be a chronic problem in confirmatory carbohydrate testing . A review of the use of different plating media and confirmatory tests showed that the use of certain media and tests changed over time.

Infect Immun, 1983 Nov, 42(2), 446 - 52
Strain distribution in extents of lysozyme resistance and O-acetylation of gonococcal peptidoglycan determined by high-performance liquid chromatography; Swim SC et al.; The extent of lysozyme resistance and O-acetylation of purified peptidoglycan (PG) from 20 strains of Neisseria gonorrhoeae was examined to determine how widespread these properties are among various subsets of gonococcal isolates . To determine digestibility by lysozyme, we treated {3H}- or {14C}glucosamine-labeled PG with hen egg white lysozyme (HEW-LZ) and determined the size distribution of HEW-LZ soluble PG at the completion of the reaction by molecular-sieve high-performance liquid chromatography, using a Varian TSK SW2000 column, a method that proved considerably more efficient than traditional chromatography for fractionating low-molecular-weight PG fragments solely on the basis of size . The extent of HEW-LZ resistance was expressed as the percentage of PG that was larger in size than disaccharide peptide tetramers (including insoluble PG removed by centrifugation) . The percent O-acetylation was determined by converting insoluble PG totally to uncross-linked monomers by the combined action of Chalaropsis B muramidase followed by Escherichia coli endopeptidase and then quantitating radioactivity in O-acetylated and non-O-acetylated monomers after paper chromatography . The PG of the vast majority (19 of 20) of gonococcal strains examined was extensively HEW-LZ resistant (range, 40 to 60% larger than tetramers) and extensively O-acetylated (range, 34 to 52%) . Only the PG of strain RD5 (highest rate of PG turnover among gonococci so far examined and the prototype of gonococci having O-acetyl-deficient PG) had greatly reduced O-acetylation (15%) and exhibited virtually no HEW-LZ resistance (2% larger than tetramers) . Extensive HEW-LZ resistance and O-acetylation were apparently not associated specifically with (i) a given type of colonial variant (piliated versus nonpiliated or opaque versus transparent), (ii) a given type of clinical isolate (local versus disseminated), (iii) the extent of laboratory passage, or (iv) (with the possible exception of penicillin-resistant strain FA102) the presence of one or more genetic loci governing antibiotic resistance among members of an isogenic set of gonococci . From this survey, we conclude that lysozyme resistance and extensive O-acetylation of PG are widespread among gonococci and, thus, that most strains are potential sources of hydrolase-resistant PG that conceivably could persist as macromolecular fragments in vivo.

Medicine (Baltimore), 1983 Nov, 62(6), 395 - 406
Disseminated gonococcal infection: a prospective analysis of 49 patients and a review of pathophysiology and immune mechanisms; O'Brien JP et al.; Forty-nine patients with disseminated gonococcal infection (DGI) hospitalized at Boston City and University Hospitals over a 7-year period were studied . Patients with clinical manifestations of DGI and with cervical, urethral, rectal, pharyngeal, synovial or blood cultures positive for Neisseria gonorrhoeae were separated into two groups based on the presence or absence of suppurative arthritis . There were 19 cases of suppurative arthritis (Group II) and 30 cases with only tenosynovitis, skin lesions, or both (Group I) . Blood cultures were positive only in Group I patients (43%) and synovial fluid cultures only in Group II patients (47%) . Polyarthralgia was the most common initial symptom in both groups of patients . Twenty-six Group I patients had tenosynovitis (87%), while only 4 Group II patients (21%) had tenosynovitis (p less than 0.001) . The knee was the most commonly involved suppurated joint . Twenty-seven Group I patients (90%) had skin lesions compared to 8 Group II patients (42%) (p less than 0.001) . Some of these lesions progressed on treatment; some patients were unaware of their lesions . Genitourinary symptoms were unusual in both groups of patients . Eleven women (33%) were menstruating or were pregnant at the onset of DGI . Thirteen patients had histories suggestive of previous gonococcal infections; one had recurrent DGI . This patient and one other were found to have complement abnormalities . There were no cases of endocarditis or meningitis . Four patients had unexplained liver function abnormalities . All patients recovered uneventfully . Strains isolated from disseminated sites were predominantly of the transparent phenotype (90%) . Many strains (58%) required arginine, hypoxanthine and uracil for growth . They were also more susceptible to penicillin than reported strains that cause pelvic inflammatory disease . Most strains were of a single outer membrane protein coagglutination serogroup, WI (85%) . These characteristics did not vary between the Group I and Group II isolates . The two groups of strains, however, did vary in their complement-dependent bactericidal reactivity to normal human sera . Eighteen of 24 Group I strains (75%) versus 9 of 19 Group II strains (47%) resisted killing by all normal human sera tested (p less than .05) . Likewise, convalescent sera from Group II patients were able to kill their infecting strains more often than did sera from Group I patients (70% vs 17%) (p less than 0.01) . Thus, variations in the clinical expression of disease in patients with DGI may be explained, in part, by differences in certain phenotypic and immunologic features of infecting strains.

Gene, 1983 Nov, 25(2-3), 241 - 7
Construction and characterization of a new shuttle vector, pLES2, capable of functioning in Escherichia coli and Neisseria gonorrhoeae; Stein DC et al.; In vitro recombination techniques were used to construct a bifunctional shuttle vector capable of functioning in Neisseria gonorrhoeae and Escherichia coli . This 6-kb plasmid contains a selectable phenotype, beta-lactamase production, which functions in both organisms . It also contains the lac region from pUC9 that allows for the direct selection of hybrid plasmids in the appropriate E . coli hosts by disruption of beta-galactosidase alpha complementation . The lac region contains several unique restriction sites useful for cloning: EcoRI, SmaI, BamHI and SalI.

J Clin Microbiol, 1983 Nov, 18(5), 1047 - 50
Inactivation of the polyanionic detergent sodium polyanetholsulfonate by hemoglobin; Edberg SC et al.; Sodium polyanetholsulfonate (SPS) has been added to blood culture media for many years . Its incorporation results in a higher yield of positive blood cultures due to its inactivation of antimicrobial cationic compounds . The most active of these cations include complement components, aminoglycoside-aminocyclitol antibiotics, and receptors on polymorphonuclear leukocytes . There have been reports from studies conducted outside patient blood culture bottles that SPS itself may possess antibacterial activity against some isolates of Neisseria meningitidis, Neisseria gonorrhoeae, and Peptostreptococcus anaerobius . Conversely, in patient clinical trials there has been no significant difference in pathogen isolation rates in the presence or absence of SPS . In an attempt to explain this in vitro/in vivo disparity, a search was undertaken to elucidate which variable constituent in blood, heretofore not studied quantitatively, might have a major effect on modulating the activity of SPS . It was found that hemoglobin combined stoichiometrically with SPS with a Kd of approximately 10(-7) mol/liter . Optimum SPS inactivation occurred at an SPS/hemoglobin ratio of 1:6 (wt/wt) . SPS-sensitive isolates of N . gonorrhoeae and N . meningitidis were protected by the addition of hemoglobin from the antimicrobial effects of this polyanion in time-kill studies . This protection was directly related to the amount of SPS combined in solution . Therefore, the amount of free hemoglobin in solution must be measured when studying the antimicrobial activity of polyanions or when evaluating the effect of different polyanions on the recovery rates of pathogens in patient blood culture clinical trials.

Sex Transm Dis, 1983 Oct-Dec, 10(4 Suppl), 276 - 80
Mycoplasma hominis in cervicitis and endometritis; Paavonen J et al.; The presence of serum IgG antibody to Mycoplasma hominis was studied by enzyme immunoassay in 150 women with suspected cervicitis at a clinic for sexually transmitted diseases . Positive levels of antibody were associated with gravidity and parity but not with age, method of birth control, or sexual behavior . Women from whom M . hominis was isolated had higher antibody levels than those from whom M . hominis was not isolated, regardless of the presence or absence of mucopurulent cervicitis . In women with mucopurulent cervicitis, M . hominis did not interact synergistically with Chlamydia trachomatis to affect the severity of cervicitis or the number of polymorphonuclear leukocytes on gram-stained cervical tissue . A striking association was found between plasma cell endometritis and the prevalence and level of serum antibody to M . hominis . Similarly, clinical findings suggesting endometritis were associated with the prevalence and level of this antibody . In contrast, endometritis was not associated with the isolation of M . hominis from the cervix, although it was associated with the isolation of C . trachomatis and Neisseria gonorrhoeae . Urethritis in male sexual partners of women with mucopurulent cervicitis was associated with the isolation of C . trachomatis but not of M . hominis from the women.

J Reprod Med, 1983 Oct, 28(10 Suppl), 712 - 5
The staging of acute salpingitis and its therapeutic ramifications; Monif GR; PIP: The classical signs of salpingitis are fever, bilateral adnexal tenderness and/or the presence of masses, and signs of an elevated white blood count (WBC) and erythrocite sedimentation rate . These are absent in the majority of women . Acute salpingitis should be suspected in any woman with lower abdominal discomfort and can be verified by needle culdocentesis . Proper staging can be a deciding factor in the patient's cure and future fertility and helps in the selection of antibiotics . The presence or absence of Neisseria gonorrhoeae should be determined first . Some complicating factors during these procedures include: 1) the presence of an IUD when disease within the fallopian tubes tends to be more advanced than can be ascertained from clinical findings, 2) prior inflammatory disease of the fallopian tube, and 3) bilateral tubal ligation . If peritonitis has been inferred by the demonstration of rebound tenderness or by culdocentesis, confirmation can be achieved by ultrasonography or CAT scan of the pelvis . Once the variables have been identified the information can be assessed according to the current classification of acute salpingitis; staging is an attempt to create clinical subjects based upon the fact that each differs in its major therapeutic goal . For acute salpingitis without peritonitis, therapy is with doxycycline . For acute salpingitis with peritonitis, in order to preserve fallopian structure and function, there has to be adequate coverage for principal venereal pathogens, and treatment is a combination of cefoxitin and doxycycline . For acute salpingitis with evidence of tubal occlusion or ruptured tuboovarian complex treatment is with penicillin, clindamycin, and tobramycin . For a case of ruptured tuboovarian complex combinations of antibiotics are used and if these fail surgery is indicated .

Mikrobiyol Bul, 1983 Oct, 17(4), 259 - 66
{The causes of hospital infections in the Medical School Hospital of Cumhuriyet University}; Durmaz R et al.; Samples taken from the clinics were bacteriologically examined in order to find out the incidence of the hospital infections . During the winter, at the control of atmospheric flora in the clinics was isolated S . aureus (58.21%), S . albus (16.67%), E . coli (16.92%), Diphtheroid bacillus (6.22%), Streptococcus spp (5.3%), Neisseria (1.66%), Bacillus subtilis (0.19%), Fungus (0.77%) . Also in the summer it was isolated as following bacteria; S . albus (55.1%), S . aureus (17.9%), E . coli (10.5%), Streptococcus spp (9.6%), Neisseria (5.12%), Fungus (1.49%), Bacillus subtilis (0.07%) . 33.3% dirty result was found from the air of surgery . When the control of disinfectants and sterile instruments it was isolated bacteria mostly responsible from hospital infectants as Ps . aeruginosa Staphylococcus spp, E . coli ext.

Sex Transm Dis, 1983 Oct-Dec, 10(4), 195 - 7
Physician utilization of a gonococcal antibody screening test; Beebe JL; A gonococcal antibody test was introduced for use by the physician-clients of a private reference laboratory accompanied by distribution of literature regarding recommended use and interpretation of the test . The pattern of use of the tests was analyzed, and a telephone survey of clients was conducted to determine the manner of physician utilization of the test with regard to 69 patients with reactive test results . Despite recommendations to the contrary, the group surveyed used the test for males (22%) and symptomatic individuals (61%) . Culture for Neisseria gonorrhoeae was not performed for 54% of patients with reactive tests for antibody to N . gonorrhoeae . Most physicians interviewed did not heed recommendations for the use of the test or correctly interpret test results.

Sex Transm Dis, 1983 Oct-Dec, 10(4), 191 - 4
Treatment of uncomplicated gonorrhea in men with single-dose moxalactam; Handsfield HH; Men with uncomplicated urethral or rectal infection due to beta-lactamase-negative Neisseria gonorrhoeae were treated with single doses of moxalactam (1.0 g given intramuscularly) . Urethral or anorectal infection was eradicated in 95 of 100 men who returned for follow-up visits three to eight days after treatment; four of eight pharyngeal gonococcal infections were eradicated . The geometric mean minimal inhibitory concentration of moxalactam for 119 pretreatment gonococcal isolates was 0.088 micrograms/ml (range, 0.008-1.0 microgram/ml), and gonococci isolated from homosexual men were significantly more resistant to moxalactam and penicillin G than were isolates from heterosexual men . Post-gonococcal urethritis (PGU) developed in 24 (29%) of 84 subjects who were followed for 12-30 days; 17 (71%) of the cases of PGU were due to Chlamydia trachomatis . Among 21 homosexual men with rectal gonorrhea, five (24%) had coexisting rectal infection with C . trachomatis . Moxalactam is comparable to other single-dose regimens for the treatment of uncomplicated urethral or anorectal gonorrhea in men due to beta-lactamase-negative N . gonorrhoeae.

Sex Transm Dis, 1983 Oct-Dec, 10(4), 187 - 90
Attachment of two auxotypes of Neisseria gonorrhoeae to cells of donors of African, European, and Indian descent; Noble RC et al.; Gonococci of the Arg-, Hyx-, Ura- auxotype are isolated most commonly from white patients and seldom from black patients . Five gonococcal isolates of the Arg-, Hyx-, Ura- auxotype and five of the Pro- auxotype were tested for their ability to attach to buccal epithelial cells or to attach or be ingested by polymorphonuclear leukocytes taken from two individuals each of three different racial backgrounds: European-American (caucasian), black American, and Indian from India . Despite the differences in race of the six individuals, there were no differences in the attachment or ingestion of the two gonococcal auxotypes to the two different cell types . The study does not explain why the Arg-, Hyx-, Ura- auxotype is isolated more frequently from whites.

Sex Transm Dis, 1983 Oct-Dec, 10(4), 180 - 3
A preliminary evaluation of the Gonozyme test; Burns M et al.; Gonozyme is a solid-phase enzyme immunoassay that detects antigens of Neisseria gonorrhoeae in clinical specimens . The test was 100% sensitive and 96.8% specific when applied to 71 urethral specimens from men with symptomatic urethritis, and 89.5% specific for 19 urethral specimens from men examined after eradication of gonorrhea by antibiotics . For cervical specimens obtained before therapy from 368 women with gonorrhea, the Gonozyme test had a sensitivity of 88.5% and a specificity of 94.3% . The test was 100% specific when used for testing of 37 cervical specimens obtained after therapy of gonorrhea . The predictive values of a positive Gonozyme test were 90.5% for cervical specimens from women attending a sexually transmitted disease clinic and 97% for urethral specimens from men with urethritis . The predictive values of negative Gonozyme tests in these same circumstances were 100% for urethral specimens and 93.6% for cervical specimens.

Sex Transm Dis, 1983 Oct-Dec, 10(4), 173 - 9
Gonococcal attachment to eukaryotic cells; James JF et al.; The attachment of Neisseria gonorrhoeae to eukaryotic cells grown in tissue culture was analyzed by use of light and electron microscopy and by labeling of the bacteria with {3H}- and {14C}adenine . Isogenic piliated and nonpiliated N . gonorrhoeae from opaque and transparent colonies were studied . The results of light microscopy studies showed that the gonococci attached to cells of human origin, including Flow 2000, HeLa 229, and HEp 2 . Studies using radiolabeled gonococci gave comparable results . Piliated N . gonorrhoeae usually attached in larger numbers than nonpiliated organisms, and those from opaque colonies attached more often than isogenic variants from transparent colonies . Day-to-day variation in rate of attachment was observed . Scanning electron microscopy studies showed the gonococcal attachment to be specific for microvilli of the host cells . It is concluded that more N . gonorrhoeae from opaque colonies, as compared with isogenic variants from transparent colonies, attach to eukaryotic cells grown in tissue culture.

Can J Microbiol, 1983 Oct, 29(10), 1309 - 13
Growth responses of Neisseria gonorrhoeae auxotypes to required amino acids and bases in liquid medium; Hendry AT; Neisseria gonorrhoeae strains can be grouped or differentiated (auxotyped) by their requirements for none, or any one or more of proline, uracil, hypoxanthine, and citrulline or ornithine . Most strains were readily assessed because they responded with growth or no growth on each defined auxanographic medium . Other strains gave indeterminate responses on agar and the reasons were not obvious . Liquid growth studies for quantifying the usual responses showed that yields of appropriate N . gonorrhoeae auxotrophs were proportional to replacement concentrations of any one of these amino acids or bases, of methionine, or of cysteine plus cystine . This type of response, where log growth rates and lag times were unaffected, is proposed as the basis for defining (simple) auxotrophy in gonococci . The formula of the defined medium was improved by increasing proline, uracil, and hypoxanthine beyond limiting concentrations, and decreasing citrulline or ornithine, and cysteine plus cystine . Fatty acid--free bovine albumin was used to ensure homogeneous growth in liquid media . In agar, it was superior to starch for the nonnutritive protective effect required by many strains.

Antimicrob Agents Chemother, 1983 Oct, 24(4), 597 - 9
In vitro antimicrobial susceptibility of penicillinase-producing and intrinsically resistant Neisseria gonorrhoeae strains; Cohen MS et al.; The in vitro susceptibility of penicillinase-producing and intrinsically resistant Neisseria gonorrhoeae strains to 13 antimicrobial agents was tested . Regardless of the type of resistance, these organisms remained quite susceptible to newer cephalosporin agents, including moxalactam, cefoperazone, cefotaxime, and ceftazidime.

J Clin Lab Immunol, 1983 Oct, 12(2), 83 - 6
ABO blood groups and susceptibility to gonococcal infection . III . Role of isohemagglutinins in increased association of Neisseria gonorrhoeae to monocytes from blood group B individuals; Kinane DF et al.; The association of human monocytes of different ABO blood groups with gonococci was examined under various conditions . Blood group B monocytes in the presence of autologous heat inactivated serum (HIS) showed increased association over monocytes of the other ABO groups with their autologous sera . No statistically significant trends in ABO monocyte association were noted for assays carried out in the absence of autologous HIS . Absorptions of isohemagglutinins from sera reduced the gonococcus-monocyte association level to that of controls.

South Med J, 1983 Oct, 76(10), 1325 - 6
Gonococcal endocarditis with initially negative blood cultures; Donachie RJ Jr et al.; This case of gonococcal endocarditis in a young man highlights the recognized capacity of Neisseria gonorrhoeae to destroy an infected valve, and illustrates that emergency valve replacement in the presence of congestive heart failure may be life-saving . The utility of the echocardiogram and the reportedly low yield of positive blood cultures in this disease are represented.

Infect Immun, 1983 Oct, 42(1), 99 - 105
Phagocytic killing of Neisseria gonorrhoeae by human monocytes; Mezzatesta JR et al.; The ability of human monocytes to phagocytize and kill nonpiliated opaque (T3) and transparent (T4) gonococci was investigated in a tumbling tube suspension assay . A serum-sensitive strain, F62, and a serum-resistant strain, FA19, were studied . CFU remaining after incubation with monocytes were used to assess the extent of killing . The data show that 50% of T3 and T4 gonococci of both strains were killed by monocytes over a 2-h period . Serum was necessary for the killing of transparent gonococci of both strains as well as for FA19 T3 . Concentrations of serum ranging from 0.5 to 10% were equally effective, and heat-labile components were required . Killing of F62 T3, however, occurred in the absence of serum . An increased ratio of bacteria to monocytes decreased the rate of killing . A 30-min preopsonization of gonococci in 10% serum resulted in an enhanced rate of killing . Monocytes were able to kill plate-grown, but not log-phase, organisms . Disruption of the monocytes by sonication to release internalized bacteria did not increase the number of viable organisms . The addition of 10 micrograms of cytochalasin B per ml completely inhibited the reduction in colony numbers over time . These data indicate that freshly isolated human monocytes are capable of phagocytizing and killing nonpiliated gonococci.

Br J Vener Dis, 1983 Oct, 59(5), 285 - 8
Epidemiological characterisation of Neisseria gonorrhoeae isolates from the Far East; Odugbemi TO et al.; One hundred strains of Neisseria gonorrhoeae (including 30 penicillinase producing (PPNG) strains) originating from Korea were characterised by plasmid analysis, auxotyping, and serogrouping . Eighty per cent of the isolates possessed the conjugative 24.5 megadalton (Mdal) plasmid . A novel 7.8 Mdal plasmid was present in four isolates (one PPNG and three non-PPNG strains) . Seventy five per cent of all the strains tested were wild type and belonged to serogroup WII, while 20% were proline requiring and belonged to serogroup WII . Two of the remaining strains were tyrosine auxotrophs, while another strain was arginine requiring; these three strains carried the conjugative plasmid and belonged to serogroup WII.

Sex Transm Dis, 1983 Oct-Dec, 10(4 Suppl), 289 - 93
Enzyme immunoassay for serum antibody to Mycoplasma hominis in women with acute pelvic inflammatory disease; Miettinen A et al.; A sensitive, four-layer modification of an enzyme immunoassay was developed for the determination of serum antibodies to Mycoplasma hominis . The suitability of the test for diagnostic use was studied with women who had acute pelvic inflammatory disease (PID) . Twenty (23%) of 86 women with PID from whom paired sera were obtained demonstrated a significant change in levels of IgG antibody, a finding suggestive of recent infection with M . hominis . The occurrence of such change was not related to the isolation of Chlamydia trachomatis or Neisseria gonorrhoeae from the lower genital tract . Women with PID had significantly higher levels of IgG and IgA antibody to M . hominis, whereas the amount of IgM antibodies present did not differ between the groups . Levels of IgG antibody increased and those of IgM antibody decreased with increasing age . This change was found both among women with PID and among controls.

Br J Vener Dis, 1983 Oct, 59(5), 293 - 7
Sultamicillin in the treatment of gonorrhoea caused by penicillin sensitive and penicillinase producing strains of Neisseria gonorrhoeae; Atia WA et al.; A single oral dose of 2 g of sultamicillin and 1 g of probenecid was effective in the treatment of men with uncomplicated gonococcal urethritis caused by both penicillin sensitive strains of Neisseria gonorrhoeae and penicillinase producing strains of N gonorrhoeae (PPNG) . Of 94 infected men who attended for at least one follow up examination, 91 (97%) were cured . The remaining three (3%) patients were still infected at follow up . Two of these patients had been re-exposed to an infected partner and were considered to be possible reinfections, while the third was deemed a treatment failure . Six of the 94 patients were infected with PPNG strains and all were successfully treated . Plasmid analysis of the PPNG strains showed Asian and African types both with and without transfer plasmid.

Br J Vener Dis, 1983 Oct, 59(5), 289 - 92
Antimicrobial sensitivity of Neisseria gonorrhoeae . Comparison of penicillinase producing and non-penicillinase producing strains; Herzog C et al.; The sensitivity of 42 strains of penicillinase producing Neisseria gonorrhoeae (PPNG) and 46 strains of non-PPNG was tested against benzyl penicillin, spectinomycin, erythromycin, cefuroxime, ceftriaxone, tetracycline, sulphamethoxazole, and trimethoprim . The minimum inhibitory concentrations (MICs) of all antimicrobials, except trimethoprim and ceftriaxone, differed significantly for PPNG and non-PPNG strains . Ceftriaxone was the most active compound tested, the MIC for all strains being less than or equal to 0.015 mg/1 . PPNG were less sensitive than non-PPNG strains to spectinomycin . It remains to be seen whether the increase in prevalence of PPNG strains is followed by a gradual increase in low level resistance to spectinomycin as well as the occasional finding of high level resistance to this antibiotic.

Br J Vener Dis, 1983 Oct, 59(5), 298 - 301
Cefaclor and cefamandole as alternatives to spectinomycin in the treatment of men with uncomplicated gonorrhoea; Panikabutra K et al.; Between 25 December 1981 and 11 March 1982, 400 men with uncomplicated gonococcal urethritis were randomly assigned to one of four treatment regimens: spectinomycin 2 g intramuscularly (group A); cefamandole 1 g intramuscularly after probenecid 1 g orally (group B); cefaclor 3 g orally with probenecid 1 g orally (group C); and cefaclor 3 g orally (group D) . The cure rates were 91 of 92 (98.9%) in group A, 68 of 96 (70.8%) in group B, 88 of 92 (95.8%) in group C, and 86 of 96 (89.6%) in group D . Cefaclor at a dose of 3 g given orally with 1 g probenecid appears to be an effective alternative to spectinomycin 2 g in the treatment of gonorrhoea in areas where strains of penicillinase producing Neisseria gonorrhoeae (PPNG) are prevalent.

N Z Med J, 1983 Sep 28, 96(740), 716 - 8
Unsuspected Chlamydia trachomatis in females attending a sexually transmitted diseases clinic; Say PJ et al.; One hundred and five women attending Auckland sexually transmitted diseases clinic were reviewed because of positive cervical cultures for Chlamydia trachomatis . Their average age was 19 years, 70% were European; 28% were Maori . In half the patients the positive culture was a chance finding and therefore treatment was delayed resulting in six patients (12%) developing pelvic inflammatory disease . Eight out of nine male contacts, subsequently traced, had asymptomatic urethritis, one having epididymitis . One patient had no evidence of urethritis but was chlamydia positive . Associated pathogens present in the women were Neisseria gonorrhoeae (26%), Trichomonas vaginalis (6%), Gardnerella vaginalis (46%) and Candida albicans (19%) . These findings support a need for routine chlamydial testing in female patients attending sexually transmitted diseases clinics and epidemiological treatment of female contacts of men with non-specific urethritis.

S Afr Med J, 1983 Sep 17, 64(12), 451 - 4
The enzyme-linked immunosorbent assay (ELISA) in the laboratory diagnosis of gonorrhoea . A comparative evaluation; De Klerk E et al.; An enzyme-linked immunosorbent assay (ELISA) was used to detect levels of antibodies to Neisseria gonorrhoeae in 100 male patients with suspected gonorrhoea attending a clinic for sexually transmitted diseases . Although significantly higher antibody levels were detectable in patients with clinically diagnosed gonorrhoea confirmed by laboratory tests, positive results were also obtained in 26% of the control subjects, who were presumed to be healthy . Serum anticomplement activity was present in 8% of the subjects with false-positive results, while tests for rheumatoid factor were positive in 14% . However, these problems could be eliminated to a certain extent by including a negative control or background well for each serum sample . Because the ELISA was found to be of high sensitivity and moderate specificity it is concluded that it is a useful serodiagnostic test for gonorrhoea.

Ann Microbiol (Paris), 1983 Sep-Oct, 134B(2), 257 - 67
A new taxon in the genus Neisseria; Riou JY et al.; Among 3,520 strains of Neisseria and Branhamella received in the laboratory during the last seven years, 13 could not be speciated . These 13 strains (Neisseria sp . group) were isolated from the throats of healthy children in Europe and Africa . The Neisseria sp . group oxidized glucose and maltose similarly to N . meningitidis . The observation of polysaccharide synthesis prompted the authors to examine the genomic relationship between the Neisseria sp . group and the type strains of all species of Neisseria and Branhamella . Additional phenotypic characteristics were also examined . Results indicated that the 13 strains in this study belong to the genus Neisseria, in which they constitute one homogenous hybridization group . They belong to the same genospecies as N . gonorrhoeae, N . meningitidis, N . flavescens and N . lactamica . However, they differ from N . meningitidis in production of polysaccharides, growth requirements and the lack of gamma-glutamyl transferase activity.

J Ethnopharmacol, 1983 Sep, 8(3), 279 - 86
Rwandese herbal remedies used against gonorrhoea; Van Puyvelde L et al.; In the course of systematic studies on biologically active substances from medicinal plants of Rwanda (Central Africa) we have screened the indigenous drugs used against gonorrhoea for their antimicrobial activity . From the 25 plants tested, 16 were found to have an activity against Neisseria gonorrhoea and N . meningitidis, 6 against Streptococcus pyogenes and 5 against Staphylococcus aureus . Thus, out of 23 indigenous drugs, 17 remedies (74%) were found to be associated with one or more plants with an activity against gonorrhoea.

Mol Immunol, 1983 Sep, 20(9), 1039 - 49
Inhibition of microbial IgA proteases by human secretory IgA and serum; Gilbert JV et al.; Microbial IgA proteases cleave human serum IgA1 immunoglobulin, but human secretory IgA is resistant to hydrolysis . We have found this resistance to be due to an inhibition of protease activity that is mediated by the Fab region of secretory IgA . The IgA proteases of the genus Neisseria are more sensitive to inhibition than is the protease of Streptococcus sanguis . There is also a serum inhibitor of Neisseria proteases that co-chromatographs with IgG . Monoclonal (myeloma) human IgG proteins and plasma protease inhibitors such as alpha-1-antitrypsin and alpha-2-macroglobulin do not inhibit . Human sera do not contain inhibitor to S . sanguis protease activity . We conclude that microbial IgA proteases are subject to inhibition by IgA in secretions and IgG in serum, and this activity is most consistent with being an anti-enzyme antibody . The insensitivity of S . sanguis IgA protease to inhibition is unexplained but provides further evidence that the IgA proteases are structurally diverse.

J Adolesc Health Care, 1983 Sep, 4(3), 171 - 3
Isolation of Neisseria meningitidis from anogenital sites in adolescents: clinical implications; Jaffe LR et al.; Neisseria meningitidis is being increasingly isolated from the urethra, cervix, and anal canal of sexually active individuals . We found a similar phenomenon in inner-city black and Hispanic adolescents . In 1981, cultures of 92 isolates of Neisseria were made from the anogenital region of sexually active adolescents; 81 (88.0%) were N . gonorrhoeae, 3 (3.3%) could not be speciated, and 8 (8.7%) were N . meningitidis . Since N . meningitidis has been associated with urethritis and pelvic inflammatory disease, it should be considered a pathogen when identified in the urethra or cervix and should be appropriately treated . The health implications of isolating N . meningitidis from the anal canal are less clear, although it has been rarely associated with proctitis . Neisseria isolates from anogenital sites cannot be assumed to be gonococci and, therefore, should be distinguished from N . meningitidis.

J Infect Dis, 1983 Sep, 148(3), 462 - 71
DNA hybridization technique for the detection of Neisseria gonorrhoeae in men with urethritis; Totten PA et al.; A technique to detect Neisseria gonorrhoeae directly in clinical specimens was developed using a modified DNA-hybridization method . It uses the gonococcal cryptic plasmid as the radiolabeled probe, can detect as few as 100 colony-forming units of N gonorrhoeae or as little as 0.1 pg of purified gonococcal plasmid DNA, and is highly specific . This technique for differentiating between gonococcal and nongonococcal urethritis was evaluated in men with symptomatic urethritis in Seattle . Sixty-three (89%) of 71 who had cultures positive for N gonorrhoeae were also positive by DNA hybridization, and all 42 whose cultures were negative were also negative by DNA hybridization . Five of six isolates from patients who were positive by culture but negative by hybridization lacked the gonococcal cryptic plasmid and belonged to a unique auxo-type which requires proline, citrulline, and uracil for growth.

J Bacteriol, 1983 Sep, 155(3), 1324 - 32
Sequence-specific DNA modification in Neisseria gonorrhoeae; Korch C et al.; Neisseria gonorrhoeae 82409/55(pJD1) is postulated to possess six DNA sequence-specific cytosine methyltransferases and one DNA sequence-specific N6-adenine methyltransferase . From the DNA sequencing of the plasmid pJD1 (manuscript in preparation) by a modification of the Maxam and Gilbert chemical cleavage procedure, the cytosine methylation specificities were demonstrated . Five of these methylating enzymes and their respective specificities are M . NgoI (formula; see text) does not methylate the cytosine of its recognition sequence, in agreement with a detected adenine modification . A biological implication of these different DNA methylating activities is discussed.

Fertil Steril, 1983 Sep, 40(3), 322 - 9
Infertility after acute salpingitis with special reference to Chlamydia trachomatis; Svensson L et al.; Of 552 women with laparoscopically verified acute salpingitis (AS), 299 were reviewed 2.5 to 7.5 years later . Cervical secretions from these women had been cultured for the presence of Chlamydia trachomatis and Neisseria gonorrhoeae . For 49 of 82 women with visually normal pelvic organs, such cultures were also performed; these women served as control subjects . In women exposing themselves to pregnancy, 50 (23.3%) of 197 AS patients and 2 (6.7%) of 30 control women were infertile for at least 1 year (P less than 0.02) . After one episode of AS, women harboring chlamydiae, gonococci, both, or neither of these microorganisms in the cervix on admission seemed to have the same fertility prognosis . Infertility was correlated with the number of AS episodes, the erythrocyte sedimentation rate (millimeters per hour) at admission, and the severity of the inflammatory reactions of the tubes . The use of oral contraceptives at admission was found to be a positive prognostic factor regarding fertility . Oral contraceptives might protect the patient from severe tubal inflammatory reactions.

Drug Intell Clin Pharm, 1983 Sep, 17(9), 615 - 22
Third-generation and investigational cephalosporins: II . Microbiologic review and clinical summaries; Garzone P et al.; In vitro susceptibility of Streptococcus pyogenes, Staphylococcus aureus, Staphylococcus epidermidis, Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli, Serratia marcescens, Hemophilus influenzae, Bacteroides fragilis, and Neisseria gonorrhea to three new second-generation and eight third-generation cephalosporins is tabulated . In general, the newer cephalosporins have an extended spectrum of activity against gram-negative bacteria, including Serratia marcescens, Pseudomonas aeruginosa, and Neisseria gonorrhea . They also tend to be active against anaerobes, including Bacteroides fragilis . However, they generally have less activity against gram-positive bacteria when compared with the first- and second-generation cephalosporins . Clinical summaries are given for each of the cephalosporins, with emphasis on the results of comparative clinical trials . These cephalosporins may prove especially useful in nosocomial infections with resistant organisms, intraabdominal infections, febrile episodes in the granulocytopenic patient, and meningitis.

Z Hautkr, 1983 Aug 15, 58(16), 1165 - 76
{Winuron - alternative single-dose therapy of gonorrhea}; Fechner WC et al.; 152 ambulatory patients suffering from gonorrhoea were treated with Winuron in an open clinical trial . A single oral dose of rosoxacin 300 mg proved to be sufficient to cure 97.4% of the patients . Follow-up examination revealed only 4 cases of Neisseria gonorrhoea left . Already 3 days after therapy, the clinical symptoms had subsided in 84.1% of the patients . The substance was well-tolerated . Side effects were observed in 14.5% of the cases, being mild and transitory, though . Good and antibacterial efficacy of rosoxacin in vitro as well as the high healing quotient in combination with the shortest possible duration of therapy make Winuron a valuable alternative to penicillin.

JAMA, 1983 Aug 12, 250(6), 794 - 5
Neisseria gonorrhoeae conjunctivitis . An outbreak during an epidemic of acute hemorrhagic conjunctivitis; Alfonso E et al.; Ten patients with gonococcal conjunctivitis were examined during an epidemic of acute hemorrhagic conjunctivitis (AHC) . Eye cultures in all cases demonstrated Neisseria gonorrhoeae, and seven also had isolates of N gonorrhoeae in genital specimens . All patients responded well to antimicrobial therapy . The patients had used a folk remedy in which they had applied urine to their eyes to treat the symptoms of AHC.

Lab Anim Sci, 1983 Aug, 33(4), 377 - 9
Epistaxis and bullae in cynomolgus macaques (Macaca fascicularis); Olson LC et al.; Epistaxis and bullae occurred in 35 of 54 cynomolgus macaques (Macaca fascicularis) . Individual cases developed randomly during a 3 to 4 week period in the winter, and resolved within a week of onset . Clinical signs included nasal and eyelid swelling, bloody nasal discharge, sneezing, and bullous areas above the eyes . Affected animals remained active and alert . Staphylococcus aureus and Neisseria catarrhalis were isolated from nasal swabs . Hemagglutination inhibition titers for measles were negative . Biopsies of the bullous areas disclosed acute inflammatory edema and cellulitis.

Acta Pathol Microbiol Immunol Scand {B}, 1983 Aug, 91(4), 257 - 60
Pyrimidine biosynthesis in Neisseria meningitidis . 2 . Regulation of enzyme synthesis; Jyssum S; In Neisseria meningitidis aspartate carbamoyltransferase (ACTase), ornithine carbamoyltransferase (OCTase), and carbamoylphosphate synthetase (CPSase) showed incomplete repression by uracil and arginine . De-repression studies with pyrimidine and arginine mutants showed no de-repressed levels of these enzymes.

Acta Pathol Microbiol Immunol Scand {B}, 1983 Aug, 91(4), 245 - 50
Influence of blood cells on the expression of bacteriocin-like activity in Neisseria meningitidis; Jyssum K et al.; The inhibitors responsible for the bactericidal activity found in four strains of Neisseria meningitidis were strongly bound to or inactivated by blood cells . The bactericidal effects were specifically influenced by human cells of types O, A, B and AB . Cells from horse, sheep and rabbit had no significant effect . The bacteriostatic effect observed in one strain of N . meningitidis was more moderately reduced in the presence of animal cells as well as human cells . The effects of the blood cells were connected with pellets from lysates of the blood cells . The bacteriostatic effect was also moderately reduced in the presence of plasma, hemoglobin and methemoglobin regardless of origin, and to some extent of cytochrome C . CaCl2 slightly enhanced the bacteriostatic effect.

J Clin Microbiol, 1983 Aug, 18(2), 436 - 7
Septicemia due to a maltose-positive, glucose-negative strain of group C Neisseria meningitidis; Watanakunakorn C et al.; A glucose-negative, maltose-positive strain of group C Neisseria meningitidis was isolated from the blood of a 63-year-old man . Interestingly, maltose degradation was detected by radiometric methods but not by growth methods.

J Med Microbiol, 1983 Aug, 16(3), 295 - 302
Auxotyping of Neisseria gonorrhoeae isolated in the United Kingdom; Copley CG et al.; One hundred and twenty consecutive isolates of Neisseria gonorrhoeae from the County of Avon, UK, were examined by auxotyping and penicillin susceptibility testing . Requirements for proline (Pro), arginine (Arg), hypoxanthine (Hyp), uracil (Ura) and methionine (Met) were determined with a modified Heckels' medium . Prototrophic strains accounted for 29.9% of isolates and were a heterogeneous group as judged by penicillin susceptibility testing . The group most generally susceptible to penicillin required Arg-Hyp-Ura, and represented 27.5% of isolates . The Pro-Argo-Ura auxogroup (10% of isolates) had the narrowest range of penicillin susceptibility . Prototrophic strains had a reduced growth rate on arginine-free medium . Investigations of this phenomenon and suitable methods for auxotyping are reported.

J Bacteriol, 1983 Aug, 155(2), 498 - 504
Heterogeneity and variation among Neisseria meningitidis lipopolysaccharides; Tsai CM et al.; Eight immunotype lipopolysaccharides (LPSs) of Neisseria meningitidis were prepared by the phenol-water procedure and characterized by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and sugar analyses . By SDS-PAGE and a highly sensitive silver strain . N . meningitidis LPSs from cells grown in tryptic soy broth were shown to contain one or two predominant components and a few minor, somewhat higher-molecular-weight components . The molecular sizes of the two predominant components were approximately the same as those of two E . coli rough-type LPSs, one with a complete core and the other with an incomplete core . The molecular weight of the major LPS component varied somewhat among different immunotypes but was estimated to be in the range of 4,200 to 5,000 . By sugar analyses, the eight immunotype LPSs were different in their monosaccharide compositions . All contained glucose, galactose, heptose, glucosamine, and 2-keto-3-deoxyoctonate, but in different molar ratios . The growth of N . meningitidis in tryptic soy broth under different levels of aeration resulted in a change in the two major LPS components seen on the SDS-PAGE gel . High aeration increased the amount of the smaller component, whereas low aeration increased the amount of the larger component . Sugar analyses of LPSs from high and low aeration indicated that the larger LPS component contained more galactose residues per molecule . Use of different media for cell growth may also result in small, but noticeable, variations in the LPS components and in the galactose content of the LPS . The observed heterogeneity of N . meningitidis LPS may explain why many strains of N . meningitidis appear to possess more than one immunotype.

Br J Vener Dis, 1983 Aug, 59(4), 242 - 4
Acrosoxacin in the treatment of uncomplicated gonorrhoea; Walsh RJ et al.; Acrosoxacin was given as a single 300 mg oral dose to 105 patients with acute gonorrhoea . Of the 100 patients followed completely there was a 93% cure rate and 33% of men developed postgonococcal urethritis (PGU) . This compared with a 97% cure and 30% PGU with 2 megaunits penicillin . The in vitro activity of acrosoxacin in Nottingham against strains of Neisseria gonorrhoeae showed that it was a highly active agent with 90% of strains inhibited by a concentration of 0.03 mg/l.

Br J Vener Dis, 1983 Aug, 59(4), 237 - 41
Neisseria gonorrhoeae: stability of typing markers after natural transmission; Copley CG et al.; The gonococcal isolates from 15 contact pairs and three large contact groups were examined using various methods to assess the stability of different typing markers . With the exception of one contact group which showed variable proline requirements, the auxotypes were stable during natural transmission . Serogrouping using the coagglutination method to detect W and M antigens was undertaken . The lipopolysaccharide M antigens were readily lost and gained during transmission whereas the protein W antigens represented stable markers and are thus useful for epidemiological studies.

Br J Vener Dis, 1983 Aug, 59(4), 232 - 6
Penicillinase-producing Neisseria gonorrhoeae isolates from different localities in south east Asia . Susceptibility to 15 antibiotics; Ng WS et al.; Sixty four penicillinase-producing Neisseria gonorrhoeae (PPNG) and 24 non-penicillinase-producing (non-PPNG) strains isolated from six different south east Asian localities were tested by the agar dilution method against 15 antibiotics . All isolates were susceptible to spectinomycin and sulphamethoxazole-trimethoprim (19:1 ratio) . A large proportion of both PPNG and non-PPNG strains showed, however, a decreased susceptibility to tetracycline, kanamycin, and erythromycin: 49% with minimum inhibitory concentrations (MICs) of tetracycline greater than or equal to 2 micrograms/ml, 34% with MICs of kanamycin greater than or equal to 32 micrograms/ml, and 80% with MICs of erythromycin greater than or equal to 2 micrograms/ml . These MIC cut-off values were chosen since they are close to the highest concentrations of these antibiotics attainable in serum after drug administration . Resistance to these antibiotics was not related to penicillinase production and does not appear to be confined to gonococci isolated from one particular locality . Strains showing resistance concurrently to two or three of these drugs were often isolated from different south east Asian countries . All eight cephalosporins tested were effective against both PPNG and non-PPNG strains . On a weight to weight basis the new cephalosporins--namely, moxalactam, cefoperazone, cefotaxime, and ceftriaxone--were the most effective . In contrast to those of cefoxitin, cefuroxime, moxalactam, and cefoperazone the MICs of cefamandole, cefotaxime, and ceftriaxone were significantly affected when the inoculum size was increased from 10(3) to 10(6) colony forming units (cfu).

Hautarzt, 1983 Aug, 34(8), 403 - 6
{Determination of pathogens in blood in disseminated gonococcal infection . Case report and overview of the literature}; Korting HC et al.; Although Neisseria gonorrhoeae has been recognized as causative agent of infectious disease not only of the genital region but also of other organs already at the end of the 19th century, disseminated gonococcal infection as a clinical entity has been defined fairly recently, i.e., during the last decade . In particular, it has been very difficult for a long time to detect Neisseria gonorrhoeae in the blood of patients suffering from this form of gonorrhea . Therefore, the case of a 22-year-old woman is presented who developed fever, arthritis, and pustules and from whose cervix, rectum, and blood Neisseria gonorrhoeae could be grown . Based on the reports in the literature and our own experience indispensable and further desirable diagnostic measures to be adopted in such cases are discussed.

Acta Pathol Microbiol Immunol Scand {B}, 1983 Aug, 91(4), 251 - 5
Pyrimidine biosynthesis in Neisseria meningitidis . 1 . Demonstration of enzyme activities; Jyssum S; Activities of the five enzymes specific for the pyrimidine biosynthetic pathway, aspartate carbamoyl-transferase (ACTase), dihydroorotase (DHOase), dihydroorotate dehydrogenase (DHOdehase), orotate phosphoribosyltransferase (OMPppase), and orotidine 5'-phosphate decarboxylase (OMPdecase) were found in cell-free extracts of Neisseria meningitidis . Extracts also contained enzyme activities corresponding to the arginine pathway enzyme ornithine carbamoyltransferase (OCTase), and to carbamoylphosphate synthetase (CPSase), the enzyme common to both pathways . N . meningitidis possessed a single glutamine-dependent CPSase.

Am J Med, 1983 Jul 28, 75(1B), 93 - 7
Urine as a specimen for diagnosis of sexually transmitted diseases; Schachter J; The case of specimen collection has led to the suggestion that urine might be a useful specimen for the isolation of sexually transmitted disease agents . It would only be an appropriate specimen for agents that infect the urethra, such as Neisseria gonorrhoeae or Chlamydia trachomatis . Comparative tests have shown that culture of urine for chlamydiae (from men with urethritis) or for gonococci from women is an insensitive procedure . Gonococci can be isolated from urine from men at rates essentially equivalent to culture of urethral swabs . If specimens can be processed promptly (to avoid bactericidal effects of urine), culture of urine can likely be useful for screening asymptomatic men for gonococcal infection.

Lancet, 1983 Jul 9, 2(8341), 67 - 70
Comparative study of ceftriaxone and spectinomycin for treatment of uncomplicated gonorrhoea in men; Handsfield HH et al.; Single-dose ceftriaxone, 125 mg or 250 mg intramuscularly (IM), was compared with spectinomycin, 2 g IM, for treatment of men with uncomplicated urethral or anorectal infections due to penicillinase-negative Neisseria gonorrhoeae . Cure rates were 100% for 31 and 28 men treated with 125 mg and 250 mg ceftriaxone, respectively, and 97% for 58 men given spectinomycin . Among patients followed up for greater than or equal to 14 days, post-gonococcal urethritis occurred in 25% of 44 men treated with ceftriaxone and 19% of 47 given spectinomycin (p = NS) . The geometric mean minimum inhibitory concentration of ceftriaxone for 79 pre-treatment isolates of N gonorrhoeae was 0.0058 microgram/ml, and all strains were inhibited by less than or equal to 0.063 micrograms/ml . Neither drug caused perceptible toxicity, but patient acceptance was greater for ceftriaxone than for spectinomycin . Ceftriaxone in a single dose of 125 mg is effective against uncomplicated urethral or anorectal gonorrhoea in men and may become a regimen of choice for this infection.

J Clin Microbiol, 1983 Jul, 18(1), 56 - 62
Modified oxidation-fermentation medium for detection of acid production from carbohydrates by Neisseria spp . and Branhamella catarrhalis; Knapp JS et al.; A modified oxidation-fermentation medium was developed as a practical medium for highly sensitive and specific detection of acid production from carbohydrates by Neisseria spp . and Branhamella catarrhalis . A total of 756 strains representing 17 Neisseria spp . and Branhamella catarrhalis were tested in this medium, in which the protein concentration was reduced relative to the carbohydrate concentration, phenol red was substituted for bromthymol blue at a low concentration, and the initial pH was adjusted to 7.2 . Sugar utilization patterns were consistent with published results and with other cultural and biochemical characteristics for these species . The reactions obtained using this medium were qualitatively better and more reproducible than those obtained in cystine-Trypticase agar (BBL Microbiology Systems, Cockeysville, Md.) medium.

J Urol, 1983 Jul, 130(1), 138 - 9
Gonococcal infection of the median penile raphe; Clifford GR et al.; Atypical involvement of the male genitourinary tract by Neisseria gonorrhoeae, such as isolated accessory glandular infection without urethritis, is a rare presentation of a common disease . We report a case of gonococcal abscess of the median raphe of the penis.

Am J Dis Child, 1983 Jul, 137(7), 650 - 3
Kingella (Moraxella) kingae infections in children; Bosworth DE; Kingella (Moraxella) kingae occasionally colonizes the nasopharynx and rarely causes serious infections . Three children with K kingae infections treated over a two-month period were studied . Epidemiologic investigation concluded that infection was community acquired, not pseudoinfection or nosocomial infection . Except for prompt laboratory recognition of the organism, no identifiable factors explained the observed prevalence . Five additional K kingae infections were reviewed . Affected sites included blood (two), valves (two), bone (two), joint (one), and disk space (one) . Three patients had underlying disease; one was immunosuppressed . Kingella kingae resembles other members of the Neisseriaceae family and causes similar infections except meningitis . It is differentiated by colonial characteristics and standard biochemical tests . Treated infections responded to penicillin G potassium . Gram-negative bacteria uncommonly are implicated in endocarditis, arthritis, osteomyelitis, and diskitis; K kingae deserves recognition as a pathogen in these pediatric infections.

Sex Transm Dis, 1983 Jul-Sep, 10(3), 114 - 8
Nonspecific vaginitis and other genital infections in three clinic populations; Hill LH et al.; Nonspecific vaginitis was present in 37% of 40 patients attending the Special Urology (Sexually Transmitted Disease) Clinic at the Victoria General Hospital, in 23% of 75 patients attending the Family Planning Clinic, and in 23% of 13 patients attending the Prenatal Clinic at the Grace Maternity Hospital in Halifax, Nova Scotia . The mean prevalence was 27% . Subjective complaints of vaginal odor were significantly associated with nonspecific vaginitis (P less than .001), but symptoms of vaginal discharge or vulvar irritation and itching were not . No correlations were found between the presence of nonspecific vaginitis and the isolation of Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum, Trichomonas vaginalis, or vaginal yeast species . The organic acid present in vaginal washings that best correlated with the presence of nonspecific vaginitis was succinic acid.

Sex Transm Dis, 1983 Jul-Sep, 10(3), 138 - 40
The isolation of Neisseria gonorrhoeae: a comparison of three culture transport systems; Spence MR et al.; Endocervical swabs for the culture of Neisseria gonorrhoeae from 417 patients attending a pelvic infections clinic were evaluated . Three swabs were obtained from each patient . One swab was plated directly onto Thayer-Martin medium and taken shortly thereafter to a microbiology laboratory for evaluation . A second swab was inoculated into modified Stuart's transport media and transported soon afterward to the hospital microbiology laboratory . The third specimen was plated onto Transgrow media and transferred according to routine transportation protocols to the Maryland State Health Department for evaluation . The prevalence of Neisseria gonorrhoeae infection in this population was 14.6% (61/417) . The sensitivities of the direct plating and modified Stuart's systems with on-site evaluation were 87% (53/61) and 85% (51/61), respectively, while the sensitivity of Transgrow plating with off-site evaluation was only 64% (39/61) . These findings argue against the use of a system of Transgrow plating and off-site processing of culture specimens to screen for infections with Neisseria gonorrhoeae.

Sex Transm Dis, 1983 Jul-Sep, 10(3), 111 - 3
Quantitative disk method for storage of Neisseria gonorrhoeae; McBride ME; A medium has been devised for the storage of Neisseria gonorrhoeae in the form of quantitated disks at -70 C . The medium consists of bovine serum albumin, 5%; inositol, 10%; glutamate, 5%; gelatin, 10%; and charcoal, 0.3% . Thirty-one strains of N . gonorrhoeae have been stored for 12 months and seven strains for 20 months . The organisms have maintained good viability and stability of colonial morphology . This procedure provides a means of maintaining high-density populations of freshly isolated strains of N . gonorrhoeae in quantitated form without subculture.

Rev Can Biol Exp, 1983 Jul, 42(2), 191 - 7
Modulation by staphylococci of the response of mice infected with Neisseria gonorrhoeae; Jacques M et al.; Most strains of Neisseria gonorrhoeae are rapidly eliminated from the peritoneal cavity of mice following an experimental infection . However, we could modify the rate of clearance of N . gonorrhoeae by preteating (48 h) the mice with sublethal doses of Staphylococcus aureus coagulase-positive strains which provoke the rapid appearance of activated phagocytes; we showed that these have increased activities of their B-galactosidase and their enzymes able to reduce nitroblue tetrazolium (NBT) . Presumably, these activated phagocytes participated in the more efficient elimination of N . gonorrhoeae cells from the peritoneal cavity, that is 3 log units instead of 1 for the control, within the first 2 hours after their injection . There was no increase in the clearance of N . gonorrhoeae from the peritoneal cavity of mice when these were pretreated with cyclophosphamide . The use of enzyme-treated staphylococci (protoplasts) showed that some component of the coagulase-positive S . aureus cell wall seems responsible for the stimulation observed . This modulation of the response of mice to N . gonorrhoeae could serve as an improved method to evaluate the virulence of different N . gonorrhoeae strains.

J Clin Microbiol, 1983 Jul, 18(1), 178 - 84
Cultivation of Neisseria gonorrhoeae under low-oxygen conditions; Kellogg DS et al.; Sixteen Neisseria gonorrhoeae strains were examined for their abilities to grow under reduced oxygen tension . Low oxygen tensions were developed by evacuation-replacement procedures in which anaerobes and oxidation-reduction indicators were used as controls . All strains survived 96 h in a medium reduced to below -125 mV without visible growth . Detectable growth occurred at 0.05% oxygen, and 33% of normal colony size under air (21% oxygen) was obtained at 0.15% oxygen . Population selection did not determine survival and growth, but carbon dioxide was required . Characteristic colony morphologies were not evident at the lower oxygen concentrations . Colonial variation was not influenced during survival under anaerobic conditions or growth under low oxygen levels (0.15%) . Medium differences were not significant affectors . We concluded that N . gonorrhoeae will grow under tensions suitable for anaerobes, and will demonstrate certain modifications of behavior under these conditions.

Infect Immun, 1983 Jul, 41(1), 74 - 82
Effect of dilution rate on lipopolysaccharide and serum resistance of Neisseria gonorrhoeae grown in continuous culture; Morse SA et al.; Growth of Neisseria gonorrhoeae strain FA171 in continuous culture under glucose-limiting conditions resulted in a growth-rate-dependent change in the lipopolysaccharide (LPS) . The evidence for this change is an alteration in the mobility of purified alkali-treated LPS on sodium dodecyl sulfate-polyacrylamide gels and a quantitative difference in the amount of the LPS serotype antigen . The LPS from cells grown at a low dilution rate (0.12 h-1) contained ca . eightfold less serotype antigen than the LPS from cells grown at a high dilution rate (0.56 h-1) . The decrease in LPS serotype antigen was associated with an increase in sensitivity to the bactericidal activity of normal human serum and an increase in cell surface hydrophobicity . An increase in the amount of serotype antigen was associated with a reduction in the accessibility of a monoclonal antibody to a core LPS determinant, an increase in resistance to normal human serum, and a decrease in cell surface hydrophobicity . The microheterogeneity of gonococcal LPS with respect to the content of serotype antigen may result from an alteration in the metabolism of glucose.

Sex Transm Dis, 1983 Jul-Sep, 10(3), 135 - 7
One gram of cefoxitin cures uncomplicated gonococcal urethritis caused by penicillinase-producing Neisseria gonorrhoeae (PPNG); Sanchez PL et al.; Therapy of disease caused by penicillinase-producing Neisseria gonorrhoeae with lower-than-standard doses of cefoxitin was evaluated . A pilot study showed that doses of greater than or equal to 1 g were adequate, whereas 500-mg doses consistently failed . After the pilot study, 89 men with gonorrhea were treated with 1 g of cefoxitin given intramuscularly plus 1 g of probenecid given orally . Of the 89 men, 86 were cured . Sixty per cent were infected with penicillin-resistant strains of N . gonorrhoeae . The three men who were culture-positive on follow-up had been sexually reexposed, whereas none of those with negative cultures had had reexposure . These clinical results indicate that a treatment regimen of 1 g of parenteral cefoxitin plus 1 g of oral probenecid appears to be as effective as the standard 2-g dose . Regimens using doses lower than 1 g are ineffective.

Infect Immun, 1983 Jul, 41(1), 106 - 13
Differences in the adhesive properties of Neisseria meningitidis for human buccal epithelial cells and erythrocytes; Trust TJ et al.; The ability of clinical and carrier isolates of Neisseria meningitidis to adhere to human buccal epithelial cells and erythrocytes was investigated . Four of the 10 fimbriated strains were able to hemagglutinate . Serial subculture of three of these strains resulted in a loss of ability to hemagglutinate and was coincident with a loss of fimbriation . Other fimbriated strains were unable to hemagglutinate but did adhere to buccal epithelial cells . Subculture of one of these strains for as many as 42 passages did not result in loss of fimbriation or ability to adhere to buccal epithelial cells . The attachment of this strain to buccal epithelial cells was inhibited by glycoconjugates . Further, pH exerted different influences on the attachment of hemagglutinating and non-hemagglutinating fimbriated strains to buccal epithelial cells and erythrocytes . The results suggest that different fimbrial mechanisms are involved in the attachment of N . meningitidis to different cell types and that hemagglutination is not an absolute test for fimbriae.

J Immunol, 1983 Jun, 130(6), 2809 - 13
Decreased C5b67-inhibitor activity in two families with hereditary functional deficiency of the eighth component of complement; Zeitz HJ et al.; In addition to its role in hemolysis and host defense against Neisseria infection, the eighth component of human complement (C8) is one of several plasma proteins that are C5b67-inhibitors (C5b67-INH) . The recent identification in our laboratory of two new families with hereditary deficiency of C8 provided an opportunity to study further the role of C8 as a C5b67-INH . Based on mixing and reconstitution experiments, the deficiency of C8 seemed to be due to a selective lack of the C8 beta-chain in one family and the C8 alpha-gamma subunit in the other family . Sera from individuals homozygous for the C8 abnormality were substantially deficient in C5b67-INH activity as well as totally deficient in hemolytic activity . Sera from control individuals possessed approximately 2500 C5b67-INH U/ml, whereas sera from the C8-deficient individuals had markedly depressed C5b67-INH activity, with a mean of only 428 U/ml . C5b67-INH activity was completely reconstituted in C8-deficient serum by the addition of purified human C8 . We conclude that C8 constitutes the substantial majority of the C5b67-INH activity of normal human serum.

Clin Orthop, 1983 Jun, (176), 206 - 9
Musculoskeletal infection with nongonococcal neisseria species not associated with meningitis; Degan TJ et al.; Five patients with type III musculoskeletal infection from nongonococcal Neisseria species were examined during a 13-month period . The initial clinical diagnosis was incorrect in all cases . Synovial fluid analysis and Gram's stain were not helpful, and the correct diagnosis was made only after culture reports were available . The patients responded well to antibiotic treatment, but two patients with underlying rheumatoid arthritis required surgical debridement . All patients were asymptomatic, with resolution of their infection at follow-up evaluation . An early correct diagnosis is mandatory and Neisseria infection should be considered in patients with pre-existing joint disease.

Br J Vener Dis, 1983 Jun, 59(3), 189 - 92
Pelvic inflammatory disease associated with Chlamydia trachomatis infection after therapeutic abortion . A prospective study; Qvigstad E et al.; PIP: Chlamydia trachomatis was cultured from the cervix of 70 of 557 (12.6%) patients admitted for therapeutic abortion . Postoperatively, 22 (3.9%) developed acute pelvic inflammatory disease (PID); of these women, 14 (63.6%) had harbored C . trachomatis in the cervix prior to the abortion . Thus, of 70 patients with chlamydia infection, 14 (20%) developed PID postoperatively . Of the chlamydia-positive patients, 6 of 15 (40%) aged 20 years and 8 of 53 (15%) patients aged 20-30 developed PID . 12 of 70 women with chlamydial infections showed a significant increase in serum chlamydial IgG antibody titers over a 4-week period; 4 of these women developed PID . Neisseria gonorrheae was recovered from only 4 patients, 1 of whom developed PID after the abortion . Treatment with a single dose of intravenous doxycycline (200 mg) was given prior to and during surgery to about 1/2 of the patients . In this study, such a regimen had no protective effect against the development of PID associated with C . trachomatis . author's modified

Southeast Asian J Trop Med Public Health, 1983 Jun, 14(2), 191 - 4
Diagnosis of gonorrhoea using a genetic transformation test at a venereal disease clinic in Thailand; Sangsue S et al.; A genetic transformation test (GTT), a technique in which gonococcal DNA is detected in clinical specimens, was used to search for Neisseria gonorrhoeae infections in 37 men and 159 women at the Venereal Disease clinic in Cholburi, Thailand . Swabs were collected in duplicate from cervical specimens from 159 women and from urethral specimens from 37 men . One of each specimen was cultured on Thayer-Martin media while the other was mailed to the United States at room temperature for the GTT which involved a delay of 10 to 14 days . With the urethral specimens N . gonorrhoeae was identified in 84% (31/37) of specimens and there was 100% concordance between the results of the GTT and culturing specimens directly on Thayer-Martin media . With cervical specimens N . gonorrhoeae was isolated from 26% (41/159) by the standard culture technique and 19% (13/159) by the GTT . Seventy-six percent of the culture positive specimens were positive with the GTT and two specimens from which N . gonorrhoeae were not isolated were positive in the GTT . The GTT technique enables physicians to send swab collected from patient with suspected gonorrhoea without any special transport media to a central laboratory for laboratory diagnosis of gonorrhoeal infections . This technique which uses reagents which are available in most bacteriology laboratories, should facilitate surveillance of gonorrhoea especially when specimens are collected in clinics where bacteriology laboratory facilities are not available.

NIPH Ann, 1983 Jun, 6(1), 91 - 101
Gas-chromatographic screening of capsular polysaccharides of Neisseria meningitidis; Bryn K et al.; Thirteen systemic strains, i e strains isolated from systemic infections, and 77 carrier isolates of Neisseria meningitidis were serogrouped by agglutination and analyzed by gas chromatography (GC) of phenol extracts . For systemic strains the sugar patterns were in accordance with their group-specific capsular polysaccharides (CPS) . Some carrier isolates revealed unexpected GC profiles . Upon immunological retesting with new sera, GC results were generally confirmed . Occasional isolates initially serogrouped as B or Y completely lacked neuraminic acid . Some non-groupable isolates were shown by ultracentrifugation and GC to have significant amounts of this sugar likely to originate from CPS of known composition or from unknown polysaccharides . One such originally non-groupable isolate showed a weak agglutination reaction specifically with group B antiserum when reexamined . Generally, carrier isolates had lower amounts of CPS than systemic strains of the same group . Five successive isolates from one carrier were first serogrouped as X, Z or non-groupable, but they had high amounts of galactosamine and 2-keto-3-deoxy octonate, sugars characterizing CPS of serogroup 29E . These isolates were confirmed by agglutination with recently available group 29E antiserum to be of this serogroup, which has not been reported before in Norway . Ultracentrifugation revealed the presence of unknown polysaccharides containing glucose, galactose or glucosamine, but further purification of these polymers is required to determine their composition and immunological importance.

Geburtshilfe Frauenheilkd, 1983 Jun, 43(6), 366 - 9
{Chlamydia trachomatis in the urogenital tract of pregnant women}; Martius J et al.; In two hundred and thirty three prenatal patients from the Prenatal Clinic of the University of Wurzburg cervical, vaginal and urethral swabs were taken for microscopic examination and culture for Chlamydia trachomatis (C . trachomatis), Neisseria gonorrhoeae (N . gonorrhoeae), Trichomonas vaginalis (T . vaginalis), Beta-hemolytic streptococci, Candida species, Ureaplasma urealyticum (U . urealyticum), Mycoplasma species and facultatively pathogenic and apathogenic aerobic bacteria . In ten cases (4%) C . trachomatis was found . In six cases hemolytic streptococci group B were detected . Fifty two cases showed a Candida species . Seventy nine cases presented U . urealyticum . One case showed a Mycoplasma species and one case showed Trichomonas vaginalis . Striking was the significantly increased rate of premature rupture of the membranes in the group with U . urealyticum compared to the group without U . urealyticum.

Proc Natl Acad Sci U S A, 1983 Jun, 80(12), 3831 - 5
Properties of the major outer membrane protein from Neisseria gonorrhoeae incorporated into model lipid membranes; Young JD et al.; The major outer membrane protein from Neisseria gonorrhoeae was incorporated into artificial planar bilayer membranes by a detergent-dilution procedure . The integrated protein forms voltage-dependent aqueous pores with a minimal pore diameter estimated to be 11 A . A pore of this size suggests a role for this protein in macromolecular sieving at the level of the outer membrane . This protein self-associates preferentially in triplets of three equal unit conductance steps of 130 pS (in 0.1 M NaCl) each . The two-state model may be applied to explain the voltage-dependent conductance . The average lifetime of the open state of single channels is strongly dependent on the applied voltage, the channels shifting to the closed state at higher voltages . The pore is anion selective, differing from porins of other Gram-negative bacteria studied so far but resembling the voltage-dependent anion-selective channel of the outer membrane of mitochondria.

J Exp Med, 1983 Jun 1, 157(6), 2049 - 60
Isolation of a high molecular weight polyphosphate from Neisseria gonorrhoeae; Noegel A et al.; Neisseria gonorrhoeae, as well as other Neisseriae, produce polyphosphate . This polyphosphate exists in two forms . Approximately half of it is loosely associated with the cells and can be recovered by washing in neutral buffers under conditions in which no significant lysis of the cells is observed . The other half is either intracellular or tightly associated, because it requires digestion of the cells with perchloric acid or sodium hypochlorite . Polyphosphate obtained by both methods was purified by column chromatography and chemically characterized . In contrast to other organisms, gonococci do not respond with increased polyphosphate synthesis when shifted from phosphate starvation to a phosphate-rich medium . In addition, gonococcal polyphosphate does not serve as a depletable phosphate source during phosphate starvation . All strains of Neisseriae examined produce substantial amounts of polyphosphate.

Infect Immun, 1983 Jun, 40(3), 903 - 11
Resistance of O-acetylated gonococcal peptidoglycan to human peptidoglycan-degrading enzymes; Rosenthal RS et al.; Two naturally occurring forms of gonococcal peptidoglycan (PG) were tested for their susceptibility to human PG hydrolases . Purified 3H-labeled PG substituted extensively with O-acetyl derivatives (O-PG; from Neisseria gonorrhoeae FA19) and 14C-labeled O-acetyl-deficient PG (non-O-PG; from N . gonorrhoeae RD5) were mixed together and treated with either normal human sera (NHS) or with lysozyme purified from human polymorphonuclear leukocytes (PMN-LZ) . The initial rate of hydrolysis of O-PG by NHS or by PMN-LZ was two- to fourfold less than that of its non-O-PG counterpart in the same tube . When the reactions were allowed to go to completion . NHS solubilized both PGs completely, whereas PMN-LZ solubilized all of the non-O-PG and left ca . 60% of the O-PG insoluble . The PMN-LZ-soluble fraction of O-PG consisted largely of glycosidically linked fragments with molecular weights greater than ca . 10(4), whereas the corresponding non-O-PG was degraded to lower-molecular-weight fragments, exclusively . At completion, NHS hydrolyzed both PGs to fragments whose size was equal to or smaller than that of the free disaccharide unit of PG, suggesting that human sera contain a peptide-splitting (amidase) activity and a glycosidase activity, in addition to that of the well-known muramidase . NHS also promoted the release of high-molecular-weight PG fragments from intact gonococci . The persistence of human hydrolase-resistant PG in the form of soluble macromolecular fragments may potentiate the biological effects of gonococcal PG in vivo.

Br J Vener Dis, 1983 Jun, 59(3), 186 - 8
Microbiology of vaginal discharge in Nairobi, Kenya; Mirza NB et al.; Among women attending a sexually transmitted disease (STD) clinic in Nairobi with vaginal discharge, Neisseria gonorrhoeae and Chlamydia trachomatis were isolated from the cervix in 32 (26%) of 122 and four (7%) of 58 women respectively . Infection with Trichomonas vaginalis, Candida albicans, Gardnerella vaginalis, and Mycoplasma spp were diagnosed in 42 of 122 (34%), 26 of 110 (24%), 75 of 100 (75%), and 42 of 89 (47%) women respectively . Mixed infections with at least two pathogens were found in 23 (26%) of 89 women examined for all microorganisms . Infection with N gonorrhoeae was significantly associated with abdominal pain.

J Bacteriol, 1983 Jun, 154(3), 1498 - 501
Evolutionary analysis of the 7.1-kb beta-lactamase-specifying R-plasmid of Neisseria gonorrhoeae by restriction endonucleases; Mayer LW et al.; A physical map of restriction enzyme sites was made for the large beta-lactamase-specifying gonococcal R-plasmid (pMR0360) isolated in 1976 . Single sites in the plasmid were mapped for 11 endonucleases, and multiple sites of cleavage were mapped for 17 other enzymes . Conclusions about the structure and origin of this plasmid are discussed.

Br J Vener Dis, 1983 Jun, 59(3), 176 - 8
Comparison of ceftriaxone with cefoxitin in the treatment of penicillin-resistant gonococcal urethritis; Zajdowicz TR et al.; Since cefoxitin has been shown to be an effective alternative to spectinomycin for the treatment of infections due to penicillinase-producing strains of Neisseria gonorrhoeae (PPNG) its efficacy was compared with that of a new cephalosporin, ceftriaxone (R013-9904) . One hundred and twenty eight men with culture-confirmed gonococcal urethritis were treated with either 250 mg of ceftriaxone intramuscularly or 2 g of cefoxitin intramuscularly with oral probenecid 1 g . The incidence of penicillin-resistant strains in each group was about 60% . Ceftriaxone was completely effective in treating both penicillin-sensitive and penicillin-resistant gonococcal urethritis . No side effects were noted . Ceftriaxone thus seems to be an effective and safe alternative to either spectinomycin or cefoxitin in the treatment of penicillin-resistant gonococcal urethritis.

Br J Vener Dis, 1983 Jun, 59(3), 172 - 5
Cefuroxime, thiamphenicol, spectinomycin, and penicillin G in uncomplicated infections due to penicillinase-producing strains of Neisseria gonorrhoeae; Tupasi TE et al.; The use of cefuroxime and thiamphenicol in uncomplicated gonococcal infection was studied in 562 women confined to a clinic to preclude reinfection before cultural confirmation of cure . Cefuroxime was as effective as spectinomycin in the treatment of infections due to penicillinase-producing strains of Neisseria gonorrhoeae (PPNG) and was significantly more effective than 4.8 units of aqueous procaine penicillin G with probenecid among non-penicillinase-producing (non-PPNG) strains . Thiamphenicol was highly effective against PPNG, but the failure rate in infections with non-PPNG was high and appeared to be related to the minimum inhibitory concentrations of thiamphenicol . This rate was not, however, significantly higher than that for PPNG strains . Thiamphenicol might therefore be used as an alternative for infections due to PPNG strains . If, however, thiamphenicol is used widely, selection of more resistant strains and thus an increasing proportion of failures may be expected.

Obstet Gynecol, 1983 Jun, 61(6), 702 - 4
Second-look laparoscopy after acute salpingitis; Wolner-Hanssen P et al.; Patients with a laparoscopically verified first episode of acute salpingitis were offered a second-look laparoscopy to determine the effectiveness of the treatment regimen in terms of anatomic end result as well as to correlate the anatomic end result with future fertility . Until now, 13 women have been subjected to such relaparoscopy 16 to 33 weeks after the acute illness . At the acute stage of the disease, 11 of the women had serologic and/or cultural evidence of genital infection with Chlamydia trachomatis, three of whom also had Neisseria gonorrhoeae . All were culture-negative after treatment . In eight patients relaparoscopy showed that previously adherent adnexa were apparently normal, whereas in two patients a deterioration of the laparoscopic findings was found . Two patients had bilateral occluded tubes, for a preliminary infertility rate of 15% . These preliminary observations suggest that second-look laparoscopy after acute salpingitis might be a useful method for early objective evaluation of treatment results.

J Clin Microbiol, 1983 May, 17(5), 934 - 5
Neisseria lactamica septicemia in an immunocompromised patient; Schifman RB et al.; Neisseria lactamica was isolated from the blood of a 7-year-old girl who was immunosuppressed from chemotherapy for acute lymphocytic leukemia . She was receiving trimethoprim-sulfamethoxazole prophylactically . The isolate was resistant to trimethoprim-sulfamethoxazole and sensitive to penicillin . The patient responded to intravenous penicillin therapy . The organism did not produce immunoglobulin A1 protease.

Can J Microbiol, 1983 May, 29(5), 584 - 92
Induced changes in the surface of Neisseria gonorrhoeae; Norrod EP et al.; Growth of Neisseria gonorrhoeae strain F62 on medium containing pyruvate and a high ratio of cysteine to cystine resulted in functional and structural changes that are consistent with phenotypic changes in lipopolysaccharide . Both transparent (O-) and moderately opaque (O+) variants became more sensitive to killing by normal human serum and resistant to killing by pyocin G, a bacteriocin from Pseudomonas aeruginosa . Electrophoresis of outer membranes in the presence of sodium dodecyl sulfate demonstrated differences also dependent upon the growth medium . When gels were treated with periodic acid and stained with silver, lanes containing outer membranes obtained after growth in the modified medium demonstrated two bands in addition to those independent of the growth medium . The enhancement of these additional bands by periodate treatment indicated that they represent material containing carbohydrate . The mechanism by which the changes in the growth medium affected the surface of N . gonorrhoeae is not known; however, the changes demonstrated by electrophoresis were dependent upon either the high concentration of cysteine or the high ratio of cysteine to cystine.

J Clin Pathol, 1983 May, 36(5), 511 - 4
Histology of rectal gonorrhoea in men, with a note on anorectal infection with Neisseria meningitidis; McMillan A et al.; The histology of the rectal mucosa in 57 men with culturally-proven rectal gonorrhoea is described and the results compared with the findings in biopsies from 57 non-infected men . An acute inflammatory cell infiltration of the rectal mucosa was found in three (5.3%) and two (3.5%) infected and non-infected men respectively . Twenty-one (36.8%) men with rectal gonorrhoea and nine (15.8%) non-infected men had an increased number of chronic inflammatory cells in the lamina propria.

Infect Immun, 1983 May, 40(2), 843 - 6
Characterization of concatemeric plasmids of Neisseria gonorrhoeae; Johnson SR et al.; Three strains of Neisseria gonorrhoeae carried novel plasmids of 7.8 megadaltons (mdal) molecular mass in addition to plasmids previously observed in this organism . The presence of the 7.8-mdal plasmids was not accompanied by any distinguishable phenotype in the strain possessing them . Analysis of plasmid DNA with restriction endonucleases showed that these plasmids were composed of three directly repeated copies of a 2.6-mdal cryptic plasmid frequently found in N . gonorrhoeae . In addition, the 7.8-mdal plasmids exhibited characteristics common to the 2.6-mdal plasmid, structural lability and sites resistant to cleavage with HpaII . The concatemeric forms of the cryptic plasmid appear to be stable in these strains and do not undergo internal recombination to produce the 2.6-mdal monomer, nor were higher concatemers detected.

Infect Immun, 1983 May, 40(2), 816 - 9
Confirmation of association of protein I serotype of Neisseria gonorrhoeae with ability to cause disseminated infection; Cannon JG et al.; Previous work indicates that strains of Neisseria gonorrhoeae isolated in Seattle, Wash., and Atlanta, Ga., show an association between serotypes 1 and 2 of protein I of the outer membrane and the ability to cause disseminated infection (T.M . Buchanan and J.F . Hildebrandt, Infect . Immun . 32:985-994, 1981) . By using the same serotyping system, we confirmed the association between those serotypes and both disseminated infection and serum resistance in strains from North Carolina . Some strains of the same serotype had protein I species with different apparent molecular weights.

Obstet Gynecol, 1983 May, 61(5), 635 - 40
Evaluation of cefamandole nafate for the treatment of acute gonococcal salpingitis; Hemsell DL et al.; Eighty-six women with suspected acute salpingitis were treated with parenteral cefamandole . From 53 (62%) of these Neisseria gonorrhoeae was recovered from an anogenital site(s) at admission . These women were younger, of lower parity, had pain for a shorter period of time, responded more rapidly to therapy, and required less antimicrobial agent for clinical cure than those from whom N gonorrhoeae was not recovered . The clinical success observed in these women was 94%, and only 2% of 122 gonococcal isolates were resistant to cefamandole in vitro.

Infect Immun, 1983 May, 40(2), 523 - 8
Synergistic effect of Bordetella pertussis lymphocytosis-promoting factor on protective activities of isolated Bordetella antigens in mice; Robinson A et al.; The effect of low levels of added lymphocytosis-promoting factor (LPF) on the ability of several antigenic preparations isolated from Bordetella pertussis and other bacteria to protect mice against intracerebral infection with B . pertussis was examined . LPF was found to enhance the protective activities of filamentous hemagglutinin, 22S antigen, and fimbriae isolated from B . pertussis . Outer membrane protein preparations from phase I B . pertussis which had LPF removed by haptoglobin affinity columns or inactivated by glutaraldehyde, sodium dodecyl sulfate, or Formalin had reduced protective activities but were made fully protective by the readdition of LPF . Similarly, outer membrane protein preparations from Bordetella bronchiseptica, Bordetella parapertussis, or phase IV B . pertussis lacking LPF were protective only when low levels of LPF were added to the preparations . Outer membrane protein preparations from Neisseria gonorrhoeae or Escherichia coli were nonprotective even in the presence of added LPF . The purified LPF by itself was nonprotective unless treated with glutaraldehyde . LPF that had been detoxified with glutaraldehyde was, however, ineffective at enhancing the protective activity of antigenic preparations . The synergistic effect of LPF is discussed in relation to its known biological properties.

JAMA, 1983 Apr 15, 249(15), 2069 - 72
Polymicrobial polyarticular septic arthritis; Petty BG et al.; A bacteriology technologist was found to have acute polyarticular arthritis after a brief prodromal illness . Gram's stain of fluid from the right knee showed pleomorphic gram-negative organisms, while that of fluid from the right elbow and left wrist showed gram-negative cocci and diplococci . Culture of fluid from the right knee yielded Salmonella enteritidis . Cultures of fluid from all other joints, collected after starting therapy, were negative . An enzyme-linked immunosorbent assay of fluid from the right elbow confirmed Neisseria meningitidis, group C . This organism was also isolated from the patient's throat . This case represents concurrent infection of separate joints by two bacterial pathogens, one confirmed by culture and one by current immunodiagnostic techniques.

Schweiz Med Wochenschr, 1983 Apr 2, 113(13), 462 - 70
{Epidemiology of Neisseria gonorrhoeae isolated in Switzerland: sensitivity to antibiotics and auxotyping}; Arini A et al.; In a study to determine the epidemiological situation of N . gonorrhoeae (NG) in Switzerland, 149 strains isolated from different regions over the period September 1981 to February 1982 were analyzed for sensitivity to various antibiotics (minimum inhibitory concentration {MIC} for penicillin G, ampicillin, cefuroxime, tetracycline, thiamphenicol, and spectinomycin) and for their auxotype . From the results obtained it can be concluded that (1) the PPNG (penicillinase producing NG) strains are not a problem at present in Switzerland; (2) 15% of the non-penicillinase producing NG strains are "less sensitive" to penicillin G (MIC equal to or greater than 0.5 micrograms/ml); (3) sensitivity level of the NG strains to the various antibiotics assayed and the auxotypes do not show any significant peculiarity when compared to the data reported in other countries; (4) penicillin G should still be used as the first choice antibiotic at present in Switzerland, with spectinomycin, thiamphenicol and cefuroxime as second choice antibiotics; (5) when compared according to the geographical origin of their isolation, the NG strains show specific peculiarities, a fact which could lead to an antibiotic therapy policy more suited to specific regions.

J Gen Microbiol, 1983 Apr, 129 (Pt 4), 1097 - 102
Cytotoxicity of Neisseria gonorrhoeae for human peripheral blood phagocytes; Casey SG et al.; The toxicity of gonococci {strain BS4 (agar)} for human peripheral blood polymorphonuclear phagocytes, infected in vitro, was assessed by light microscopic examination of Giemsa stained cell deposits of polymorphonuclear phagocytes which had ingested these bacteria . The cytotoxicity elicited by viable gonococci, assessed by percentage lysis and concomitant reduction in the number of polymorphonuclear phagocytes increased as the ratio of gonococci to phagocytes in the original suspension mixture was raised . Pretreatment of viable gonococci with antiserum raised to whole organisms increased the cytotoxic effect produced by the organisms . Killed (heat or UV irradiation) gonococci caused little or no cytotoxicity, even when the organisms were pretreated with specific antiserum . Hence, the lysis of polymorphonuclear phagocytes appears to be caused by a factor or factors produced by viable gonococci and not by LPS per se.

Acta Pathol Microbiol Immunol Scand {B}, 1983 Apr, 91(2), 107 - 11
Expression of bacteriocin-like activity in batch cultures of Neisseria meningitidis and consequences for genetic recombination; Jyssum K et al.; The bactericidal activity found in four strains of Neisseria meningitidis and the bacteriostatic effect observed in one were expressed in the exponential phase of batch cultures and continued during the stationary phase . The active material was stable for more than 50 hours in agar media . In mixed cultures a strain with inhibitory activity eradicated a sensitive strain, and dominated the culture in the latter part of the exponential phase . Recombination took place in mixed cultures when at least one of the strains had the genetic properties which determine competence in transformation . The presence of inhibitory activity increased the recombination frequency at least ten-fold . Genetic markers were introduced into a strain with inhibitory activity from sensitive strains of N . meningitidis and from N . cinerea.

Antimicrob Agents Chemother, 1983 Apr, 23(4), 541 - 4
In vitro antimicrobial activity of eight new beta-lactam antibiotics against penicillin-resistant Neisseria gonorrhoeae; Kerbs SB et al.; Increasing numbers of cases of penicillin-resistant gonorrhea necessitate the evaluation of new antibiotics for treatment of this disease . We tested the susceptibility of 92 penicillinase-producing (PP) Neisseria gonorrhoeae isolates and 88 penicillin-susceptible (PS) isolates to eight new beta-lactam antibiotics . The minimal inhibitory concentrations of these antibiotics were determined by the agar plate method . PP and PS N . gonorrhoeae isolates were susceptible to clinically achievable levels of all antibiotics tested . There were, however, marked differences among the drugs with regard to the concentration required to inhibit growth . The PP N . gonorrhoeae isolates were extremely susceptible to ceftriaxone, ceftizoxime, and cefotaxime, highly susceptible to moxalactam and cefoperazone, and less susceptible to cefoxitin, ceforanide, and cefonicid (geometric mean minimal inhibitory concentrations were 0.002, 0.003, 0.007, 0.03, 0.07, 0.6, 2.4, and 3.1 micrograms/ml, respectively) . Although this in vitro study showed PP N . gonorrhoeae isolates to be comparatively more susceptible to ceftriaxone, ceftizoxime, and cefotaxime than to the other antibiotics, these results may not correlate with clinical efficacy.

Infect Immun, 1983 Apr, 40(1), 369 - 80
Preparation and physicochemical and immunological characterization of polysaccharide-outer membrane protein complexes of Neisseria meningitidis; Beuvery EC et al.; A crude complex containing group C polysaccharide, outer membrane proteins, and lipopolysaccharide (LPS) was isolated from the cell-free culture liquid of Neisseria meningitidis serogroup C, serotype 2a . Group C polysaccharide and LPS were removed from this complex, resulting in an outer membrane complex and a purified complex, respectively . Analysis by electron microscopy showed the outer membrane origin of the crude complex and the outer membrane complex, whereas such a structure was absent in the purified complex . Sodium dodecyl sulfate-polyacrylamide gel electrophoresis patterns of the three complexes were identical . Pyrolysis-mass spectrometry data correlated well with those obtained by the biochemical assays and suggested a low LPS content in the purified complex and a low polysaccharide content in the outer membrane complex . The purified complex was shown to be nonpyrogenic and could be prepared with the same yield as that of purified polysaccharide . The immunogenic activities of the complexes were studied in mice . The antibodies were measured by the enzyme-linked immunosorbent assay; and the bactericidal antibody assay . All complexes induced immunoglobulin G antibodies to group C polysaccharide as well as to the serotype antigen, although the removal of polysaccharide and LPS resulted in a reduction of the immunogenic activities of outer membrane complex and purified complex, respectively . A second dose of all complexes produced a clear booster effect of both antibody responses . The antibodies were bactericidal.

Br J Vener Dis, 1983 Apr, 59(2), 98 - 9
Penicillinase-producing Neisseria gonorrhoeae among prostitutes in Surabaya; Sastrowidjojo H et al.; Thirty-six strains of penicillinase-producing Neisseria gonorrhoeae (PPNG) were detected among 794 prostitutes between October 1981 and May 1982 in Surabaya, Indonesia . The high prevalence of PPNG strains among the high-class prostitutes and a lower prevalence among the low-class suggest that regular mass treatment for syphilis did not play an important role in the emergence and spread of PPNG; the importation of PPNG strains from abroad is more likely to have been responsible.

Br J Vener Dis, 1983 Apr, 59(2), 94 - 7
Antigonococcal effects of vaginal tampons; Arko RJ et al.; Different brands of vaginal tampons varied significantly (p less than 0.0001) in their anti-bacterial effects when tested with 46 strains of Neisseria gonorrhoeae . Gonococcal strains recovered from patients with disseminated infections were substantially more sensitive to the anti-bacterial effects of tampons than were strains from patients with uncomplicated genital infections . Strains from patients with pelvic inflammatory disease were moderately sensitive . Tampons showing strong in-vitro antigonococcal effects were also generally effective in vivo in eliminating gonococcal infections from subcutaneous chambers in mice . Extracts of the Rely tampon showed no in-vitro antigonococcal effect, however, but did induce antibacterial activity when injected into subcutaneous chambers in mice . These results emphasise the importance of both in-vitro as well as in-vivo testing of tampon materials to elucidate more fully the nature of their antibacterial effects and their potential for affecting vaginal pathogens and disease processes.

Br J Vener Dis, 1983 Apr, 59(2), 100 - 2
Single 1 g dose of cefotaxime in the treatment of infections due to penicillinase-producing strains of Neisseria gonorrhoeae; de Koning GA et al.; One hundred and two patients with an uncomplicated infection due to penicillinase-producing strains of Neisseria gonorrhoeae (PPNG) were treated with a single 1 g dose of cefotaxime . At follow-up within 15 days all genital and rectal infections were cured . Pharyngeal infections also seemed to respond to this treatment . A relatively high proportion (30.9%) of patients, however, developed post-gonococcal urethritis.

J Clin Lab Immunol, 1983 Apr, 10(4), 173 - 8
ABO blood group and susceptibility to gonococcal infection . I . Factors affecting phagocytosis of Neisseria gonorrhoeae; Blackwell CC et al.; The effect of opsonization of Neisseria gonorrhoeae by isohaemagglutinins from normal serum on attachment to human polymorphonuclear leukocytes (PMN) was investigated . No significant differences between sera from blood groups O, A, B or AB were found . Differences in attachment of gonococci were related to differences in lipopolysaccharide detected by sensitivity to R-type pyocines of Pseudomonas aeruginosa . Non-pilate variants of each test strain markedly stimulated nitroblue tetrazolium (NBT) reduction in PMN, but their pilate variants were essentially inactive in the NBT test.

Fortschr Med, 1983 Mar 24, 101(11), 488 - 90
{Differential diagnosis and therapy of male urethritis}; Krause W et al.; The infectious male urethritis is characterized by the urethral discharge, which is clear or purulent due to the number of leucocytes . Infection occurs mostly in sexual intercourse . Neisseria gonorrhoeae today causes only about 20-30% of the infections . Gramnegative bacteria are demonstrable by microscopic examination of the urethral discharge, otherwise by cultivation . Ureaplasma and chlamydia trachomatis, an intracellular growing bacterium, are the most frequent agents in infectious urethritis . They are often found together, the cultivation requires special laboratory conditions . They are common saprophytis bacteria within the urethra (u . urealyticum in up to 50%), their number of colony forming units of urethritis, like yeasts, viruses, trichomonas are rare . The treatment of gonorrhoic urethritis is done by penicillin or spectinomycin . Infections by u . urealyticum and c . trachomatis are treated with tetracyclin . Although spontaneous healing is not uncommon, therapy should be performed with respect to the high risk of following prostatitis and epididymitis.

J Infect, 1983 Mar, 6(2), 171 - 4
A study of the relationship between ABO blood groups, secretor status and infection with Neisseria gonorrhoeae; Johnson AP et al.; The distribution of ABO blood groups and secretor status among 216 male caucasian patients with gonorrhoea was not significantly different from that in 2043 male caucasians who formed a comparison population.

Med Trop (Mars), 1983 Mar-Apr, 43(2), 155 - 61
{Epidemic of Neisseria meningitidis cerebrospinal meningitis in the Ruhengeri health district (Rwanda)}; Vimont-Vicary P et al.; Rwanda is a central african country where mean altitude is high (1,800 m), dwelling scattered, and population density important (372/km2) . In 1978, a CSM epidemic broke out and raged for 4 years . Death incidence was very noticeable: 223/100 000 . Treatment by an unique doses of chloramphenicol proved to be effective . As a consequence of an experimental immunization campaign, limited to one township, local population immunity is still solid after three years.

J Gen Microbiol, 1983 Mar, 129 (Pt 3), 885 - 8
Degrees of O-acetylation and cross-linking of the peptidoglycan of Neisseria gonorrhoeae during growth; Lear AL et al.; The progress of incorporation of radioactive glucosamine into the O-acetylated and non-O-acetylated sub-units of the insoluble peptidoglycan of growing Neisseria gonorrhoeae was examined . More than 80% of the final degree of cross-linking was achieved within 3 min; the remainder of the process took much longer . Rapid O-acetylation occupied up to 10 min, at which time only about 65% of the maximum value had been reached . There was thus evidence for maturation of peptidoglycan both in regard to cross-linking and to O-acetylation.

J Gen Microbiol, 1983 Mar, 129 (Pt 3), 877 - 83
Peptidoglycan-degrading enzymes in ether-treated cells of Neisseria gonorrhoeae; Chapman SJ et al.; The incubation of peptidoglycan fragments with ether-treated cells of Neisseria gonorrhoeae resulted in breakdown products that showed the presence of previously undescribed lytic enzymes . The properties of an endopeptidase able to hydrolyse peptide-linked bis-disaccharide peptide dimer to monomer units were examined . An exo-N-acetyl-glucosaminidase was also shown to release free N-acetylglucosamine . The breakdown pattern of glycosidically-linked dimer indicated the existence of an endo-N-acetylglucosaminidase . The activities of the latter enzyme and of the endopeptidase were both sensitive to beta-lactam antibiotics.

Pediatr Infect Dis, 1983 Mar-Apr, 2(2), 99 - 101
Pharyngeal gonorrhea in young children; Groothuis JR et al.; Among 16,100 visits to a pediatric clinic, 103 children (0.6%) fulfilled criteria for child abuse and 16 of the 103 patients (15.5%) suffered sexual abuse . Throat cultures from 13 children were positive for Neisseria gonorrhoeae in 7 patients (54%) . Ages of infected children ranged from 2.5 to 9 years with a mean age of 4.9 years . N . gonorrhoeae was also isolated from cervical (four) and rectal (one) cultures in four of seven patients tested . No child had symptoms related to the oropharynx . All children were treated with a single dose of 100,000 units aqueous procaine penicillin G per kg intramuscularly and 25 mg probenecid per kg orally . Three of the seven children required retreatment for persistently positive pharyngeal cultures . All cases could be traced to sexual abuse by a male contact . Routine culturing of the oropharynx for N . gonorrhoeae in abused children and their siblings may uncover some unsuspected sexual abuse cases.

Antimicrob Agents Chemother, 1983 Mar, 23(3), 481 - 2
Comparative in vitro activity of Sch 29,482, a new oral penem, against Neisseria gonorrhoeae; Khan MY et al.; The in vitro activity of Sch 29,482, a new oral beta-lactam antimicrobial agent, was compared with those of norfloxacin, rosoxacin, ampicillin, erythromycin, and tetracycline against 142 Neisseria gonorrhoeae strains . Sch 29,482 was as active as norfloxacin and rosoxacin . Its activity was greater than the other three antimicrobial agents . It inhibited 90% of the isolates, regardless of beta-lactamase activity, at a concentration of less than or equal to 0.06 micrograms/ml.

Z Hautkr, 1983 Mar 1, 58(5), 307 - 14
{Gonorrhea diagnosis}; Hoting E; The diagnostic procedure in gonorrhoea always starts with staining methods that the physician at first has to rely on in spite of their limited evidence, and that may justify specific treatment . Only culture, oxydase reaction, and biochemical differentiation (e.g . carbohydrate degradation test) can provide exact identification of pathogenic species of Neisseria . Further techniques can answer for antibiotic resistance and penicillinase production . Serological methods are employed with chronic or complicated gonococcal infections as well as with epidemiological investigations.

J Clin Microbiol, 1983 Mar, 17(3), 485 - 8
Rapid evaluation of gonococcal and nongonococcal urethritis in men with Limulus amoebocyte lysate and a chromogenic substrate; Prior RB et al.; A chromogenic substrate was used with Limulus amoebocyte lysate (LAL) and compared by parallel testing with the traditional gelation LAL method for the rapid evaluation of exudative urethritis in 125 male patients . Of these patients, 67 had positive cultures for Neisseria gonorrhoeae and 58 were negative . The corresponding prevalence of gonococcal urethritis was 53.6% . For assay, diluted urethral samples and chromogenic substrate were added directly to single-test LAL vials, and objective color endpoint determinations were made visually after a 10-min incubation period at 37 degrees C . Sensitivity and specificity were 98.5% and 93.1%, respectively, with an overall accuracy in predicting culture results of 96.0% . The predictive value of a positive LAL test was 94.3% in our patient population; in a population with a prevalence of gonococcal urethritis of only 10%, the predictive value would be 61.3% . Results were not statistically different from those obtained by the 30-min gelation LAL method or by Gram-stained smears read by experienced microscopists (P greater than 0.05) . Unlike the delicate gel, the color endpoint was not prone to accidental mechanical disruption during incubation or reading . Thus, use of a chromogenic substrate greatly improved the utility and speed of the LAL assay for evaluating men with exudative urethritis while not affecting the accuracy of the test.

Clin Obstet Gynecol, 1983 Mar, 26(1), 111 - 24
Gonorrhea; Spence MR; PIP: This report provides an overview of the Neisseria gonorrhoeae microbe and the syndromes associated with it that are currently of significance in obstetric and gynecologic patients . The prevalence of gonorrhea varies significantly between populations . Accurate incidence figures are difficult to obtain but about 1 million infections/year are reported in the US, 2/3 in patients aged 16-24 . The disease is more common in urban areas and in the US the largest number of new cases occur in the summer . Age, sex, contraceptive method, multiple sex partners, and habitation patterns appear to be risk factors . In the male, urethritis is considered to represent uncomplicated disease . Male complications may include infection of the epididymus, urethral stricture, and disseminated disease . Approximately 80% of infected women appear to be asymptomatic . In the female, cervicitis and urethritis are considered uncomplicated disease, while complications may include disseminated gonococcal infections and pelvic inflammatory disease, which may have longterm sequelae . Arthritis, amniotic infection syndrome, and ophthalmia neonatorum are possible complications in pregnant patients . Penicillinase-producing N . gonorrhoeae were 1st described in 1976 in the US and the number of cases is increasing . Both sexes may have pharyngitis, proctitis, and the arthritis-dermatitis syndrome . The most reliable test for diagnosis is a positive culture; instructions for the culture are included . Serologic tests are under investigation but thus far no cost-effective technique has been developed . Antigen detection techniques, which permit diagnosis within 24 hours, appear to be on the verge of widespread utilization . N . gonorrhoeae is sensitive to a large number of antibiotics, including penicillin, tetracycline, and erythromycin . Therapy usually depends on the severity of the disease, the resistance patterns of organisms in specific geographic locales, the exposure and toxicity of the drugs, and the potential site of infection . Care should include treatment of sexual partners and follow-up test-of-cure evaluation in all patients .

Pediatrics, 1983 Mar, 71(3), 333 - 6
Prevalence of cervical Chlamydia trachomatis and Neisseria gonorrhoeae in female adolescents; Fraser JJ Jr et al.; The prevalence of cervical infection with Chlamydia trachomatis and Neisseria gonorrhoeae was examined in 125 girls receiving primary gynecologic care in a general adolescent clinic . C trachomatis was isolated in 8% of the patients using a microtiter tissue-culture method, and N gonorrhoeae was found in 12% . A significant association was found between the use of oral contraceptives and positive chlamydial cultures . Patients with Chlamydia-positive cultures were frequently asymptomatic and exhibited no positive findings on physical examination . Three of ten women with cervical chlamydial infection developed pelvic inflammatory disease . These results support the use of cervical screening for both of these pathogens in sexually active adolescents.

Antimicrob Agents Chemother, 1983 Mar, 23(3), 477 - 8
Comparative in vitro activity of cefodizime, ceftazidime, aztreonam, and other selected antimicrobial agents against Neisseria gonorrhoeae; Khan MY et al.; The in vitro activities of three new beta-lactam antimicrobial agents, cefodizime, ceftazidime, and aztreonam (formerly azthreonam), were compared with those of cefotaxime, cefuroxime, cefoxitin, and penicillin against 100 beta-lactamase-negative and 42 beta-lactamase-positive Neisseria gonorrhoeae strains . The three new antimicrobial agents showed excellent activity against N . gonorrhoeae regardless of beta-lactamase production . Cefodizime was as active as cefotaxime and more active than the other test antimicrobial agents . It inhibited all isolates at a concentration of less than or equal to 0.016 micrograms/ml.

Antimicrob Agents Chemother, 1983 Mar, 23(3), 349 - 51
Comparative efficacy of cefmenoxime versus penicillin in the treatment of gonorrhea; Obaid SR et al.; A total of 121 men with complicated infections caused by beta-lactamase-negative Neisseria gonorrhoeae were included in this study . They were randomly assigned to regimens of either cefmenoxime (1.0 g) or procaine penicillin G (4.8 X 10(6) U) intramuscularly . Only the penicillin group also took 1.0 g of probenecid orally . A total of 99 patients completed the study, providing data from 108 infected sites . In the cefmenoxime group, there were 49 urethral, 1 rectal, and 2 pharyngeal infections; in the penicillin group, there were 49 urethral, 4 rectal, and 3 pharyngeal infections . In the cefmenoxime group, all except one urethral infection were eradicated . This patient admitted having had sexual intercourse during the follow-up period and was considered to be reinfected . In the penicillin group, all except one pharyngeal infection were cured . No adverse reactions were noted in either group . In this study, cefmenoxime was as effective as penicillin in the treatment of gonococcal urethritis in men.

Rev Infect Dis, 1983 Mar-Apr, 5 Suppl 1, S154 - 60
Cefoperazone therapy for obstetric and gynecologic infections; Strausbaugh LJ et al.; The safety and clinical efficacy of cefoperazone therapy for obstetric and gynecologic infections have been evaluated in clinical trials involving 107 women hospitalized at nine medical centers . The indications for cefoperazone therapy have included post-partum and postoperative uterine infections, pelvic inflammatory disease, postoperative pelvic infections, and miscellaneous pelvic infections . A variety of aerobic and anaerobic bacteria, including members of the genera Staphylococcus, Streptococcus, Escherichia, Klebsiella, Proteus, Neisseria, Bacteroides, Peptococcus, and Peptostreptococcus, were isolated from these patients . More than 80% of these isolates were inhibited in vitro by cefoperazone concentrations less than or equal to 2.0 micrograms/ml . Symptomatic cures were achieved in 91% of patients, and 96% of isolated pathogens were eradicated during therapy . Adverse drug-related reactions occurred in only 4% of patients . Follow-up laboratory evaluations demonstrated only minor abnormalities that affected a small number of patients . These results indicate that cefoperazone offers safe and effective therapy for common obstetric and gynecologic infections.

Obstet Gynecol, 1983 Mar, 61(3), 299 - 303
Laparoscopy in women with chlamydial infection and pelvic pain: a comparison of patients with and without salpingitis; Wolner-Hanssen P et al.; A review was made of clinical and laboratory findings in 104 women who, during 1978 to 1981, were subjected to laparoscopy because of symptoms suggestive of acute salpingitis, and who harbored Chlamydia trachomatis but not Neisseria gonorrhoeae in the genital tract . The patients with acute salpingitis (N = 76) did not differ significantly from those with visually normal fallopian tubes (N = 28) in regard to age distribution, parity, contraceptive method used, proportion of women with urethritis symptoms, increased vaginal discharge, vomiting, diarrhea, elevated rectal temperature, elevated white blood cell count, and palpable pelvic masses . The acute salpingitis patients more often had irregular bleeding and an elevated erythrocyte sedimentation rate, whereas the patients without acute salpingitis more often had a short history of pelvic pain . The two groups overlapped considerably with respect to the number of symptoms and clinical signs of pelvic infection . The results emphasize the value of laparoscopy in the diagnosis or exclusion of a tubal infection in association with a chlamydial genital infection and pelvic pain, even if there are comparatively few additional symptoms of ascending infection.

Br J Vener Dis, 1983 Feb, 59(1), 44 - 6
Blood group, secretor status, and susceptibility to infection by Neisseria gonorrhoeae; Kinane DF et al.; To determine whether the presence or absence of anti-B isohaemagglutinin in individuals of blood group B increases their susceptibility to gonococcal infections 567 new patients attending a sexually transmitted disease clinic were screened for blood group and secretor status . Of the patients with blood group B, 20.1% had gonorrhoea and 12% had not . A higher percentage (20.9%) of patients with no anti-B isohaemagglutinin had gonorrhoea compared with those without (12.1%) . There was, however, no synergy between the absence of anti-B isohaemagglutin and nonsecretion of water-soluble blood group B antigen . Further research is needed to determine the underlying host-parasite interactions responsible for the increased susceptibility to gonorrhoea in these individuals.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1983 Feb, 253(4), 500 - 8
{beta-Lactamase-positive Neisseria gonorrhoeae . II . Localization of homologous regions between the 3.2 mdalton and 4.6 mdalton plasmids by DNA-DNA heteroduplex studies}; Dickgiesser N; The difference between the 4.6 MDalton and 3.2 MDalton N . gonorrhoeae plasmids, both inducing penicillinase production, is examined by restriction endonuclease analysis, transcription-/translation studies and DNA-DNA heteroduplex analysis . One difference between those plasmids is that the 4.6 MDalton one carries a region with inverted repeats on both ends between coordinates 0.9 and 2.3 . This region is an insertion sequence most probably . The length of the inverted repeats is 0.15 to 0.19 MDalton . An other difference between both the plasmids is that the 4.6 MDalton one, but not the 3.2 MDalton one, induces a protein of 10800 molecular weight.

Br J Vener Dis, 1983 Feb, 59(1), 41 - 3
Plasmid profile, serogrouping, and auxotyping of Neisseria gonorrhoeae isolates from Africa; Odugbemi TO et al.; The plasmid patterns of 90 isolates of Neisseria gonorrhoeae (including 39 penicillinase-producing strains) originating from various countries in Africa were determined . Serogrouping by coagglutination and auxotyping were used to characterise the isolates . The 4.4-megadalton plasmid was present in seven isolates out of 39 penicillinase-producing strains, two of which occurred with a conjugative 24.5-megadalton plasmid . The African strains were predominantly serogroup WI and wild type . Arginine-dependent isolates were as common as proline-dependent types.

J Rheumatol, 1983 Feb, 10(1), 5 - 11
Experimental models of bacterial arthritis: a microbiologic and histopathologic characterization of the arthritis after the intraarticular injections of Neisseria gonorrhoeae, Staphylococcus aureus, group A streptococci, and Escherichia coli; Goldenberg DL et al.; We report the first reproducible experimental model of gonococcal arthritis, utilizing the intraarticular injection of virulent strains of N . gonorrhoeae . An acute, purulent synovitis with a marked polymorphonuclear leukocyte infiltrate developed during the 1st 24 h and persisted for at least 72 h, followed by a more chronic, mononuclear, proliferative synovitis . The histopathologic characteristics of this acute, then chronic synovitis were comparable to that after the intraarticular injection of other bacteria . N . gonorrhoeae could not be recovered from the injected joints 24 h after their inoculation, whereas Staphylococcus aureus, hemolytic streptococci, and E . coli could be recovered for days to weeks after the intraarticular injection.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1983 Feb, 253(4), 495 - 9
{beta-Lactamase-positive Neisseria gonorrhoeae . I . Studies of 3.2 mdalton and 4.6 mdalton plasmids with restriction endonucleases and in vitro transcription/translation}; Dickgiesser N; Nine 3.2 MDalton and twelve 4.6 MDalton plasmids of beta-lactamase-positive N . gonorrhoeae have been analysed by restriction endonucleases and in vitro transcription/translation experiments . No difference could be shown neither between the 4.6 MDalton plasmids nor the 3.2 MDalton plasmids by the endonucleases BamHI, HpaII, HindII and AluI . The result of the transcription/translation experiments was that all the 4.6 MDalton plasmids examined carried the same information as did the 3.2 MDalton ones . Therefore, all the 4.6 MDalton plasmids must have been spread from one original plasmid as did the 3.2 MDalton plasmids.

Obstet Gynecol, 1983 Jan, 61(1), 48 - 51
Disseminated gonococcal infections; Al-Suleiman SA et al.; A four-year retrospective review of 55 patients with disseminated infections from Neisseria gonorrhoeae revealed that this complication occurs in young adults, with a predominance in women (80%) . The most common manifestation of disseminated gonococcal infection was arthritis, which occurred in 47 patients (85.5%) . The second most common manifestation of disseminated gonococcal infection was dermatitis, which occurred in 33 patients (60%) . A thorough history, a careful physical examination, and a high index of suspicion are essential for the diagnosis . Disseminated gonococcal infection can be confirmed by isolation of gonococci from potential sites, including urethra, cervix, rectum, oropharynx, and blood . Early diagnosis and adequate therapy are necessary to prevent serious complications . The role of the gynecologist in preventing, diagnosing, and/or treating this disorder is emphasized.

Acta Gastroenterol Latinoam, 1983, 13(2), 163 - 9
{Microflora of the upper part of the small bowel in healthy Peruvian subjects}; Vidal-Neira L et al.; In 20 healthy Peruvians aerobic cultures were done of upper small bowel contents, obtained following the method of the string capsule or Enterotest, and of faringeal material, obtained doing gargles with sterilized water . In 15 (75%) of the 20 subjects cultures of small bowel contents either were sterile (in 5 subjects, or 25% of the total) or revealed only diverse aerobic germs (in 10 subjects, or 50% of the total), the germs more frequently found being: negative coagulase staphylococcus albus (in 7 subjects, or 35% of the total), alpha hemolytic streptococcus (in 4 subjects, or 20% of the total) and Neisseria catarrhalis (in 4 subjects, or 20% of the total) . In 5 (25%) of the 20 subjects, coliform bacteria were found in the upper small bowel (Klebsiella pneumonia in 2, and Escherichia coli in the remaining 3) . Of those 5 subjects, only 2 (10% or the total of 20) had the microorganisms exclusively in the bowel, and in both the concentration of germs was 10(4)/ml . On the contrary, the 3 remaining subjects (15% of the total) had coliforms also in the pharynx; in 2 of the 3 subjects the concentration of germs found in the bowel was 10(3)/ml, and, in the remaining one, 10/ml; only one of the 3 subjects presented germs in the pharynx in a greater concentration than in the bowel, while another presented germs in the same concentration in both localizations, and the remaining one presented germs in the bowel in a concentration lower than in the pharynx.(ABSTRACT TRUNCATED AT 250 WORDS)

Acta Obstet Gynecol Scand, 1983, 62(3), 231 - 4
Levels of ampicillin and doxycycline in human oviduct mucosa and serum; Brihmer C et al.; A common treatment for salpingitis today includes ampicillin (AMPI) and doxycycline (DC), the former against Neisseria gonorrhoeae and the latter against Chlamydia trachomatis . The concentrations of doxycycline in oviduct mucosa were found about equal to that of serum and well above the minimum inhibitory concentrations (MIC's) for the bacteriae in question . The concentration of AMPI in the oviduct mucosa was only about 1/40 of that in serum, i.e . 1/10 of the MIC, which jeopardizes the effectivity of AMPI in the treatment of salpingitis.

Clin Ther, 1983, 5(5), 509 - 14
A single injection of moxalactam for acute gonorrhea; Lutz B et al.; This study evaluated the efficacy of and tolerance to moxalactam in the treatment of uncomplicated gonorrhea, including two infections with penicillin-resistant strains . After appropriate cultures, 87 women and 64 men each received 1 gm of moxalactam intramuscularly as a single injection . Penicillinase-producing Neisseria gonorrhoeae was isolated from one man who had persistent urethritis after therapy with ampicillin . Another isolate showed high relative resistance to penicillin . At follow-up in three to seven days, moxalactam eradicated N gonorrhoeae from all 120 evaluable patients including the two with penicillin resistance and five women with rectal gonorrhea . Moxalactam administered intramuscularly was well tolerated and the few adverse effects were usually mild . In this study, 1 gm of moxalactam appeared to be virtually 100% effective and safe for therapy of adults with uncomplicated anogenital gonorrhea.

Arch Dermatol Res, 1983, 275(6), 388 - 92
Distribution of auxotypes and correlation to antibiotic susceptibility of 169 recent clinical Neisseria gonorrhoeae isolates from Munich; Ruckdeschel G et al.; In Munich 169 isolates of Neisseria gonorrhoeae were investigated with respect to nutritional profiles (auxotypes) and antibiotic susceptibility . Of the 165 penicillin-susceptible strains 97 proved to be prototrophic (auxotype 1), 42 proline-dependent (auxotype 2) . Only 3 arginine-, hypoxanthine- and uracil-dependent strains (auxotype 14) were found . A total of 10 different auxotypes were identified among the non-penicillinase-producing strains and one among the penicillinase producers . The minimal inhibitory concentrations of penicillin G ranged from 0.01 to 1 microgram/ml, those of cefuroxime from 0.001 to 4 mg/ml; tetracycline and kanamycin had a narrow spectrum of effective concentrations, from 0.25 to 8 micrograms/ml and from 4 to 64 micrograms/ml respectively . The type 14 strains showed the well-known high susceptibility to penicillin G.

Dermatologica, 1983, 167(4), 204 - 7
Cultural proof of Neisseria gonorrhoeae in synovial fluid in disseminated gonococcal infection; Korting HC et al.; Disseminated gonococcal infection is not too rare, and joint involvement is one of its prominent features . Although diagnosis in general is based on clinical findings and microbiological examination of the genitals and sometimes blood, there are cases in which exact diagnosis can only be made after the investigation of synovial effusion . An observation of this kind is presented, and the general value of the aspiration of synovial fluid in disseminated gonococcal infection is discussed . Special interest is also given to the possible coincidence of disseminated gonococcal infection and other sexually transmitted diseases as for example trichomoniasis, both of which were found in our case.

Ann Biol Clin (Paris), 1983, 41(3), 209 - 11
{Study of beta-lactamase in Neisseria gonorrhoeae by a gel adaptation of the iodometric method}; Guibourdenche M et al.; A simple protocol for the demonstration of a beta-lactamase in the gonococcus has been adapted from the iodometric technique on agar medium developed by Labia and Barthelemy {13} . This protocol has been applied to 70 strains which produce this enzyme isolated in France and in three African countries.

Scand J Infect Dis, 1983, 15(2), 149 - 51
Sulfonamide resistance in Neisseria meningitidis strains liberating various amounts of free endotoxin; Solberg O et al.; The relationship between sulfonamide susceptibility and the ability to liberate endotoxin was studied in 50 strains of Neisseria meningitidis . The endotoxin activity was investigated by the Limulus lysate test in growing cultures of 25 sulfonamide-resistant and 25 sensitive strains . The sulfonamide-resistant strains tended to have a higher endotoxin activity in cultures grown for 6 h than sensitive ones, and had also a higher amount of free, filtrable endotoxin.

An Esp Pediatr, 1983 Jan, 18(1), 20 - 7
{Pharyngeal carriers of Neisseria meningitidis and N . lactamica in childhood}; Taracena B et al.; A prospective study was undertaken with the purpose of finding out the proportion of pharyngeal carriers of N . meningitidis and N . lactamica among our infantile school population . Seven groups constituted by, approximately, 200 infants each, were studied along two years . Samples were taken in two different schools, for each each group, at a period of average incidence (February, April, June and October) . Infants were between five and six years of age and made a total of 1,315 individuals, which we consider representative of our school infantile population . Positivity for N . lactamica was around 20%, whereas 10% of infants were carriers of N . meningitidis . Among the latter 56% were group B, 15% group Y, 5% group A and 20% agglutinated spontaneously . The remainder fell into several serogroups (10 unclassifiable, six 29E and one each, X, W135 and Z) . Concerning group B serotypes, except for 22 not typable cases, most carriers were serotype 2, while the remainder were distributed in seven other serotypes . These findings are comparable to those seen in the population with clinical disease . However the number of carriers remained constant and, in contrast to what happened with clinical patients, was unrelated to seasonal variations . Resistance of N . meningitidis to chemotherapy was the following: sulfadiazine 100%, ampicillin 19%, rifampicin 20% and penicillin 0% . The latter can not be considered a good choice in prophylaxis.

Sex Transm Dis, 1983 Jan-Mar, 10(1), 14 - 7
Changes in the prevalence of auxotypes of Neisseria gonorrhoeae among black and white patients attending a clinic for sexually transmitted diseases; Noble RC et al.; Before 1978, isolates of Neisseria gonorrhoeae from white patients attending a venereal disease clinic were more susceptible to penicillin G than were isolates from black patients, because the whites were more frequently infected with the Arg- Hyx- Ura- auxotype that was highly susceptible to penicillin . Recent isolates from the same clinic show a change both in the auxotypes and in the penicillin susceptibility of N . gonorrhoeae infecting the two patient groups . Of 211 isolates studied in 1978, the four most common auxotypes were, in decreasing frequency: Pro-, nonrequiring, Arg- Hyx- Ura- and Arg- . In the present study of 265 isolates, the order of frequency was nonrequiring; Pro-; Pro- Arg-(Orn*) Ura-; and Arg- Hyx- Ura- . The Pro- Arg-(Orn*) Ura- auxotype was new to the clinic and was significantly more frequent in white than in black patients and significantly more resistant to penicillin than were gonococci of the remaining auxotypes . With the appearance of the Pro- Arg-(Orn*) Ura- auxotype among white patients, there was no significant difference in the susceptibility to penicillin of isolates of N . gonorrhoeae from the two groups of patients.

J Antimicrob Chemother, 1983 Jan, 11(1), 15 - 20
Penicillinase-producing gonococci in the Netherlands in 1981; van Klingeren B et al.; In 1981 1180 penicillinase producing strains of Neisseria gonorrhoeae (PPNG) were isolated in the Netherlands, an incidence of approximately 10% of all gonococcal isolates . Determination of the plasmid pattern of 915 of these strains brought to light important shifts of predominant plasmid patterns in a short period of time . Significant differences between the large cities point to local spread of PPNG strains from different origins . The susceptibility of the PPNG strains to clinically relevant antibiotics varied with the plasmid pattern; this stresses the necessity of permanent surveillance of gonococcal infections and of regular evaluation of the recommendations for antimicrobial treatment.

J Virol, 1983 Jan, 45(1), 367 - 74
Substrate specificity of two bacteriophage-associated endo-N-acetylneuraminidases; Kwiatkowski B et al.; For Escherichia coli Bos12 (O16:K92:H-), a bacteriophage (phi 92) has been isolated which carries a depolymerase active on the K92 capsular polysaccharide . As seen under the electron microscope, phi 92 belongs to Bradley's morphology group A and is different from the phage phi 1.2 previously described (Kwiatkowski et al., J . Virol . 43:697-704, 1982), which grows on E . coli K235 (O1:K1:H-), depolymerizes colominic acid, and belongs to morphology group C . The specificity of the phi 1.2- and phi 92-associated endo-N-acetylneuraminidases has been studied with respect to the following substrates (all alkali treated, and where NeuNAc represents N-acetylneuraminic acid): (i) {-alpha-NeuNAc-(2 leads to 8)-}n (colominic acid), (ii) {-alpha-NeuNAc-(2 leads to 8)-alpha-NeuNAc-(2 leads to 9)-}n (E . coli K92 polysaccharide), and (iii) {-alpha-NeuNAc-(2 leads to 9)-}n (Neisseria meningitidis type C capsular polysaccharide) . The increase in periodate consumption of these glycans upon incubation with purified phi 1.2 or phi 92 particles was measured, and the split products obtained from all substrates after exhaustive degradation were analyzed by gel chromatography . It was found that the Neisseria polysaccharide is not appreciably affected by either virus enzyme and that phi 1.2 only depolymerizes a small fraction of the K92 glycan . Colominic acid, however, is completely degraded by both agents, phi 92 yielding smaller fragments (one to six NeuNAc residues) than phi 1.2 (two to seven) . Phage phi 92 additionally depolymerizes the K92 glycan, essentially to oligosaccharides of two, four, and six residues . The size distribution of these K92 oligosaccharides indicates that the phi 92 enzyme predominantly cleaves the alpha(2 leads to 8) linkages in this polymer.

J Infect Dis, 1983 Jan, 147(1), 87 - 94
Phagocytosis and killing of Neisseria gonorrhoeae by Trichomonas vaginalis; Francioli P et al.; Type 2 and 4 transparent and opaque Neisseria gonorrhoeae demonstrated a logarithmic loss of viability with a half life of approximately 10-30 min when incubated in the presence of Trichomonas vaginalis . Although this effect was observed in the absence of serum for most types of gonococci tested, it was consistently enhanced by the addition of human serum . Only for type 4 transparent gonococci did this process show an absolute serum requirement . Cytochalasin B inhibited the loss of viability . The nonphagocytic cattle parasite Tritrichomonas foetus did not ingest or kill N . gonorrhoeae . Electron microscopy revealed phagocytic uptake and degradation of N . gonorrhoeae in T . vaginalis, indicating that the loss of viability of N . gonorrhoeae was the result of phagocytosis followed by intracellular killing of gonococci by T . vaginalis.

J Bacteriol, 1983 Jan, 153(1), 429 - 35
Peptidoglycan biosynthesis in Neisseria gonorrhoeae strains sensitive and intrinsically resistant to beta-lactam antibiotics; Dougherty TJ; Treatment of penicillin-sensitive and intrinsically resistant Neisseria gonorrhoeae strains with their respective inhibitory concentrations of penicillin caused rapid cell death . When the peptidoglycan syntheses of these two strains were examined in the presence of penicillin, the sensitive strain continued to make this cell wall polymer for an extended time, whereas the resistant strain underwent a rapid and marked depression in synthesis . Examination of the labeled sodium dodecyl sulfate-insoluble peptidoglycan made in the presence of inhibitory concentrations of penicillin revealed further differences . The primary effect on the penicillin-sensitive gonococcus was a slight change in peptide cross-linking and a sharp decline in the degree of O-acetylation . In contrast, the resistant strain exhibited a substantial decline in cross-linking, with a very moderate change in O-acetylation . The degree of saturation of the individual penicillin-binding proteins (PBPs) was assessed under these conditions . PBP 2, which exhibits a reduced affinity for penicillin in the resistant strain, appeared to be related to O-acetylation, whereas PBP 1 was implicated in the transpeptidation reaction.

Annu Rev Med, 1983, 34, 337 - 58
Urethral infections in men and women; Wong ES et al.; Gonococcal and nongonococcal urethritis (NGU) remain the two most common sexually transmitted diseases seen in males in developed countries (1, 2) . The past decade has witnessed important developments in these diseases, including the emergence of penicillinase-producing Neisseria gonorrhoeae (3, 4), the recognition of Chlamydia trachomatis (5-8) and Ureaplasma urealyticum (6, 9, 10) as etiologic agents of NGU, a clearer understanding of the spectrum of illness caused by these agents, and the use of newer therapeutic regimens . In both sexes, these agents can either cause mucosal urogenital tract infection (urethritis, cervicitis) or spread contiguously or hematogenously to produce epididymitis, endometritis, pelvic inflammatory disease or disseminated gonococcal infection . In this paper we review important advances in the epidemiology, pathogenesis, diagnosis, and treatment of urethral infections in men and women, emphasizing particularly the acute urethral syndrome in women.

Microbios, 1983, 38(151), 7 - 14
Cloning and restriction enzyme analysis of a Neisseria gonorrhoeae plasmid; Savva D; A 4.2-kb cryptic plasmid (pDS1) isolated from Neisseria gonorrhoeae FA101 has been cloned in Escherichia coli using the plasmid pUC9 . Restriction enzyme maps of both native pDS1 and cloned pDS1 have been constructed; these indicate that the external C may be modified in some of the 5' CCGG 3' sites of the gonococcal plasmid.

Ann Acad Med Singapore, 1983 Jan, 12(1), 70 - 3
The susceptibility of Neisseria gonorrhoeae isolated in Singapore to ceftriaxone, cefotaxime, gentamicin and cotrimoxazole; Sng EH et al.; 240 and 183 strains of non-PPNG and PPNG isolated in 1981 were studied for their susceptibility to ceftriaxone and cefotaxime respectively . All the strains were susceptible to 0.016 microgram/ml of either antibiotic . PPNG from males were less susceptible to cefotaxime than non-PPNG or PPNG from females . PPNG isolated in 1979 were less susceptible to gentamicin than non-PPNG . The relatively high MIC values of cotrimoxazole may account for the high treatment failure rate encountered with the drug.

Mol Gen Genet, 1983, 189(1), 77 - 84
Characterization of a chimeric beta-lactamase plasmid of Neisseria gonorrhoeae which can function in Escherichia coli; Stein DC et al.; A chimeric beta-lactamase encoding plasmid, containing the 4.4 Mdal beta-lactamase plasmid and the 2.6 Mdal cryptic plasmid of Neisseria gonorrhoeae has been characterized by physical and biological methods . Digestion with restriction enzymes indicates the presence of the following restriction sites: 1 site: AccI, AvaI, HgiAI, HincII, MstI, PstI, PvuII, XbaI and XorI; 2 sites: HindIII and BamHI; 3 sites: BclI, Sau96I and AvaII; 6 sites: HinfI; greater than 8 sites: AluI, BbvI, DdeI, HgaI, HhaI, HpaII, MspI, Sau3A, TacI and TaqI . No restriction sites were found for the following: BglI, BglII, BstEII, EcoRI, EcoRII, HpaI, HphII, KpnI, SacI, SalI, SmaI, SstI, SstII, and XhoI . Five plasmid specific proteins have been identified by DNA directed in vitro protein synthesis (43K, 41K, 30K, 16K and 14K) . The location on the physical map of the coding regions for each of these proteins has been determined by the following methods: using plasmid DNA restricted by various enzymes in an in vitro protein synthesis system; identifying promoter-containing regions by digesting plasmid DNA with DdeI, adding RNA polymerase and then determining which fragments are retained by nitrocellulose . This plasmid contains both parental phenotypes in that it encodes penicillin resistance and possesses the sequence necessary for uptake in the gonococcus . Transformation data indicate that this plasmid can function in both E . coli and N . gonorrhoeae and that growth in E . coli has no effect on the plasmid's ability to transform the gonococcus.

Chemotherapy, 1983, 29(6), 415 - 8
In vitro activity of norfloxacin against Neisseria gonorrhoeae; Piffaretti JC et al.; Norfloxacin, an analogue of nalidixic acid, is a novel antibacterial compound active against both gram-negative and gram-positive pathogens . 142 Neisseria gonorrhoeae isolates proved to be remarkably sensitive to it; the MIC50 and MIC90 values for norfloxacin were 0.03 microgram/ml and 0.06 microgram/ml, respectively, for the strains resistant to the penicillins; for the strains susceptible to the penicillins, the same value of 0.03 microgram/ml was found both for the MIC50 and MIC90 . 100% of the strains were inhibited by 0.125 microgram/ml of the drug: this concentration is far below the serum levels (1.5 micrograms/ml) achievable following normal dosage . Clinical trials should be performed to establish whether the activity in vivo corresponds to that found in vitro.

Ann Acad Med Singapore, 1983 Jan, 12(1), 61 - 9
The susceptibility of Neisseria gonorrhoeae isolated in Singapore to antimicrobial agents--studies on changes in susceptibility patterns over the years; Sng EH et al.; The results of antibiotic MIC determination on gonococci isolated in Singapore over several years were studied . 53.6% of the strains isolated in 1981 had penicillin MIC values of 0.5 microgram/ml or more . The implementation of a control programme was followed by an increase in the susceptibility of the gonococcus to penicillin, ampicillin and tetracycline . An outbreak of PPNG occurred in 1978 while the control programme was on . In the initial period the PPNG was less susceptible to tetracycline, kanamycin and spectinomycin than the non-PPNG . Later on, as the PPNG was subjected to the same antibiotic selective pressures as the non-PPNG, the differences were less obvious . Following the use of kanamycin as a front-line drug, the percentage of PPNG isolated was stabilized.

Sex Transm Dis, 1983 Jan-Mar, 10(1), 18 - 23
Association of auxotypes of Neisseria gonorrhoeae and susceptibility to penicillin G, spectinomycin, tetracycline, cefaclor, cefoxitin, and moxalactam; Noble RC et al.; Isolates of Neisseria gonorrhoeae from 304 patients attending a venereal disease clinic were examined by a plate dilution method for their susceptibility to six antibiotics: penicillin G, spectinomycin, tetracycline, cefaclor, cefoxitin, and moxalactam . The isolates were also characterized by gonococcal auxotyping . The most frequent auxotypes were Nonrequiring, 58%; Pro-, 14%; Pro- Arg (Orn*) Ura-, 14%; Arg- Hyx- Ura-, 6%; and a miscellaneous group consisting of 8% of the isolates . If the entire group of isolates were examined, moxalactam was the most active of the antibiotics; 94% of the isolates were inhibited by less than or equal to 0.25 microgram/ml . The Pro- Arg (Orn*) Ura- isolates were relatively resistant to penicillin G and cefoxitin . The Arg- Hyx- Ura- group of isolates was the most susceptible of the auxotypes to all of the antibiotics except spectinomycin . The uncommon auxotype Arg (Orn*) Ura- has a requirement for arginine that is satisfied by citrulline but not by ornithine . The results of the present study indicate that the nutritional requirements of gonococci may be associated with their response to certain antibiotics.

Sex Transm Dis, 1983 Jan-Mar, 10(1), 7 - 13
Inhibition of active transport and macromolecular synthesis by pyocin 103 in Neisseria gonorrhoeae; Stein DC et al.; The mechanism of inhibition of Neisseria gonorrhoeae by pyocin 103 was examined . Pyocin 103 decreases the viability of N . gonorrhoeae immediately after its addition to logarithmically growing cells by single-hit kinetics . This inhibition was paralleled by an immediate cessation of protein synthesis, RNA synthesis, and active transport . From the data presented, it is likely that pyocin kills N . gonorrhoeae in the same manner that it kills Pseudomonas aeruginosa, i.e., by interfering with energy metabolism.

J Immunol Methods, 1982 Dec 30, 55(3), 297 - 307
The use of Tween 20 as a blocking agent in the immunological detection of proteins transferred to nitrocellulose membranes; Batteiger B et al.; The determination of the immunoreactivity of protein antigens in complex mixtures has been greatly facilitated by combining their separation via sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) with electrophoretic transfer to nitrocellulose membrane (NCM), and probing of bound proteins with specific antisera . Methods using various buffers and blocking agents have been published, but no studies have been published which compare these methods with each other or with others of potential merit . We have performed such a comparative study using protein antigens from Chlamydia trachomatis and Neisseria gonorrhoeae . In addition, we describe a method that blocks unoccupied protein binding sites on NCM with the nonionic detergent Tween 20, rather than proteins . This system proved to be equivalent or superior to other methods evaluated in the detection of immunoreactive proteins, and permitted staining of the NCM for protein after immunological probing . Such staining allowed precise identification of immunoreactive proteins . In addition, individual stained proteins could be excised and assessed for bound antibody in an indirect radioimmunoassay.

Lancet, 1982 Dec 18, 2(8312), 1366 - 8
Antimicrobial resistance of Neisseria gonorrhoea in Bangkok: is single-drug treatment passé; Brown S et al.; 201 gonococcal isolates obtained from patients attending clinics in Bangkok were tested for in-vitro antimicrobial susceptibility . 42% of these isolates were penicillinase-producing Neisseria gonorrhoeae (PPNG); of the 116 isolates of non-PPNG 53% had a penicillin minimum inhibitory concentration (MIC) greater than or equal to 1 microgram/ml and the remainder had MIC greater than or equal to 0.06 microgram penicillin/ml . Similarly high in-vitro resistance was found for six of eight other antimicrobial agents tested . These high antimicrobial MICs reflect the difficulties encountered in selecting therapeutic agents for the control of gonorrhoea in Thailand . Single-drug treatment for gonorrhoea may no longer be effective in some settings . There is an urgent need to evaluate combination therapies appropriate to such settings.

J Gen Microbiol, 1982 Dec, 128 (pt 12), 3077 - 81
Outer membrane proteins of Neisseria gonorrhoeae associated with survival within human polymorphonuclear phagocytes; Parsons NJ et al.; The determinant(s) of gonococcal resistance to killing by human polymorphonuclear (PMN) phagocytes appear to be present in outer membrane vesicles (OMV) purified from lithium chloride extracts of Neisseria gonorrhoeae strain BS4 (agar) by wheat germ agglutinin (WGA) affinity chromatography . OMV neutralized the ability of antisera raised against whole gonococci to drastically reduce the capacity of strain BS4 (agar) to survive within PMN phagocytes . Furthermore, analysis by SDS-PAGE of OMV/WGA precipitates from lithium chloride extracts of strain BS4 (agar) and strain BSSH, which was more susceptible to phagocyte killing than strain BS4 (agar) and yielded OMV with poor antiserum-neutralizing activity, suggested that three proteins were associated with resistance to phagocyte killing.

Proc Natl Acad Sci U S A, 1982 Dec, 79(24), 7881 - 5
Genetic and biochemical analysis of gonococcal IgA1 protease: cloning in Escherichia coli and construction of mutants of gonococci that fail to produce the activity; Koomey JM et al.; The biological significance of bacterial extracellular proteases that specifically cleave human IgA1 is unknown . We have prepared a gene bank of gonococcal chromosomal DNA in Escherichia coli K-12 using a cosmid cloning system . Among these clones, we have identified and characterized an E . coli strain that elaborates an extracellular endopeptidase that is indistinguishable from gonococcal IgA1 protease in its substrate specificity and action on human IgA1 . Analysis of recombinant plasmids and examination of plasmid-specific peptides in minicells have shown that the IgA1 protease activity in E . coli is associated with expression of a Mr 140,000 peptide . We have isolated IgA1 protease-deficient mutants of Neisseria gonorrhoeae by reintroduction of physically defined deletions of the cloned gene into the gonococcal chromosome by transformation.

Br J Vener Dis, 1982 Dec, 58(6), 359 - 62
Detection of Neisseria gonorrhoeae antigen by a solid-phase enzyme immunoassay; Aardoom HA et al.; The Gonozyme test (Abbott Laboratories) is a new enzyme immunoassay for detecting Neisseria gonorrhoeae antigens in specimens from the urethra in men and the endocervix in women . To evaluate the usefulness of the assay 249 patients were investigated . The results obtained with the immunoassay were compared with those of culture and microscopy of Gram-stained smears . The sensitivity and specificity of the test were high in men with urethritis and acceptable in different groups of women . As the sensitivity of the Gonozyme test was much higher than that of microscopy for endocervical specimens it might be useful as a rapid screening test for the detection of gonorrhoea in women.

Pathol Biol (Paris), 1982 Dec, 30(10), 859 - 60
{Bacteriological diagnosis of Neisseria ovis . Apropos of a strain isolated from keratoconjunctivitis of lambs}; Riou JY et al.; The authors report a case of bacteriologic diagnosis of Neisseria ovis isolated from a keratoconjunctivitis of lamb . Difficulties of diagnosis and taxonomic position of N . ovis are briefly discussed.

Clin Obstet Gynaecol, 1982 Dec, 9(3), 565 - 92
Sexually transmitted diseases in pregnancy; Ross SM; PIP: Numerous sexually transmitted diseases--syphilis, gonococcal infections, group B beta-hemolytic streptococcal infection, chlamydial infections, mycoplasmas, herpes simplex virus, cytomegalovirus infections, hepatitis B viral infections, fungal infection, trichomonas vaginalis, condylomata acuminata, and scabies--are of concern when they occur during pregnancy, either because of their potential adverse effects on the fetus or the chance of a modified reaction in the pregnant woman . This article discusses each of these venereal diseases in turn, providing information on diagnosis, prevention, and treatment . Pregnancy appears to have a benign effect on syphilis in the mother, but the fetus is likely to suffer from abortion, intrauterine death, intrauterine growth retardation, and congenital syphilis, underscoring the need for serologic testing of symptomatic pregnant women and treatment with penicillin . Neisseria gonorrhoea, still a prevalent sexually transmitted disease among women of childbearing age, is of considerable seriousness during pregnancy due to the risk of contamination of the newborn during passage through the birth canal . Infants delivered of women infected with chlamydia may develop a neonatal inclusion conjunctivitis, nasopharygitis, otitis media, or an afebrile pneumonia syndrome .

J Clin Lab Immunol, 1982 Dec, 9(3), 169 - 72
Phagocyte recognition of Neisseria gonorrhoeae; Kinane DF et al.; Human monocytes show an increased ability to bind pilate rather than non-pilate gonococci . Polymorphonuclear leucocytes (PMN) do not discriminate between pilate and non-pilate variants . PMN, however, bind appreciably more gonococci (either pilate or non-pilate) than monocytes . The results help to explain the role of pili on gonococci as virulence factors and in the immune response.

J Antibiot (Tokyo), 1982 Nov, 35(11), 1441 - 7
Studies on a new antibiotic M-92 produced by Micromonospora . III . Biological activities; Tani K et al.; The six major components of M-92, a new antibiotic complex produced by Micromonospora verruculosa MCRL 0404 showed a similar type of antimicrobial spectrum . Among these components, VA-2 exhibited the most potent antimicrobial activity, particularly significantly against some Gram-positive bacteria and Neisseria . VA-2 and BN-1 also exhibited marked inhibitory effects against L-forms of Staphylococcus aureus 209P and Mycoplasma . The MICs of VA-2, BA-4 and BN-1 were remarkably affected by the pH of the test medium, the inoculum size and the amount of horse serum added in the medium . By intraperitoneal administration, these components showed good protective effects in mice infected intraperitoneally with Staphylococcus aureus Smith . However, the protective effect decreased remarkably by other administration routes . In addition, components such as VA-2 and BN-1 exhibited cytotoxicity against HeLa S-3 cells in vitro and excellent in vivo antitumor activity against Ehrlich carcinoma . VA-2 possessed a high order of acute toxicity to mice {LD50:1.9 mg/kg (i.p.); 1.8 mg/kg (i.v.)}, but others were relatively less toxic.

Br J Ophthalmol, 1982 Nov, 66(11), 728 - 31
Ophthalmia neonatorum in the 1980s: incidence, aetiology and treatment; Pierce JM et al.; In a survey of 450 consecutive births in Southampton a 12% incidence has been found of ophthalmia neonatorum . Bacterial pathogens were isolated from only one-third of the cases, while nonpathogens were isolated from as many cases as controls . There was an incidence of chlamydial infection of 3.7 per 1000 live births, while Neisseria gonorrhoeae could not be found . Chloramphenicol is recommended for topical antibacterial treatment, but chlamydial infection will not respond; it must be considered in 'resistant' cases, when both the neonate and the parents will need treatment with erythromycin or tetracycline.

Can J Microbiol, 1982 Nov, 28(11), 1265 - 72
Phenotypic changes in colonial morphology of Neisseria gonorrhoeae; Norrod EP et al.; Phenotypic changes in the colonial morphology of four opacity variants of Neisseria gonorrhoeae strain F62 occurred upon growth in the presence of 14 mM pyruvate . Each of the naturally occurring opacity variants, a transparent, an opaque, and two deeply opaque, became more opaque; in addition, colonies of the opaque variants became rougher . Pyruvate did not appear to have a direct function in these colonial changes . Its effects were due to the ability of pyruvate to retard the oxidation of cysteine that was added to the medium in a defined supplement . Sodium dodecyl sulfate--polyacrylamide gel electrophoresis (SDS-PAGE) of outer membranes showed that the opacity-associated proteins of the naturally occurring variants were not affected by growth in the presence of pyruvate; therefore, the induced opacity changes appear to have another basis . However, other proteins were affected . SDS-PAGE of the outer membranes, as well as of cell fractions composed predominantly of cytosol and of cytoplasmic membranes, revealed quantitative differences in the protein profiles after growth in the presence of pyruvate of each variant.

J Med Microbiol, 1982 Nov, 15(4), 541 - 50
Detection of gonococcal antigens by an indirect sandwich enzyme-linked immunosorbent assay; Sarafian SK et al.; The detection of gonococcal antigens by an indirect sandwich ELISA system is described . The feasibility of using rabbit antiserum raised against whole cells of Neisseria gonorrhoeae strain 9 to detect gonococcal lipopolysaccharide, whole cells, and outer membrane (OM) protein was investigated . OM protein was found to be the main antigen detectable with the antiserum in a direct ELISA system . A positive result in the indirect assay could be obtained with a minimum of 46 to 92 ng of gonococcal OM protein or with 6.6 X 10(3) cfu of N . gonorrhoeae . The sensitivity of the assay was found to be approximately eightfold lower with OM complex from a strain of N . meningitidis serogroup B for which the minimum amount of OM protein detected was 375 ng . Negative results were obtained with OM complex from Streptococcus agalactiae, Bacteroides bivius and Escherichia coli . The assay seems to be highly specific for gonococcal antigens . The sensitivity of the assay and its specificity commend it for further evaluation in the detection of gonococcal antigens in clinical specimens.

Rev Infect Dis, 1982 Nov-Dec, 4 Suppl, S701 - 7
Moxalactam therapy for obstetric and gynecologic infections; Gall SA et al.; Moxalactam, a new cephalosporin antibiotic with a broad spectrum of activity, was evaluated for safety and therapeutic efficacy in the treatment of genital tract infections in women . Fifty-three patients with postpartum endometritis or acute or chronic pelvic inflammatory disease were treated with 2 g of moxalactam iv every 8 hr, usually for five days or longer . Appropriate cultures of peripheral blood, endometrium, cul-de-sac aspirates, urine, wound, and endocervix (only for Neisseria gonorrhoeae) were performed . Overall, 90.6% (48 of 53) of the patients were successfully treated with moxalactam--86.2% (25 of 29) and 95.8% (23 of 24) of the patients with endometritis and pelvic inflammatory disease, respectively . Therapy failed in one of five bacteremic patients with endometritis . Of all the bacteria isolated from appropriate culture sites, 58% (224 of 383) were anaerobes, with anaerobic gram-negative rods--particularly Bacteroides bivius-and gram-positive cocci being predominant . Of 206 anaerobic strains tested with moxalactam by agar dilution techniques, 82% (169 of 206) were susceptible (minimal inhibitory concentration {MIC}, less than or equal to 8 micrograms/ml), 11.6% (24 of 206) were moderately susceptible (MIC, 16-32 micrograms/ml), and 6.3% (13 of 206) were resistant (MIC, greater than or equal to 64 micrograms/ml) . Among the aerobic isolates, enterococci were uniformly resistant . Thus, moxalactam performed well as a single agent in this open clinical trial for women with infections of the genital tract.

Infect Immun, 1982 Nov, 38(2), 668 - 72
Antigenicity of Neisseria gonorrhoeae outer membrane protein(s) III detected by immunoprecipitation and Western blot transfer with a monoclonal antibody; Swanson J et al.; Some properties of gonococcal outer membrane III were studied by using a monoclonal antibody (2E6) in Western blot transfer and immunoprecipitation reactions . By Western blot, the 2E6 monoclonal had a single antigenic target: outer membrane protein III . All three gonococcal strains examined exhibited identical reactivities for their protein(s) III with this monoclonal . When 125I-labeled gonococci were incubated with monoclonal antibody 2E6, lysed in Zwittergent, and antibody-antigen complexes were immunoprecipitated with protein A-Sepharose, both outer membrane proteins I and III were present in the immunoprecipitates regardless of the gonococcal strain used . Exposure of gonococci to Iodogen and 2-mercaptoethanol influences the electrophoretic migration characteristics of protein(s) III in polyacrylamide gel electrophoresis with sodium dodecyl sulfate; the antigenicity of protein(s) III was unaltered when assessed by Western blot transfer after reaction with Iodogen or 2-mercaptoethanol . These data demonstrate that outer membrane protein III is a surface-exposed antigenic moiety common to diverse strains of gonococci.

Infect Immun, 1982 Nov, 38(2), 462 - 70
Serology of Neisseria gonorrhoeae: coagglutination serogroups WI and WII/III correspond to different outer membrane protein I molecules; Sandstrom EG et al.; The 125I-labeled tryptic peptides of the outer membrane protein I of 33 previously characterized serological reference strains of Neisseria gonorrhoeae were investigated by peptide maps in relation to their coagglutination W serogroup . Serogroup WI strains tended to have lower-molecular-weight protein I molecules than did WII strains, and WIII strains had the highest-molecular-weight protein I molecules, although the serogroup could not be predicted from the molecular weights of the protein I molecules for a given strain . All 13 strains belonging to serogroup WI were found to have 11 peptides in common, as judged by their migration with respect to one another and to the internal marker valine in the peptide maps . Common peptides isolated from a given strain were found to comigrate with the corresponding common peptides from other strains in the same serogroup under various electrophoretic conditions . The 20 strains belonging to serogroups WII and WIII were all found to have 10 common peptides by the same criteria . When common peptides from serogroup WI were compared with the common peptides of serogroups WII and WIII, only three of these peptides appeared to be similar . Thus, two different outer membrane protein I molecules seem to exist which are mutually exclusive . Protein IA molecules contain the antigens recognized as serogroup WI, and protein IB molecules contain the antigens that characterize serogroups WII and WIII.

N Z Med J, 1982 Oct 27, 95(718), 725 - 8
Perihepatitis associated with pelvic infection: the Fitz-Hugh-Curtis syndrome; Keane JA et al.; Once regarded as rare, acute perihepatitis associated with pelvic inflammatory disease or Fitz-Hugh-Curtis syndrome is being diagnosed with increasing frequency . At Waikato Hospital, Hamilton in recent months 16 cases of perihepatitis have been identified, of which 12 were confirmed by laparoscopy, one at laparotomy, and one by post mortem examination . The other two were diagnosed on clinical and laboratory criteria . Neisseria infection was demonstrated in one case only . It is suggested that perihepatitis is not as rare as was hitherto believed and taught, and that the more widespread use of the laparoscope as a diagnostic tool would confirm this.

Arch Intern Med, 1982 Oct 25, 142(11), 2039 - 44
New concepts of obstetric and gynecologic infection; Eschenbach DA; Multiple organisms are usually recovered from patients with acute pelvic inflammatory disease (PID) . The sexually transmitted organisms Neisseria gonorrhoeae, Chlamydia trachomatis, and genital mycoplasmas frequently initiate infection . Although aerobic and anaerobic bacteria that constitute the normal vaginal flora are frequent secondary invaders following an initial sexually transmitted infection, these bacteria can also primarily cause PID . Early postpartum endometritis, the most common postpartum infection, amniotic fluid infection, and infection following hysterectomy are usually caused by the aerobic and anaerobic bacteria that constitute the normal vaginal flora . Because the organisms that cause the various obstetric-gynecologic infections are often found in combination, it is necessary to begin therapy with broad-spectrum antibiotics . Many of these infections are caused by anaerobic bacteria and it is often necessary to select antibiotics that inhibit anaerobes.

J Immunol Methods, 1982 Oct 15, 54(1), 101 - 5
A bactericidal microassay for testing serum sensitivity of Neisseria gonorrhoeae; Schneider H et al.; A reproducible gonococcal serum bactericidal microassay is described which has easily determined endpoints and lends itself to large scale tests . The microassay may be used to assess sensitivity to normal human serum among strains of gonococci, and to define the antigens conferring this sensitivity . It may be readily adapted to test for bactericidal activity in hyperimmune antisera and to evaluate antigens which inhibit serum bactericidal activity.

AJR Am J Roentgenol, 1982 Oct, 139(4), 667 - 71
Radiographic findings of infectious proctitis in homosexual men; Sider L et al.; Homosexual men are known to have an increased incidence of sexually transmitted proctitis . A knowledge of the pathogenesis and the radiographic appearance of these processes has resulted in earlier diagnosis and more rapid institution of appropriate therapy . While gonococcus (Neisseria gonorrhoeae) and lymphogranuloma venereum (usually Chlamydia) have long been considered the common etiologies of proctitis in this population, other organisms, such as herpes, Mycoplasma, and Entamoeba have been implicated and could give an identical radiographic and clinical pattern . Diffuse narrowing and ulceration limited to the rectum was seen in five affected homosexual men recently studied at Northwestern Memorial Hospital, Chicago.

Sex Transm Dis, 1982 Oct-Dec, 9(4), 202 - 4
Isolation of Branhamella (Neisseria) catarrhalis from men with urethritis; Doern GV et al.; Branhamella (Neisseria) catarrhalis was recovered from urethral exudates of three men with acute urethritis . In all cases gram stain of the urethral exudates revealed intracellular gram-negative diplococci morphologically compatible with Neisseria gonorrhoeae . Branhamella (Neisseria) catarrhalis should be considered as a potential cause of acute urethritis in men with urethral discharge microscopically consistent with, but culture-negative for, N . gonorrhoeae.

Sex Transm Dis, 1982 Oct-Dec, 9(4), 208 - 11
Treatment of gonococcal urethritis in men with a rifampicin-erythromycin combination; Oriel JD et al.; A group of men with uncomplicated gonococcal urethritis were treated with a single oral dose of rifampicin (900 mg) and erythromycin stearate (1 g) . Neisseria gonorrhoeae was isolated from four of 108 men at the first follow-up examination, and from none of 68 who attended a second follow-up examination . It is concluded that this rifampicin-erythromycin combination may be useful for the therapy of gonorrhea . It may be of particular value in the treatment of infections due to penicillin-resistant N . gonorrhoeae, since in vitro studies showed that both rifampicin and erythromycin were active against 20 strains of beta-lactamase-producing N . gonorrhoeae . The effect of this rifampicin-erythromycin combination against associated infections with Chlamydia trachomatis was disappointing . This organism was isolated from five of nine patients who had yielded isolates of C . trachomatis before treatment.

Sex Transm Dis, 1982 Oct-Dec, 9(4), 200 - 1
Infections with non-penicillinase-producing Neisseria gonorrhoeae treated with cefuroxime: treatment failures; de Hoop D et al.; Two men who acquired acute gonococcal urethritis in The Netherlands and who were treated with cefuroxime (1.5 g given intramuscularly) failed to respond to this therapy . Pre- and post-treatment isolates of Neisseria gonorrhoeae from these patients had MICs of 0.5 and 1.0 microgram of cefuroxime/ml.

J Exp Med, 1982 Oct 1, 156(4), 1235 - 49
Activation of complement by serum-resistant Neisseria gonorrhoeae . Assembly of the membrane attack complex without subsequent cell death; Harriman GR et al.; Interaction of the human complement system in normal human serum (NHS) with serum-resistant and -sensitive Neisseria gonorrhoeae was evaluated to better understand the mechanism of serum-resistance . Complement activity (CH50) was depleted from NHS in a dose-dependent fashion by both serum-resistant and -sensitive N . gonorrhoeae . No detectable CH50 remained in NHS incubated with 10(9) colony-forming units (CFU)/ml serum of either resistant or sensitive strains . When smaller numbers of bacteria were incubated with NHS, lesser, yet comparable, amounts of CH50 were depleted by both resistant and sensitive strains . Hemolytic C2 activity was diminished by 33% in the case of resistant N . gonorrhoeae (10(8) CFU/ml serum) and by 48% in the case of a sensitive strain . No detectable decreases in hemolytic C4 or C7 activities were found with either sensitive or resistant strains at this concentration . Both resistant and sensitive strains activated C1s in NHS . Resistant strains specifically activated 19-21% of radiolabeled C1s in NHS, whereas sensitive strains activated 18-32% . Both resistant and sensitive strains also activated C5 in NHS . In binding assays using radiolabeled C5 and C9 in NHS, resistant and sensitive strains bound comparable amounts of C5 and C9 . The number of bound C5 and C9 molecules varied according to the number of bacteria or amount of serum used in the assay . The ratio of C9/C5 bound to a sensitive strain was 6.8, and to a resistant strain was 8.2, suggesting that C5 and C9 were incorporated into membrane attack complexes (MAC) . Electron microscopic examination of resistant and sensitive strains incubated with NHS revealed that MAC is bound to the surfaces of the resistant strain as well as the sensitive strain.

J Clin Microbiol, 1982 Oct, 16(4), 754 - 5
Comparison of commercially available New York City medium and Martin-Lewis medium for recovery of Neisseria gonorrhoeae from clinical specimens; Lawton WD et al.; In 100 clinical specimens containing Neisseria gonorrhoeae, commercially prepared New York City medium in JEMBEC plates was superior to Martin-Lewis medium for recovery of gonococci in 49 specimens, equal to Martin-Lewis medium in 43 specimens, and less effective in 8 specimens.

Antimicrob Agents Chemother, 1982 Oct, 22(4), 598 - 603
In vitro susceptibility and cross-resistance of South African isolates of Neisseria gonorrhoeae to 14 antimicrobial agents; Liebowitz LD et al.; One hundred isolates of Neisseria gonorrhoeae obtained from patients attending clinics in Johannesburg, South Africa, were tested by a broth dilution technique for their minimal inhibitory concentrations (MICs) of benzyl penicillin G, ampicillin, cefoxitin, cefuroxime, cefotaxime, ceftriaxone, ceftazidime, tetracycline, minocycline, doxycycline, spectinomycin, rosaramicin, chloramphenicol, and rosoxacin . None of the isolates tested produced beta-lactamase . The MICs of penicillin ranged from less than or equal to 0.007 to 0.5 micrograms/ml . The isolates were also very susceptible to rosaramicin (minimal concentration at which 50% of isolates were inhibited {MIC50} = 0.02 micrograms/ml) and to the new cephalosporins (cefotaxime MIC50 less than 0.007 micrograms/ml, ceftriaxone MIC50 less than 0.007 micrograms/ml, and ceftazidime MIC50 less than 0.007 micrograms/ml) . By using regression analysis, good correlation was observed between the MICs of penicillin and those of the other agents, with the exception of ceftriaxone, spectinomycin, and rosaramicin . The MICs and the minimal bactericidal concentrations were within a log2 concentration of each other.

Br J Vener Dis, 1982 Oct, 58(5), 308 - 10
Penicillinase-producing Neisseria gonorrhoeae ophthalmia neonatorum in Singapore; Thirumoorthy T et al.; The problem of ophthalmia neonatorum due to penicillinase-producing Neisseria gonorrhoeae (PPNG) has grown with the increasing prevalence of PPNG strains in Singapore . The epidemiological trends, clinical features, and treatment of ophthalmia neonatorum due to PPNG have been determined from the case histories of 11 babies with this condition treated between 1978 and 1980 . All 11 cases were cured with a single intramuscular injection of kanamycin 0.5 g and 1% kanamycin eyedrops instilled for three days . In six of the 11 mothers, a non-PPNG strain was isolated.

Br J Vener Dis, 1982 Oct, 58(5), 302 - 4
Induction of phenotypically determined resistance of neisseria gonorrhoeae to human serum by sera from patients with gonorrhoea; Martin PM et al.; Some human sera contain factors which induce in gonococci a resistance to killing by fresh human sera . Individuals with serum containing these factors might possibly be more prone to gonorrhoea . A survey of the sera of 50 female and 50 male patients with gonorrhoea for resistance-inducing capacity showed, however, that the proportions of positive sera (24% for women, 28% for men) were not significantly different from those (16% for women, 24% for men) from an equal number of controls . Examination of the results, however, in relation to the type of gonococcal infection showed that: (a) the sera of 15 female patients with complicated (salpingitis) or successive infection or both did not induce resistance (statistically significant); (b) a greater proportion (34%) of sera from female patients with single gonococcal infections induced higher gonococcal resistance than for control sera (16%) (at the borderline of statistical significance); and (c) a greater proportion (38%) of sera from the few male patients with successive infections induced higher resistance than for control sera (24%) (not statistically significant).

Immunology, 1982 Oct, 47(2), 283 - 8
Analysis of antibodies in local and disseminated Neisseria gonorrhoeae infections by means of gel electrophoresis-derived ELISA; Hadfield SG et al.; Major antigens in Neisseria gonorrhoeae were identified by surface labelling the organisms with 125I and electrophoresing extracts in polyacrylamide with sodium dodecyl sulphate . Horizontal slices of the gels were cut out and tested in individual wells against patients' sera using ELISA . Serum from local gonococcal infections reacted with Protein II and, probably, lipopolysaccharide, but not with Protein I in deoxycholate (DOC) extracts and gave no reaction with Triton X-100 extracts . Serum from disseminated gonococcal infections reacted with Protein I in the DOC extract and with pili and a number of undefined possibly cytoplasmic membrane antigens in the Triton X-100 extract . The significance of the results and the potential of the method are discussed.

JAMA, 1982 Oct 1, 248(13), 1619 - 21
Vaginal spermicides and gonorrhea; Jick H et al.; All positive cultures for neisseria gonorrhoeae recorded from Dec 20, 1978, through Dec 31, 1980, for women born between 1940 and 1960 were identified among members of Group Health Cooperative of Puget Sound, Seattle, and rates of gonorrhea were calculated for recent oral contraceptive users, recent vaginal spermicide users, and women with surgical sterilization . The risk ratio (RR) estimate, based on the included population, for spermicide users compared with all others was 0.23 (90% confidence interval {Cl}, 0.10, 0.50) . When women with positive cultures for N gonorrhoeae were compared with women with negative cultures, the RR estimate comparing spermicide users with all others was 0.13 (90% Cl, 0.05, 0.34) . The results are consistent with the protective effect of vaginal spermicides against gonorrhea.

Br J Vener Dis, 1982 Oct, 58(5), 314 - 6
Ceftriaxone in the treatment of ordinary and penicillinase-producing strains of Neisseria gonorrhoeae; Rajan VS et al.; Ceftriaxone, a third generation cephalosporin, was used in a single intramuscular dose with oral probenecid to treat 124 men with infections due to non-penicillinase-producing Neisseria gonorrhoeae (non-PPNG) and 64 men with infections due to PPNG . Three different doses of ceftriaxone were used--125 mg, 62.5 mg, ad 32.5 mg, and 32.5 . The cure rate for all PPNG infections with the different doses was 100% . The cure rate for the non-PPNG infections with ceftriaxone 125 mg was 100%; those for non-PPNG infections treated with ceftriaxone 62.5 mg and 32.5 mg were 96.2% and 97.3% respectively . The 160 strains of non-PPNG and 60 strains of PPNG isolated were all susceptible to ceftriaxone with minimum inhibitory concentrations of 0.008 microgram/ml . These results are compared with those using kanamycin 2 g . Ceftriaxone is a safe and effective treatment for PPNG and non-PPNG infections.

Br J Vener Dis, 1982 Oct, 58(5), 305 - 7
Antibiotic sensitivity patterns of penicillinase-positive and penicillinase-negative strains of Neisseria gonorrhoeae isolated in Fukuoka, Japan; Yoshida S et al.; Penicillinase production and minimum inhibitory concentrations (MICs) of penicillin G, amoxycillin, doxycycline, and spectinomycin were studied for 155 gonococcal strains isolated in Fukuoka, Japan, between April and December 1981 . Of 155 isolates, 25 (16.1%) strains were identified as penicillinase-producing Neisseria gonorrhoeae (PPNG) by a rapid iodometric test . The antibiotic sensitivity of 130 penicillinase-negative (non-PPNG) and 25 PPNG strains was compared . The mean MIC of penicillin G for non-PPNG strains was 0.65 microgram/ml . Twenty-five PPNG strains had MICs of penicillin G between 6.25 and greater than 100 micrograms/ml . The susceptibility to amoxycillin and doxycycline of PPNG strains was significantly lower than that of non-PPNG strains . All the strains proved to be sensitive to spectinomycin . The MICs of four antibiotics for non-PPNG strains were significantly correlated.

Eur J Immunol, 1982 Oct, 12(10), 797 - 803
Study of the idiotypy of lipopolysaccharide-specific polyclonal and monoclonal antibodies; Hiernaux JR et al.; The monoclonal antibodies produced by a variety of hybridomas making antibody specific for E . coli 0113 lipopolysaccharide (LPS) were purified by affinity chromatography and their fine specificity studied . All reacted specifically with the polysaccharide moiety of LPS from E . coli 0113 and from Neisseria lactamica; two reacted with LPS from Pseudomonas aeruginosa and one reacted with LPS from Klebsiella pneumoniae . Polyclonal and monoclonal syngeneic and semi-syngeneic anti-idiotypic antisera were produced to study the idiotypy of LPS-specific monoclonal antibodies which express a complex cross-reactive idiotype (IdX) as well as individual idiotypes . E . coli 0113 LPS-specific antibodies produced by BALB/c mice express this IdX and the kinetics for its expression was examined using mice either primed or hyperimmunized with LPS; idiotypic maturation was observed, but we were unable to detect an auto-anti-idiotypic antibody response . This IdX was expressed on E . coli 0113 LPS-specific antibodies from all strains of mice examined, indicating that its expression is not restricted by genes linked to the IgCH locus.

Infect Immun, 1982 Oct, 38(1), 27 - 30
Effect of anti-pilus antibodies on survival of gonococci within guinea pig subcutaneous chambers; Lambden PR et al.; Guinea pigs were immunized with either alpha or beta pili from Neisseria gonorrhoeae P9 before the inoculation of subcutaneous chambers with a mixture of variants having alpha, beta, gamma, or delta pili . Animals immunized with alpha pili showed significant protection, but those immunized with beta pili did not . The degree of protection could be correlated with the cross-reactivity of the antibodies produced to the heterologous pilus types.

Sex Transm Dis, 1982 Oct-Dec, 9(4), 183 - 7
The Denver Sexually Transmitted Diseases Prevention/Training Center: a two-year performance evaluation; Judson FN et al.; The Venereal Disease Control Division of the Centers for Disease Control (Atlanta, Ga.) has funded the development of nine regional Sexually Transmitted Diseases Prevention/Training Centers . During its first two years of operation, the Denver center offered 17 courses of three types to 158 students . The performance of the Denver Center as to appropriateness of student selection and outcome measures of training was evaluated . The evaluation concentrated on students from the more extensive, two-week Level I course . Comparison of students' written examinations before and after the course demonstrated an average improvement in correct responses of 24.9% . Students rated overall course quality at 3.66 on a four-point scale . Post-course surveys 9.5 months later were completed by 74% of students and 72% of their supervisors . All student respondents take sexual and sexually transmitted disease histories, and 82% routinely prepare specimens from men and women for culture of Neisseria gonorrhoeae . Nine percent of students were no longer employed at STD clinics, but supervisors agreed that for 92% of students, training benefits outweighed lost work time . It is concluded that the perceived needs of Level I students and their supervisors have been met and that data from the survey infer satisfactory patient care in their clinics.

Biull Eksp Biol Med, 1982 Sep, 94(9), 87 - 90
{Properties of liposomal allergens of Neisseria perflava}; Fedoseeva VN et al.; Experiments on guinea-pigs were made to study the anaphylactogenic properties of neisserial allergens incorporated into phospholipid vesicles (liposomes) . The anaphylactogenic activity of the liposomal allergens was found to be reduced as shown by the general anaphylactic reaction (anaphylactic shock) seen in the guinea-pigs sensitized with neisserial allergens . The effect under consideration was coupled with intense allergen accumulation by lung tissues of the sensitized guinea-pigs . It is assumed that the reduced anaphylactogenic activity is caused by allergen isolation from lung tissues by phospholipid membranes.

J Clin Microbiol, 1982 Sep, 16(3), 595 - 7
Neisseria sicca osteomyelitis; Doern GV et al.; Neisseria sicca was identified as the cause of vertebral osteomyelitis in a male patient who had previously suffered a nonpenetrating, traumatic back injury . The identifying characteristics and antimicrobial susceptibility patterns are presented for this rare human pathogen, which heretofore has not been reported as a cause of infection localized to bone.

Antimicrob Agents Chemother, 1982 Sep, 22(3), 409 - 13
Comparison of cefuroxime and penicillin in the treatment of uncomplicated gonorrhea; Lossick JG et al.; In a randomized double-blind trial, 216 men and 142 women infected with uncomplicated gonorrhea were treated with either 1.5 g of cefuroxime or 4.8 x 10(6) U of aqueous procaine penicillin G intramuscularly and 1.0 g of probenecid . The cure rates in the treatment groups were 96 and 95%, respectively . Intramuscularly administered cefuroxime was better tolerated than was procaine penicillin . Comparative antibiotic susceptibility studies revealed that cefuroxime and penicillin were about equally active and that both were more active than cefamandole or cefoxitin . Because cefuroxime is not degraded by the action of beta-lactamase enzymes, it has promise as an alternative to spectinomycin in the treatment of penicillinase-producing Neisseria gonorrhoeae infections.

Rev Infect Dis, 1982 Sep-Oct, 4 Suppl, S448 - 52
Treatment of uncomplicated gonorrhea with cefotaxime; Handsfield HH; Three hundred seventy-six patients with uncomplicated infection due to beta-lactamase-negative Neisseria gonorrhoeae were treated with 1.0 g of cefotaxime intramuscularly or with 4.8 x 10(6) units of aqueous procaine penicillin G (APPG) intramuscularly plus 1.0 g of probenecid, administered orally . Cefotaxime eradicated 157 (98.1%) of 160 urethral or endocervical gonococcal infections, 22 (96%) of 23 rectal infections, and 8 (73%) of 11 pharyngeal infections . In comparison, APPG-probenecid eradicated 125 (98.4%) of 127 urethral or endocervical gonococcal infections, 17 (94%) of 18 rectal infections, and 4 (100%) of 4 pharyngeal infections . Of 304 domestic beta-lactamase-negative gonococcal isolates, 294 (96.7%) were inhibited by less than or equal to 0.03 microgram/ml of cefotaxime . In a separate study, cefotaxime eradicated 31 of 31 urethral infections due to beta-lactamase-positive strains of N . gonorrhoeae acquired by U.S . Navy personnel in the Philippines . Treatment with cefotaxime was tolerated better than treatment with APPG, primarily because only one injection is required for cefotaxime . The efficacy of cefotaxime was comparable to that of APPG-probenecid in the treatment of uncomplicated genital or rectal infection due to beta-lactamase-negative N . gonorrhoeae, and cefotaxime appears to be highly effective for the treatment of urethral infection due to beta-lactamase-positive N . gonorrhoeae . Further studies are needed for assessment of the efficacy of cefotaxime for treatment of pharyngeal gonococcal infection.

J Bacteriol, 1982 Sep, 151(3), 1171 - 5
Penicillinase-producing Neisseria gonorrhoeae: a molecular comparison of 5.3-kb and 7.4-kb beta-lactamase plasmids; Dickgiesser N et al.; Restriction endonuclease analysis and heteroduplex studies indicate that the only difference between the 5.3-kilobase (kb) and 7.4-kb plasmids from beta-lactamase-producing Neisseria gonorrhoeae is that the latter is the 5.3-kb plasmid with a 2.1-kb insertion . The insertion is bounded by inverted repeats of approximately 300 base pairs . Several plasmids from beta-lactamase-producing N . gonorrhoeae isolated at different times and in different countries were compared . Nine 5.3-kb plasmids were examined and found to be indistinguishable, as were sixteen 7.4-kb plasmids.

J Gen Microbiol, 1982 Sep, 128 (Pt 9), 2105 - 11
Biochemical comparison of pili from variants of Neisseria gonorrhoeae P9; Lambden PR; Four different types of pili produced by variants of Neisseria gonorrhoeae P9 were isolated and characterized . The pili differed in subunit molecular weight with SDS-PAGE and in subunit isoelectric point on agarose gels . Isoelectric points of the major molecular species in Triton-agarose gels of octylglucoside solubilized pili were: delta, pI 6.5; alpha, pI 6.0; beta, pI 5.3 and gamma, pI 5.5 . Amino acid analyses of pili showed close homology between different types but a reduction in the content of aspartate and serine was notable in the low molecular weight delta pili; also beta and gamma maps of tryptic/chymotryptic digests of pili with several major peptides apparently common to all four pilus types.

Pediatrics, 1982 Aug, 70(2), 193 - 8
Vulvovaginitis in premenarcheal girls: clinical features and diagnostic evaluation; Paradise JE et al.; Fifty-four premenarcheal patients (median age 5.8 years) with symptoms or signs of vulvovaginitis were studied, and the results of cultures of vaginal secretions were compared with those from an age-matched control group . Vaginal discharge was found on examination in 24 of 42 patients with a complaint of discharge, and in two of 12 patients without a complaint of discharge . Convincing evidence of bacterial or monilial infection was found in 14 of the 26 patients with discharge on examination, but in none of the 28 patients without discharge (P less than .001) . In the latter group pinworm infestation was present in one patient . Moniliasis occurred exclusively in girls who were pubertal (P less than .001) . Four patients were found to have gonorrhea . No patient appeared to have symptoms or signs caused by Bacteroides sp, Chlamydia trachomatis, viruses, or Trichomonas vaginalis . Noninfectious causes were identified in four patients with and 13 without discharge (P less than .025); the most common cause was poor hygiene, implicated in six patients . Bubble bath use was implicated in only one patient . In 22 patients, no specific cause could be identified . All patients with poor hygiene as the only cause, and most with no demonstrable etiology, recovered after being advised to institute improved perineal hygiene . Patients with vaginal discharge are likely to have specific infections, and therefore cultures should be taken, in particular for Neisseria gonorrhoeae . Genital pruritus in prepubertal girls has little or no etiologic specificity, but in pubertal girls with vaginal discharge it suggests the presence of monilial vaginitis.

Clin Pediatr (Phila), 1982 Aug, 21(8), 460 - 2
Changes in aerobic pharyngeal flora related to antibiotic use and the emergence of gram-negative bacilli; Yoshioka H et al.; Pharyngeal flora were evaluated semi-quantitatively by counting and differentiating the colonies growing on blood agar plates into four major bacterial groups . In children they consisted mainly of alpha-streptococci, followed by smaller portions of Neisseria, and of gram-positive organisms other than alpha-streptococci . Gram-negative bacilli did not occur under normal conditions . Oral ampicillin in a daily dose of 50 mg/kg caused suppression of the alpha-streptococci, and promoted emergence of gram-negative bacilli . Oral cephalexin in the same dose caused changes in the same direction, but less extensively than ampicillin . Parenteral aminoglycoside antibiotics in usual dosage did not change the pharyngeal flora . Differential counting of the growth is a simple and useful tool to evaluate the ecology of pharyngeal flora . It serves to monitor overgrowth of resistant organisms in the respiratory tract.

J Periodontol, 1982 Aug, 53(8), 502 - 8
Inhibition of neutrophil chemotaxis by soluble bacterial products; Van Dyke TE et al.; BACTERIAL-NEUTROPHIL INTERACTIONS may be critical determinants of virulence in periodontal diseases . This study was undertaken to examine the ability of major bacterial species from the human oral cavity to inhibit (1) peripheral blood neutrophil chemotaxis, (2) chemotactic formylmethionyl peptide binding, and (3) phagocytosis . Included were cultured supernatants and sonic extracts obtained from strains of Capnocytophaga, Bacteroides gingivalis, Fusobacterium nucleatum, Bacteroides asaccharolyticus, Capnocytophaga species, Actinobacillus actinomycetemcomitans, Neisseria, Actinomyces viscosus, Bacterionema matruchotii, Streptococcus mitis, Streptococcus mutans, and Streptococcus sanguis . Chemotaxis was measured using Boyden chambers; phagocytosis was determined using Staphylococcus aureus as the indicator organism and radioactive chemotactic peptide binding was assessed by a rapid filtration assay . None of the test organisms were cytotoxic to neutrophils or inhibited neutrophil phagocytosis . Capnocytophaga species., Bacteroides species., A . actinomycetemcomitans, and F . nucleatum produced factors which specifically inhibited neutrophil chemotaxis . Activity was lost after dialysis . Extracts of Bacteroides species, A . actinomycetemcomitans and F . nucleatum, which were not chemotactic by themselves, inhibited binding of chemotactic peptide suggesting that in vitro chemotaxis inhibition was mediated by nonchemotactic components that compete for the chemotactic factor receptor on the neutrophil . The exception was Capnocytophaga which appeared to inhibit chemotaxis by inhibition of a post-binding event . Such chemotactic inhibitors from periodontopathic organisms that inhibit neutrophil function may be important determinants of virulence.

Bull Soc Pathol Exot Filiales, 1982 Aug-Oct, 75(4), 352 - 9
{Auxotyping and sensitivity to 5 antibiotics of Neisseria gonorrhoeae strains isolated in the Central African Republic 1980 and 1981}; Georges AJ et al.; Auxotyping of 113 gonococcal strains isolated in Bangui (Central African Republic) demonstrated a majority of type "+" and type "PRO-" with an equal repartition between these two types (54 and 56) . The study of the sensitivity to 5 antibiotics was realized with 74 strains . It was shown an increasing resistance to penicillins . One strain was a penicillinase producing Neisseria gonorrhoeae (PPNG).

J Med Microbiol, 1982 Aug, 15(3), 327 - 30
Epidemiological value of lipopolysaccharide and heat-modifiable outer-membrane protein serotyping of group-A strains of Neisseria meningitidis; Griffiss JM; The lipopolysaccharide (LPS) and heat-modifiable outer-membrane protein (P') serotypes of 39 coded strains of group-A Neisseria meningitidis isolated from patients during seven geographically and temporally separate outbreaks of infection were determined blindly . LPS serotype discriminated between strains from different outbreaks and between strains of differing sulphadiazine sensitivity within a single outbreak . Thirty-seven strains were of three separate serotypes and no strain was of multiple serotypes . In contrast, P' serotypes did not discriminate between strains . Multiple serotypes for single strains and among strains from a single outbreak were the rule . LPS serotyping appears to be a useful epidemiological tool for distinguishing group-A strains of N . meningitidis.

Infect Immun, 1982 Aug, 37(2), 826 - 9
Strain-related differences in lysozyme sensitivity and extent of O-acetylation of gonococcal peptidoglycan; Rosenthal RS et al.; Peptidoglycan from Neisseria gonorrhoeae RD5 was completely degraded by hen egg white lysozyme and was not extensively O-acetylated . In contrast, peptidoglycans from gonococcal strains FA19 and FA102 (a penicillin-resistant mutant derived from FA19), were markedly resistant to digestion by hen egg white lysozyme and were extensively O-acetylated.

Infect Immun, 1982 Aug, 37(2), 632 - 41
Surface peptide mapping of protein I and protein III of four strains of Neisseria gonorrhoeae; Judd RC; Whole cells and isolated outer membranes (OMs) of four strains of gonococci were surface radioiodinated with either lactoperoxidase or Iodogen (Pierce Chemical Co., Rockford, Ill.) . These preparations were solubilized in sodium dodecyl sulfate and subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis . Surface-radioiodinated protein I (PI) and PIII bands were excised from the sodium dodecyl sulfate-polyacrylamide gel electrophoresis gels and digested with alpha-chymotrypsin, and the resultant 125I-peptide fragments were resolved by high-voltage electrophoresis and thin-layer chromatography (i.e., surface peptide mapping) . Radioemitting peptidic fragments were visualized by autoradiography . Results demonstrated that the PI molecule of each gonococcal strain studied had unique iodinatable peptides exposed on the surface of whole cells and OMs, whereas PIIIs appeared to have the same portion of the molecule exposed on the surface of bacteria or OMs, regardless of the gonococcal strain from which they were isolated . Many more radiolabeled peptides were seen in surface peptide maps of PIs from radiolabeled OMs than in those from radioiodinated whole cells, whereas different peptidic fragments were seen in the surface peptide maps of PIIIs from radiolabeled OMs than were seen in those from radiolabeled whole cells . These data suggest that PI may contribute strain-specific antigenic determinants and PIII may contribute cross-reactive determinants and that the surface exposure of PI and PIII is different in isolated OMs than in the OM of intact gonococci.

Infect Immun, 1982 Aug, 37(2), 622 - 31
125I-peptide mapping of protein III isolated from four strains of Neisseria gonorrhoeae; Judd RC; Gonococcal outer-membrane protein I (PI) and PIII were isolated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis from reduced and unreduced whole-cell and outer-membrane lysates of four strains of nonpiliated (P-), transparent (O-) Neisseria gonorrhoeae . These proteins were radioiodinated and digested with alpha-chymotrypsin . The resultant 125I-peptides were then resolved by high-voltage thin-layer electrophoresis, followed by ascending thin-layer chromatography, and visualized by autoradiography . Results corroborated previous observations regarding the structural relationships of PIs having different apparent subunit molecular weights . All PIIIs had very similar apparent primary structures, regardless of the strain from which they were isolated, the source (i.e., whole cells or outer membranes), or the reduction state of the sodium dodecyl sulfate lysates . By the techniques used, it appeared that PIII is structurally similar in all of the gonococcal strains studied, even though each strain had structurally unique PIs.

Infect Immun, 1982 Aug, 37(2), 469 - 73
Characterization of the immune response in subcutaneous chambers of guinea pigs immunized with a ribosomal preparation from Neisseria gonorrhoeae; Wannemuehler MJ et al.; Immunization of guinea pigs with ribosomal preparations has been previously shown to be protective against chamber infection with Neisseria gonorrhoeae, and this protection could be correlated with the presence of serum bactericidal antibody . Analysis of the chamber fluids from ribosome-immunized and nonimmunized guinea pigs has demonstrated that the chamber fluid may accurately reflect serum antibody levels and proteins . At least one major population of antiribosomal antibodies is present in both immune serum and chamber fluid as revealed by lines of identity between these components . Antibody- and complement-mediated bactericidal assays revealed that matched chamber fluids and sera from immune animals had comparable bactericidal titers . These results suggest that the antibody-complement-mediated bactericidal activity plays a major role in the protection against N . gonorrhoeae infection . Protection could not be explained on the basis of the cellular components of the inflammatory response since both immune and nonimmune chambers had comparable increases in polymorphonuclear neutrophils, monocytes, and lymphocytes after challenge.

J Infect Dis, 1982 Aug, 146(2), 284 - 8
Increase in titers of antibodies to Mycoplasma pneumoniae in patients with purulent meningitis; Kleemola M et al.; A fourfold or greater increase in titer of complement-fixing (CF) antibodies to Mycoplasma pneumoniae was found in 40.7% of paired sera from 54 patients with bacterial meningitis that had been proven by culture and in 10.3% of 39 patients with other bacteremic infections, but in none of eight patients with whooping cough or 40 patients with mumps meningitis . The CF antigen used was a crude lipid antigen, but comparable antibody increases were found by an enzyme-linked immunosorbent assay using a crude M . pneumoniae protein antigen . Increases were also frequently seen in nonspecific antibodies to the capsular polysaccharide of group A Neisseria meningitidis; these increases were significantly, but not completely, correlated to the nonspecific reactions to the mycoplasmal antigens . The data call for caution in interpreting serologic tests for M . pneumoniae when dealing with diseases not commonly associated with M . pneumoniae.

J Immunol, 1982 Aug, 129(2), 829 - 32
Immune response of the mouse to gram-negative bacterial outer membrane extracts as assessed with monoclonal antibodies; Mackie EB et al.; Neisseria meningitidis outer membrane extracts of known serotype antigens as well as isolates from a linear carriage study were used to immunize mice for subsequent production of monoclonal antibodies . As well, membrane extracts from one strain of Pseudomonas aeruginosa, serotype M, were used . The degree of specificity of the resulting monoclonal antibodies to the two genera differed markedly when tested with known serotype antigens . That is, antibody from a given clone reacting with more than one serotype specificity was a more frequent occurrence among clones resulting from the Pseudomonas fusion . Preexisting "natural" antibody to several Pseudomonas species is considered at least partially responsible for the diversity of the response to this genus . Evidence is presented for the divergence of specificity with time after immunization with Neisseria.

Br J Vener Dis, 1982 Aug, 58(4), 228 - 30
Comparative in-vitro activity of selected new beta-lactam antimicrobials against Neisseria gonorrhoeae; Khan MY et al.; Four new beta-lactam antimicrobials, ceftriaxone, cefotiam, cefonicid, and mecillinam, were evaluated in vitro against 72 beta-lactamase-negative and 26 beta-lactamase-positive isolates of Neisseria gonorrhoeae . Ceftriaxone was the most active of the antimicrobials tested . It inhibited all isolates, regardless of beta-lactamase activity, at a concentration of less than or equal to 0.015 microgram/ml . Cefotiam and cefonicid were also active against both groups but not as active as ceftriaxone . Both groups of N gonorrhoeae showed a high degree of resistance against mecillinam.

Br J Vener Dis, 1982 Aug, 58(4), 231 - 5
Treatment of uncomplicated gonorrhoea in women . Comparison of rosoxacin and spectinomycin; Calubiran OV et al.; A comparative study of the new antibacterial agent, rosoxacin, a quinoline derivative, with spectinomycin was made in women with uncomplicated cervical, urethral, pharyngeal, and rectal gonorrhoea . Rosoxacin was given in three oral regimens: 200 mg in a single dose, 300 mg in a single dose, and 300 mg in two doses of 150 mg four hours apart . All culture results 72 hours after administration were negative for Neisseria gonorrhoeae in all 81 women compared with 107 of 109 who received 2 g spectinomycin intramuscularly . Thirty-five of the women successfully treated with rosoxacin harboured penicillinase-producing strains of N gonorrhoeae (PPNG) and 46 non-penicillinase-producing (non-PPNG) strains . Fifty of the women treated with spectinomycin had PPNG strains and 59 non-PPNG strains . Mild self-limiting side effects, principally dizziness, occurred in varying frequency with rosoxacin, but these were difficult to evaluate owing to the characteristics of the patient population and the conditions under which the study was conducted.

Cell, 1982 Aug, 30(1), 45 - 52
Pilus expression in Neisseria gonorrhoeae involves chromosomal rearrangement; Meyer TF et al.; The Neisseria gonorrhoeae pilus protein is one of the major antigenic determinants on the cell's surface . It is comprised of identical subunits of approximately 18 kd and plays a role in the infectivity and virulence of the organism . We have cloned the gene encoding a gonococcal pilus protein into Escherichia coli, and, using one of these clones as a probe in hybridization studies, we have shown that conversion of the pilus positive to pilus negative state in N . gonorrhoeae involves chromosomal rearrangement . Although the pilus protein is produced by E . coli, it does not appear to be assembled on the surface of the cell in native form.

Infect Immun, 1982 Aug, 37(2), 481 - 5
Rates in vitro changes of gonococcal colony opacity phenotypes; Mayer LW; The rate of change of colony opacity phenotype was determined for 12 strains of Neisseria gonorrhoeae . The average rate of change was about 2 X 10(-3) per colony-forming unit per generation with a range of 0.2 X 10(-3) to 4 X 10(-3) per colony-forming unit per generation . Transition from opaque to transparent occurred at the same rate as transition from transparent to opaque . The following factors were shown to have no effect on the transition rate: (i) the state of piliation; (ii) the number of passages as a particular phenotype; (iii) alteration in the temperature, pH, or amount of oxygen in the atmosphere during growth; (iv) the addition of any of 194 compounds or mixtures to the growth media; (v) the addition of DNase or of DNA from opaque or transparent gonococci; and (vi) incubation between the opacity-transparency transition and the change resulting in the loss of piliation was seen . Some implications of the high transition rate are discussed.

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