Can J Microbiol, 1981 Jan, 27(1), 76 - 80 Cell-mediated immune response in gonococcal infection; Landolfo PJ et al.; A peripheral leukocyte migration inhibition test has been used to demonstrate cellular immunity to a protein component of Neisseria gonorrhoeae . Human leukocytes served as effector cells in an agarose method to distinguish antigen-sensitive from nonsensitive individuals . Leukocytes, preincubated with antigen, were placed in wells in medium 199 agarose . After 18 h of incubation the migration index was calculated by dividing the area of migration of cells preincubated with antigen by the area of migration of the control cells . Significant migration inhibition was demonstrated for 16 of the 30 patients with uncomplicated gonorrhoea . Maximum inhibition was obtained 7-10 days following the onset of symptoms and the duration of the response varied from 14 to more than 40 days . There was a statistically significant positive correlation between the number of previous infections and migration inhibition . A control group, which included individuals with Neisseria meningitidis infection, showed an insignificant response to this gonococcal antigen . Although these results indicate the presence of cell-mediated immunity, the significance of this response in the protection of the host or in the pathogenesis of gonococcal disease has yet to be determined. Am J Obstet Gynecol, 1980 Dec 1, 138(7 Pt 2), 996 - 1002 In vitro modeling of acute salpingitis caused by Neisseria gonorrhoeae; Draper DL et al.; Normal human fallopian tube organ culture was used as an in vitro model to study Neisseria gonorrhoeae infections . The effects of various gonococcal colony phenotypes on morphology of the epithelium were studied by scanning electron microscopy . After 30 minutes' incubation, there was striking attachment of piliated transparent phenotypes to the epithelium; however, there was no obvious pathology . After 24 hours' incubation, there were microcolony formation, slight swelling and hyperplasia of the mucosa, and occasional focal necrosis and sloughing of ciliated cells . Tissue from acute salpingitis showed widespread destruction of mucosa, hyperplasia, and crypt formation . Duplication of these findings in vitro may require longer incubation and the addition of other host factors. Am J Obstet Gynecol, 1980 Dec 1, 138(7 Pt 2), 965 - 8 Gonococcal infection in women with pelvic inflammatory disease in Lusaka, Zambia; Ratnam AV et al.; PIP: The rate of gonococcal infection among PID (pelvic inflammatory disease) patients admitted to the University Teaching Hospital in Lusaka, Zambia was assessed and found to be high . 100 women were selected for study from among the 812 PID patients admitted to the hospital over a 6 month period . Women who were pregnant, who recently delivered or had an abortion, who recently underwent gynecological surgery, who had received antibiotic treatment for their current episode of PID were excluded from the study . Endocervical smears and cultures were examined for the presence of Neisseria gonorrhoeae . 46% of the 100 patients had gonococcal infections . Since the cultures usually fail to detect all cases of gonococcal infection, the prevalence of gonorrhea among PID patients was probably somewhat higher than the findings indicated . Women with gonococcal PID, when compared to the nongonococcal PID patients tended to be younger and to have more severe PID and a history of 2 or more previous episodes of PID . The gonococcal and nongonococcal PID patients did not differ in marital status and in the number of sexual partners they had . Given the high incidence of gonococcal infection among PID patients in Lusaka, the recommendation was made that PID patients should routinely be treated with an antibiotic regimen of sufficient strength to counter gonococcal infection . Study findings were presented in tabular form . Am J Obstet Gynecol, 1980 Dec 1, 138(7 Pt 2), 1064 - 70 Surveillance, prevention, and control of sexually transmitted agents associated with pelvic inflammatory disease; Meheus AZ; Control and prevention of pelvic inflammatory disease would result from successful control of Neisseria gonorrhoeae and genital Chlamydia trachomatis infections . The same control system applies to both, but while this system is well documented in gonorrhea control, there is still no evidence that it is effective for C . trachomatis infections . Primary prevention of PID should be realized through a reduction of the incidence of gonorrhea, and the available techniques--(1) contact tracing and epidemiologic treatment, (2) screening and case finding, (3) preventive measures, (4) health education, and (5) training of the health workers--are discussed . Secondary prevention of PID can be achieved through good management of uncomplicated infections due to N . gonorrhoeae and C . trachomatis . The approach must be adapted to local conditions and should be different in developing countries with a specialized health care system for sexually transmitted disease . Good management of PID is crucial in preventing sequelae and most important are tracing and treating the male contacts of patients with PID . Measures of tertiary prevention attempt to rehabilitate the patient; the main sequelae after PID are ectopic pregnancy and infertility . Surgical techniques can restore tubal function, but these methods are complicated and have a low success rate. Am J Obstet Gynecol, 1980 Dec 1, 138(7 Pt 2), 1026 - 7 Clinical aspects of acute pelvic inflammatory disease: Cook County Hospital; Cooperman NR et al.; PIP: Cook County Hospital records were reviewed of 134 consecutive patients hospitalized for acute pelvic inflammatory disease (PID) unrelated to IUDs, delivery, or pelvic surgery . Nearly 1/2 of the patients had peritonitis or a pelvic mass and most were young or nulliparous . Neisseria gonorrhoea was recovered from the endocervices of 41 (34%) of the 120 patients and was more common among younger patients . Most patients responded to antibiotic therapy; consequently, we recommend antibiotic treatment for acute PID unless surgical emergencies cannot be excluded or patients do not improve with antibiotic therapy alone . author's modified Trop Geogr Med, 1980 Dec, 32(4), 329 - 32 Asymptomatic gonorrhoea in women attending family planning clinics in Dar es Salaam, Tanzania . Results of a pilot study; Mandara NA et al.; PIP: The authors assessed the prevalence of asymptomatic gonorrhea in Tanzanian urbran women attending family planning clinics . A random sample of 405 women attending these clinics between July and November 1978 had cervical swabs taken . Of this group, 341 were attending for family spacing and 64 were attending for treatment of infertility . 29 (7.1%) of the 405 women had Neisseria gonorrhea isolated from the cervical swabs; of the 341 there for family spacing, 26 (7.6%) had positive cultures while 3 (4.7%) of those attending for infertility were positive for gonorrhea . When screening took place, 41% of those with gonorrhea had vaginal discharge and/or cervical erosion . All of the women attending for family spacing were taking the pill and had been using some form of contraception for between 1 month and 9 years . 20 (69%) of the positive cases returned for results and were treated with penicillin . However, ohly 4 of the treated women who reurned for treatment were able to convince their male partners of the need to submit to treatment . Statistics show that gonorrhea is an increasing health problem; in Tanzania alone, over 150,000 cases were reported to the Ministry of Health in 1969 . Furthermore, it has been estimated that 10-20% of women infected with N . gonorrhea develop salpingitis . The best place to screen women when they are most likely to harbor a positive culture is at the family planning clinic or maternal-child health clinic . If screening were conducted at such clinics and assuming that the prevalence rate of asymptomatic gonorrhea is 7%, about 50,000 cases of asymptomatic gonorrhea could be detected at a cost of 7.2 million Tanzanian shillings . Treatment of infected women and men would cost much more but the ultimate savings would be enormous . Several recommendations were made based on this pilot study . Sexually transmitted diseases should be among those diseases given improved facilities, new methods of contact tracing should be developed, health education campaigns should be organized and laboratory facilities should be developed . Am J Obstet Gynecol, 1980 Dec 1, 138(7 Pt 2), 848 - 51 Economic consequences of pelvic inflammatory disease in the United States; Curran JW; Pelvic inflammatory disease is the most common serious complication of sexually transmitted infections caused by Neisseria gonorrhoeae and Chlamydia trachomatis . Initial episodes of sexually transmitted acute PID occur most frequently in the 20 to 24 year age group, while sequelae such as infertility, ectopic pregnancy, and chronic PID are most common among 25- to 34-year-old women . The apparent chronicity of the disease process suggests that the epidemic of sexually transmitted disease, which began in the mid-1960s, could be followed by an epidemic of PID and its sequelae . More than 850,000 episodes of PID occur annually, requiring more than 212,000 hospital admissions, 115,000 surgical procedures, and 2,500,000 physician visits . Ectopic pregnancies in the United States tripled from 1967 to 1977 . Direct and indirect costs for PID and PID-associated ectopic pregnancy exceeded $1.25 billion in 1979 . If PID and ectopic pregnancy rates continue unabated, by the year 2000 there will have been more than one episode of PID and three related physician visits for every two women who reached reproductive age in 1970 . Fifteen percent will require hospitalization, more than 3% will experience an ectopic pregnancy, and more than 10% will involuntarily become sterile because of PID. Am J Obstet Gynecol, 1980 Dec 1, 138(7 Pt 2), 1096 - 100 Problems and approaches to the control and surveillance of sexually transmitted agents associated with pelvic inflammatory disease in the United States; Brown ST et al.; PIP: The initial objectives of the national gonorrhea control program begun in 1972 were to reduce disease incidence and the resistance of gonococci to antibiotics . To reduce disease incidence the goal was to identify asymptomatic or unrecognized disease in women . To reduce the resistance of gonococci to antibiotics an attempt was made to minimize the use of ineffective treatments which favored the relatively resistant organisms . National gonorrhea treatment recommendations were made in 1972 and widespread use of them was promoted . By 1975 all state and local health departments had implemented a gonorrhea screening program which obtained 9.0 million cultures per year . Broad participation was encouraged to identify the maximum number of infected women, to increase provider recognition of gonorrhea, and to identify the most important providers . Laboratory, logistic, and training support was organized to ensure that the culture screening efforts were effective . Contact tracing interviews with infected men were used to identify asymptomatic women . The interview field investigation model used was that developed for syphilis . Public education was implemented to create an awareness of and support for the gonorrhea control program . The reporting of gonorrhea cases remained the primary surveillance mechanism . During the 2nd or transmitter phase, experience and theoretical consideration, which emphasized the increased importance of some disease transmitters, led to program changes . Efforts to identify patients in whom treatment failed and to limit the spread of their organisms received additional attention when penicillin producing Neisseria gonorrhoea (PPNG) was recognized . In many areas screening was targeted increasingly at patients who attended high priority providers and who attended for tests of cure and repeat testing 6-12 weeks after treatment . Patient counseling efforts began to change as many programs sought to implement tests of cure and rescreening . Clinic services received increasing attention during this period . Education efforts were directed increasingly at clinic patients and at high risk groups . In the present phase, program experiences, special studies, and analyses of national data clarified the public health importance of gonococcal pelvic inflammatory disease . Thus, program objectives were expanded to include limitation of the incidence and consequences of PID . Studies conducted in hospital emergency rooms by several programs demonstrated the feasibility of identifying women with PID, ensuring appropriate management of such women, identifying many previously untreated sexual partners . Efforts to increase the effectiveness of the gonorrhea screening program continue, but major emphasis is now placed on improved and expanded screening in hospital outpatient departments . Education efforts currently focus on providers in clinics, emergency rooms, professional schools, and private practice . Am J Obstet Gynecol, 1980 Dec 1, 138(7 Pt 2), 1042 - 7 The treatment of pelvic inflammatory disease; Rees E; The treatment of pelvic inflammatory disease depends upon the etiology of the condition . Pelvic infection (PI) after parturition and abortion, gynecologic surgery, and a variety of invasive procedures is commonly associated with the isolation of anaerobic and aerobic flora of the vagina . The factors which influence the choice of antimicrobial treatment and the role of Bacteroides fragilis and Escherichia coli are discussed . Sexually transmissible agents of importance are Neisseria gonorrhoeae and Chlamydia trachomatis . Pelvic infections associated with these pathogens require antibiotics which exert an optimum effect against them . Examination and treatment of the sexual partner(s) are important . The possible role of the anaerobic and aerobic vaginal flora as opportunistic secondary pathogens is discussed . Developments in the surgical treatment of the sequelae of PID are reviewed . The results of treatment of uncomplicated gonorrhea in 262 women are reported . C . trachomatis was isolated from 53% of women before treatment . After treatment, PI developed in 11 women who had been given penicillin and in one woman who had been given tetracycline (P = 0.0071) . It is suggested that recognition and treatment of postgonococcal cervicitis in women treated for uncomplicated gonorrhea with penicillin might provide one form of preventive treatment for nongonococcal PI. J Clin Microbiol, 1980 Dec, 12(6), 748 - 52 Comparison of modified New York City medium with Martin-Lewis Medium for recovery of Neisseria gonorrhoeae from clinical specimens; Granato PA et al.; A modified formulation of New York City medium was comparatively evaluated with Martin-Lewis medium for the recovery of Neisseria gonorrhoeae from clinical specimens . A total of 240 strains of gonococci were recovered from 1,250 specimens collected from walk-in patients attending a sexually transmitted disease clinic . N . gonorrhoeae was cultivated on both of these media from 182 clinical specimens with an additional 58 gonococcal strains isolated on either of the media . Of these discrepant gonococcal isolates, 27 strains were recovered on only modified New York City medium, whereas the remaining 31 strains were recovered on only Martin-Lewis agar . The differences in these isolation rates were not statistically significant . The overall results showed that modified New York City and Martin-Lewis media were comparable in their ability to grow gonococci from clinical material . Since modified New York City medium is capable of supporting the growth of N . gonorrhoeae, Mycoplasma pneumoniae, and urogenital mycoplasmas and inhibiting the growth of commensal microorganisms, it is possible that it may have considerable application as a multifunctional plating medium within the clinical laboratory. Acta Pathol Microbiol Scand {B}, 1980 Dec, 88(6), 311 - 5 An in vitro evaluation of two commercial blood culture media--supplemented peptone broth and supplemented tryptone soya broth; Sandven P et al.; Two commercial blood culture--supplemented peptone broth and supplemented tryptone soya broth--were compared by an in vitro method . The two media were inoculated with microorganisms suspended in fresh human blood in an attempt to mimic the clinical situation . The two media differed completely in their ability to support the growth of Neisseria meningitidis and Neisseria gonorrhoeae . Macroscopic evaluation of the blood culture medium during the incubation period was difficult when using supplemented tryptone soya broth in contrast to supplemented peptone broth . The former medium remained turbid whether microorganisms were growing or not . No other important differences between the two media were detected . Our findings indicate a need for both in vitro and in vivo studies to evaluate blood culture media and also a need for quality control of microbiological diagnostic devices before they are released for clinical use. Am J Obstet Gynecol, 1980 Dec 1, 138(7 Pt 2), 978 - 80 Gonococcal salpingitis is less likely to recur with Neisseria gonorrhoeae of the same principal outer membrane protein antigenic type; Buchanan TM et al.; If protective immunity were to develop following an episode of gonococcal pelvic inflammatory disease (salpingitis), PID should recur with organisms bearing antigens that do not react with these immune mechanisms . To test this hypothesis, gonococci from 15 women with gonococcal PID, who experienced 19 subsequent episodes of gonococcal infection, were serotyped for their principal outer membrane protein (Protein I) antigens . Of nine cases in which the initial and subsequent infections involved the same Protein I serotype, none was associated with recurrence of PID . Of 10 cases in which the initial and subsequent infections involved different Protein I types, five were associated with recurrent PID (p = 0.02) . These data suggest that an episode of gonococcal PID produces some immunity to repeated episodes of salpingitis with the same Protein I serotype, while not preventing reinfection with the same Protein I serotype . The immune response to Protein I antigen may thus provide serotype-specific protection against gonococcal salpingitis. Am J Obstet Gynecol, 1980 Dec 1, 138(7 Pt 2), 909 - 12 Pelvic inflammatory disease among women presenting to emergency rooms of hospitals in Massachusetts; O'Hare PA et al.; We obtained reports prospectively from the emergency rooms of 24 hospitals for 1 year . Nine percent of 3,505 women examined for genital infection with Neisseria gonorrhoeae were infected with this organism . Two thirds of the infected women had gonococcal pelvic inflammatory disease . The ratio of gonococcal PID to nongonococcal PID was 1:4.6 N . gonorrhoeae was isolated from 20% of women with PID in cities where the rate of all reported gonococcal infection was higher than the rate for the entire state (200 per 100,000 population) . In contrast N . gonorrhoeae was isolated from only 13.4% of women with PID in cities with gonococcal infection rates lower than the rate for the state as a whole (p less than 0.01). Am J Obstet Gynecol, 1980 Dec 1, 138(7 Pt 2), 1071 - 7 Problems in the surveillance and control of sexually transmitted agents associated with pelvic inflammatory disease in the Far East; Rajan VS; Little published data are available on pelvic inflammatory disease in the Far East . Measures available to control gonorrhea in the region are reviewed . The rising incidence of penicillinase-producing Neisseria gonorrhoeae in Singapore and the Far East and its implications concerning the pathogenesis of PID are discussed. Am J Obstet Gynecol, 1980 Dec 1, 138(7 Pt 2), 1034 - 8 Chlamydia trachomatis infection in Fitz-Hugh-Curtis syndrome; Wang SP et al.; We studied 23 patients with pelvic inflammatory disease associated with symptoms of pleuritic up'per abdominal pain, characteristic of Fitz-Hugh-Curtis syndrome (FHC) . A fourfold or greater change in antibody titer to Chlamydia trachomatis was demonstrated by microimmunofluorescence in 14; an IgG antibody titer greater than or equal to 1:1,024 was seen in 13; and IgM antibody was demonstrated in 11 . Twenty (87%) of the 23 FHC patients, including all of the 12 with paired sera obtained at least 6 weeks apart, had serologic evidence of acute C . trachomatis infection . Neisseria gonorrhoeae was isolated from seven (30%) of the 23 FHC cases, and C . trachomatis was isolated from three of 10 . Two groups of matched controls were studied; one group with PID but without FHC, and the other without PID . A larger proportion of patients with FHC had serologic evidence of acute C . trachomatis infection than either of the two control groups (p less than 0.05 for each comparison) . Among those with antibody to C . trachomatis, the geometric mean antibody titer for the FHC group (1:724) was significantly higher than that for the PID group (1:138) or for the non-PID group (1:103) . Thus, FHC is not solely attributable to infection with N . gonorrhoeae; most cases are associated with acute C . trachomatis infection. Br J Vener Dis, 1980 Dec, 56(6), 394 - 6 Gentamicin in the treatment of infections due to penicillinase-producing gonococci; Tan NJ et al.; Ninety-seven patients with infections due to penicillinase-producing Neisseria gonorrhoeae (PPNG) were treated with single doses of gentamicin 280 mg intramuscularly . The failure rate among those followed up was 3% . No significant side effects were recorded . Gentamicin is a valuable alternative in the treatment of infections due to PPNG strains. Obstet Gynecol, 1980 Dec, 56(6), 671 - 5 Genital Chlamydia trachomatis infection in women; Johannisson G et al.; Specimens for isolation of Neisseria gonorrhoeae, Chlamydia trachomatis, Candida albicans, and Trichomonas vaginalis were collected from 585 women attending clinics for venereal diseases . The isolation rates in women attending clinics for venereal diseases . The isolation rates in women with and without genitourinary symptoms, the course of untreated chlamydial infection, the occurrence of chlamydial urethritis, and the response to antibiotic treatment were investigated . A 30% incidence of chlamydial amd gonococcal infection was observed . In most cases the gonococcal infection affected both the cervix and the urethra, whereas the chlamydial infection was restricted to either the cervix or the urethra . Sampling of secretions from the urethra revealed chlamydial infections (15%) that otherwise would have remained undetected . In untreated cases chlamydiae persisted for at least 6 weeks . Bacteriologically, chlamydial infections responded equally well to doxycycline, erythromycin, and a combination of trimethoprim and sulfamethoxazole . however, symptoms persisted in 34% of the women. Am J Obstet Gynecol, 1980 Dec 1, 138(7 Pt 2), 985 - 9 Microbiology and pathogenesis of acute salpingitis as determined by laparoscopy: what is the appropriate site to sample? Sweet RL, Draper DL, Schachter J, James J, Hadley WK, Brooks GF. Acute salpingitis is a polymicrobial disease . Neisseria gonorrhoeae and anaerobic gram-positive cocci were the predominant microorganisms isolated from the fallopian tubes of salpingitis patients . Gonococci were isolated from the fallopian tubes in eight of 35 (23%) patients; anaerobic bacteria were recovered from 10 of 35 (28.5%) . Although Chlamydia trachomatis was not recovered from the fallopian tube exudate, there was abundant serologic evidence of chlamydial infection in the salpingitis patients . Twenty-three percent of patients with paired sera had a fourfold rise in IgM and IgG titer, which was consistent with systemic chlamydial infection . Comparison of cultures obtained via laparoscopy and culdocentesis suggested that culdocentesis is not an accurate reflection of the microbial milieu in the fallopian tube. Am J Obstet Gynecol, 1980 Dec 1, 138(7 Pt 2), 960 - 4 Chlamydia trachomatis infection in patients with laparoscopically verified acute salpingitis . Results of isolation and antibody determinations; Ripa KT et al.; Culture and serology studies have shown Chlamydia trachomatis (CT) to be one of the causes of acute salpingitis (AS) . In the present investigation, results of cervical cultures were correlated with serum antibody titers to CT in patients with laparoscopically verified AS . Serum samples from 206 patients, including paired sera from 80, were assayed . Of 206 patients, 118 had chlamydial IgG antibody titers of 1:64 or more . Patients with negative cultures for CT and an IgG titer of 1:64 or more had a significantly higher geometric mean titer than corresponding patients with positive cultures . In paired sera, a seroconversion or a fourfold or greater rise in IgG titer to CT was demonstrated in 35%, while a further 11% had detectable IgM antibody in a titer of 1:8 or more . The overall isolation frequency of CT was 33%, compared with 19% for Neisseria gonorrhoeae. Acta Pathol Microbiol Scand {B}, 1980 Dec, 88(6), 329 - 34 Characteristics of antisera against periodate-resistant membrane antigens from Neisseria gonorrhoeae; Roe SF et al.; Crude outer membrane (OM) was prepared by extraction of bacteria of the Neisseria gonorrhoeae strains 8551 . V, and VII, with an EDTA-containing buffer . The preparations contained the lipopolysaccharide (LPS) and at least 10 proteins as shown by SDS-polyacrylamide gel electrophoresis . Immunization of rabbits with untreated OM resulted in production of antibodies against several antigens, including LPS . Antisera raised against periodate-treated OM did not contain antibodies against LPS . These latter antisera agglutinated heat-treated (100 degrees C, 60 min) gonoccal cells by means of antibodies to one or more common agglutinogens and against a strain-specific agglutinogen that was susceptible to digestion with proteolytic enzymes . Both side agglutination and a plate agglutination test could be used to detect antibodies against these agglutinogens. J Gen Microbiol, 1980 Dec, 121(Pt . 2), 365 - 72 Immune-enhanced phagocytosis of Neisseria gonorrhoeae by macrophages: characterization of the major antigens to which opsonins are directed; Jones RB et al.; antisera were prepared in rabbits against whole organisms of colony type 1 Neisseria gonorrhoeae strains F62 and B (fron gonococcal urethritis) and 7122 (a strain typical of those associated with disseminated gonococcal infection), and against purified outer membrane components from the same strains including pili and principal outer membrane protein . Antibody levels to pili, principal outer membrane protein and lipopolysaccharide were determined using a quantitative enzyme-linked immunosorbent assay . Each antiserum was heat-inactivated and tested for opsonic for its homologous strain, and this immune-enhanced phagocytosis was decreased by adsorption with homologous purified outer membrane components: pili greater than lipopolysaccharide greater than principal outer membrane protein . Opsonic activity was approximately equal for antiserum to purified pili and antiserum to the whole organisms for each of the three strains, and purified antibody to pili was highly opsonic . The F(ab')2 fragments of antibody to pili were not opsonic, indicating a role for the Fc receptor on the phagocyte membrane in immune-enhanced phagocytosis of gonococci. Am J Obstet Gynecol, 1980 Dec 1, 138(7 Pt 1), 818 - 26 Scanning electron microscopy of attachment of Neisseria gonorrhoeae colony phenotypes to surfaces of human genital epithelia; Draper DL et al.; Attachment of different gonococcal colony phenotypes to explants of human genital tract epithelium was studied by means of scanning electron microscopy and radioisotope-labeled gonococci . Heavily piliated organisms attached in greater numbers than nonpiliated organisms . Gonococci from transparent colony phenotypes attached in higher numbers than gonococci from opaque phenotypes to all tissues studied . Transitional cells from cervical tissues showing a gradual squamocolumnar transition demonstrated more gonococci attached per surface area than either endocervical or fallopian tube epithelium . Squamous epithelium showed the fewest number of attached gonococci . In all tissues, the attachment of the gonococcus was to the tips and surfaces of the microvilli . Gonococcal colony phenotypes as well as the length and location of the cervical transition zone may influence the progression of cervical gonococcal infection to invasive disease. N Z Med J, 1980 Nov 26, 92(672), 380 - 2 Antimicrobial susceptibility of Neisseria meningitidis isolated from 1975-1979; Green MJ et al.; During the period 1975 to 1979, 88 isolates of Neisseria meningitidis from cerebrospinal fluid (CSF), 28 isolates from blood, and 89 isolates from other sources were serogrouped and tested for their susceptibility to sulphadiazine, penicillin, minocycline and rifampin . Prior to 1979, isolates from CSF or blood were predominantly serogroup B . In the sample tested, the prevalence of this serogroup decreased while the prevalence of serogroup A isolates increased, until in 1979 this was the predominant serogroup . From 1975, the incidence of sulphonamide-resistance in the serogroup B isolates from CSF or blood decreased . However, all serogroup A isolates from these sources, except the first one tested, were sulphonamide-resistant . The 89 isolates from other sources remained predominantly sulphonamide-sensitive serogroup B . All isolates were sensitive to penicillin, minocycline and rifampin. JAMA, 1980 Nov 7, 244(18), 2060 - 4 Prevalence and site-pathogen studies of Neisseria meningitidis and N gonorrhoeae in homosexual men; Janda WM et al.; Prevalence and site-pathogen studies of pathogenic Neisseria were conducted in 815 homosexual men over a 12-month period . Neisseria meningitidis was isolated from more patients than N gonorrhoeae (43.1% vs 33.1%) . A high oropharyngeal carriage of n meningitidis (42.5%) was present, with much lower urethral (0.7%) and rectal (2.0%) colonization . Although N meningitidis urethral isolates were associated with urethral discharge in five of six patients, N meningitidis in the oropharynx or rectum was not usually associated with clinical illness . Neisseria meningitidis was usually isolated from only one site in individual patients . Neisseria gonorrhoeae was isolated from the urethra (18.5%), rectum (16.3%), and oropharynx (5.6%) . Of the 270 patients with gonococcal infection, 49.1% had urethral gonorrhea only, and 20.7% were infected at two or more body sites . Virtually all patients with urethral infection had symptoms of urethritis, whereas 89.1% of patients with oropharyngeal infection and 61.9% of patients with anorectal infection had no local symptoms. J Clin Endocrinol Metab, 1980 Nov, 51(5), 957 - 61 Goiter prevalence and bacterial contamination of water supplies; Gaitan E et al.; Previous epidemiological studies have shown a significant statistical correlation (P < 0.005 to P < 0.0005) between goiter prevalence and rock types in the watersheds that supply 37 localities in Western Columbia . Bacterial contamination has also been implicated as a cause of endemic goiter . We, therefore, did bacteriological studies to incorporate this variable into the statistical model in 34 of the 37 localities previously surveyed . Samples of the water in the 34 localities were taken at the water source or intake of water supply and at the pipeline system in households and schools . Samples were collected in sterile bottles and cultured on several media for 48 h . The number of bacteria per ml was determined by Quebec's camera and the bacteria (E . coli, Bacillus sp., K . pneumoniae, Proteus sp., and Neisseria sp.) were identified according to conventional methods . Multiple regression analysis and the logistic regression model were used to analyze the data . Only two variables had significant relationships with goiter prevalence: K . pneumoniae in the water source (P < 0.01) is related to a lower prevalence and the overall concentration of bacteria in the pipeline system (P < 0.05) is related to a higher prevalence . Multiple regression analysis to compare the effects of bacteriological variables to those of geological variables indicating rock types showed sedimentary rocks in the watershed associated (P < 0.005) with higher goiter prevalence and an increased concentration of K . pneumoniae in the water source again associated (P < 0.025) with lower goiter prevalence . Bacterial concentration in the pipeline system was of marginal importance (0.05 < P < 0.10) . Thus, the presence of sedimentary rocks was the best indicator of disease . A second best indicator was the concentration of K . pneumoniae in the water source . We hypothesize that the lower goiter prevalence associated with K . pneumoniae may be a natural example of biodegradation of the organic contaminants that produce goiter. J Clin Microbiol, 1980 Nov, 12(5), 667 - 71 Aminopeptidases highly specific for glutamyl residues from Neisseria meningitidis and Moraxella urethralis; Eriquez LA et al.; Cell-associated glutamyl aminopeptidase activity was detected in several strains of Neisseria meningitidis and Moraxella urethralis grown in liquid culture . Enzymatic activity was released from washed cells by ultrasonic treatment and monitored fluorometrically by measuring the release of aryl groups from 17 different aminoacyl-beta-naphthylamides . Substrates containing a glutamyl moiety were readily hydrolyzed by both N . meningitidis and M . urethralis . Glutamyl aminopeptidase activity was partially purified from crude sonicates by means of ion-exchange and gel chromatography, and samples were examined by polyacrylamide gel electrophoresis . Kinetic and pH studies were performed to partially characterize activities . The molecular weight of the M . urethralis enzyme was approximately 88,000, whereas the apparent molecular weight of the N . meningitidis enzyme was shown to be in excess of 200,000 . M . urethralis produced two glutamyl aminopeptidases, one specific for a gamma-glutamyl moiety, the other specific for an alpha-glutamyl moiety . In contrast, N . meningitidis produced a single glutamyl aminopeptidase which hydrolyzed alpha- and gamma-glutamyl-substituted beta-naphthylamides. J Gen Microbiol, 1980 Nov, 121(1), 85 - 92 Studies of some naturally occurring auxotrophs of Neisseria gonorrhoeae; Juni E et al.; A strain of Neisseria gonorrhoeae requiring arginine, proline, glutamate and cystine as nutritional supplements was transformed, in several steps, to grow in a simple mineral medium containing cystine as the only growth factor with DNA from several clinically isolated strains of this organism . Using DNA from naturally occurring auxotrophs (auxotypes) known to require arginine, hypoxanthine and uracil (Arg-Hyx-Ura-), as well as other factors, it was possible to transfer nutritional markers, one at a time, into such prototrophs to obtain seven single marker auxotrophic strains . Three different uracil markers, two different hypoxanthine markers, an arginine marker, and an isoleucine--valine markers were each introduced into separate strains . Of 114 DNA samples from independently isolated strains of N . gonorrhoeae, 54 were able to transform all seven single marker strains to prototrophy . Six of the single marker strains failed to be transformed to prototrophy by DNA samples from 43 strains, thus demonstrating that all these strains possess at least six nutritional lesions in common . Two strains were shown to contain all seven nutritional lesions, whereas several strains contained some but not all of the seven lesions . Six of the seven single marker strains have been shown to revert spontaneously to prototrophy at low frequencies . During construction of prototrophic strains it was observed that genes conferring sensitivity to growth inhibition by nutrients in complex media were occasionally transferred along with prototrophy. Zentralbl Bakteriol A, 1980 Nov, 248(2), 239 - 47 Prevalence of serological groups of Neisseria meningitidis and their susceptibility to 31 antimicrobial agents; Cybulska J et al.; One hundred and forty four strains of Neisseria meningitidis were isolated from pathological specimens and from carriers . The source of material was randomized in Poland . Out of seven existing serological groups of Neisseria meningitidis, no strains belonging to groups D and X were isolated . Serological group B was dominating; strains isolated from patients comprised 68%, while strains from carriers were group B-positive in 52% . Pathological specimens revealed presence of strains belonging to groups A, B and C only . All strains were tested toward susceptibility to 31 antimicrobials (8 penicillins, 5 cephalosporins, 3 tetracyclines, 4 sulphonamides and 11 other drugs) . Most effective were: penicillin, carbenicillin, amoxycillin, cephalothin, and sulphonamides . Some sulphonamide-resistant strains, especially belonging to serological group C and to a lesser extent to group B, have been isolated. Antimicrob Agents Chemother, 1980 Nov, 18(5), 738 - 40 In vitro antimicrobial activity of rosoxacin against Neisseria gonorrhoeae, Chlamydia trachomatis, and Ureaplasma urealyticum; Dobson RA et al.; The antimicrobial activity of rosoxacin, a new quinoline antibacterial compound, was determined against the causative organisms of three sexually transmitted diseases . Rosoxacin demonstrated a high degree of activity against Neisseria gonorrhoeae clinical isolates, with the minimal inhibitory concentrations for 50% of these being 0.03 microgram/ml . The corresponding minimal inhibitory concentrations for penicillin, ampicillin, tetracycline, and spectinomycin were 0.25 U/ml, 0.125 microgram/ml, 0.25 microgram/ml, and 16 microgram/ml, respectively . Eleven strains of Chlamydia trachomatis were inhibited by 5 microgram of rosoxacin per ml, and each of seven Ureaplasma urealyticum strains was inhibited by 2 to 8 microgram of rosoxacin per ml . The results of these susceptibility studies, coupled with those of an earlier evaluation of the pharmacokinetics of rosoxacin, provide support for extending or undertaking clinical evaluations of this compound against infections with N . gonorrhoeae, C . trachomatis, and U . urealyticum. Antimicrob Agents Chemother, 1980 Nov, 18(5), 730 - 7 Penicillin-binding proteins of penicillin-susceptible and intrinsically resistant Neisseria gonorrhoeae; Dougherty TJ et al.; The penicillin-binding proteins (PBPs) of Neisseria gonorrhoeae were investigated by using {3H}benzylpenicillin of high specific activity . This made it possible to label the PBPs both in cytoplasmic membranes and in the membranes of actively growing cells (in vivo labeling) . A total of 20 strains isolated from different geographic locales showed the same pattern of three major PBPs, which had molecular weights of approximately 90,000, 63,000, and 48,000 . Five clinical isolates of intrinsically penicillin-resistant gonococci each exhibited reduced penicillin binding of PBPs 1 and 2 . The construction of an isogenic set of transformants with increasing levels of penicillin resistance indicated that the penA gene was associated with a decrease in penicillin binding fo PBP 2 . Decreased binding to PBP 1 is likely to accompany the newly reported pem and tem genes, which govern to highest level of penicillin resistance. J Med Microbiol, 1980 Nov, 13(4), 597 - 607 Improved media for the culture of Neisseria gonorrhoeae; Macfarlane DE et al.; The ANM medium of Hafiz and McEntegart (1976) was found to be deficient in ability to support the growth of various strains of N . gonorrhoeae . Strains that did grow required a large starting inoculum which invariably suffered a substantial drop in the number of viable organisms during the first 2 h . Investigation of the various deficiencies led to the development of liquid (G77L) and solid (G77S)media which were shown to have several advantages over existing media for the cultivation of N . gonorrhoeae . These media, which are simple to prepare, do not contain blood or serum and yet gave excellent growth . The inclusion of antibiotics, glucose and phenol red allowed the selective isolation and partial identification of N . gonorrhoeae from routine specimens . These media also gave good results in fermentation tests for the identification of neisseriae. J Gen Microbiol, 1980 Nov, 121(1), 195 - 202 Antigenic heterogeneity associated with pilus aggregation and autoagglutinability in Neisseria gonorrhoeae; Penn CW et al.; A type-specific antigen of Neisseria gonorrhoeae was previously demonstrated by two-dimensional immunoelectrophoresis, and was produced by strains adapted to growth in subcutaneous chambers in guinea pigs . This antigen was also present in 'smooth' (non-autoagglutinating) variants selected directly from the first agar cultures of three clinical isolates, without chamber passage . The type-specificity of this antigen paralleled the reactions of pili in immune electron microscopy, suggesting that the type-specific antigens were pili . However, 'rough' (autoagglutinating) variants lacking this type-specific antigen were nevertheless pilated . Examination of one strain by immune electron microscopy showed that the pili of the rough variant differed antigenically from those of the smooth variant . Pili on the rough variant tended to form extensive parallel aggregates, whereas pili on the smooth variant radiated individually from the gonococci . This physical difference might relate to the behaviour of the gonococci in suspension . The significance of pilus variation in immunity to gonococcal infection is discussed. Br J Vener Dis, 1980 Oct, 56(5), 325 - 6 Isolation of Neisseria lactamica from the female genital tract . A case report; Telfer Brunton WA et al.; Neisseria lactamica was isolated from the genital tract of a young patient with a persistent vaginal discharge . Although infection with N lactamica occurs very rarely, the importance of complete biochemical identification of neisseriae is emphasised in view of the serious social and medicolegal consequences which could result from a misdiagnosis of gonorrhoea. Br J Vener Dis, 1980 Oct, 56(5), 319 - 21 Diagnosis and management of anorectal gonorrhoea in women; Stansfield VA; A retrospective assessment of 159 female patients who had undergone proctoscopy was carried out between January and September 1977 . One hundred and twenty-seven (80%) were known contacts of gonorrhoea; of these, 63 (49.6%) were found to be infected with Neisseria gonorrhoeae . Of these, 29 (46%) harboured gonococci in the rectum as well as in the urethra and cervix while four (6.3%) harboured gonococci only in the rectum . Gram-stained smears gave positive results in only 12 of the 29 cases of rectal gonorrhoea, which indicates the importance of culturing rectal material . It is recommended that the management of anorectal gonorrhoea should be similar to that already established for urogenital infection. Rev Ig Bacteriol Virusol Parazitol Epidemiol Pneumoftiziol Bacteriol Virusol Parazitol Epidemiol, 1980 Oct-Dec, 25(4), 233 - 6 {Liquid medium for culturing Neisseria gonorrhoeae}; Gavrilescu M et al.; An original fluid medium, containing lactalbumin hydrolysate, developed for the cultivation of gonococci is described . The medium is cheap, readily prepared, efficient insuring appraisable multiplication of the microorganism, and can be stored for a long time . In the authors' experience subculture in fluid medium is preferable to other methods used for testing sensitivity to antibiotics. Acta Pathol Microbiol Scand {B}, 1980 Oct, 88(5), 281 - 6 A protein antigen characteristic of Branhamella catarrhalis . Serological identification of the genus; Eliasson I; Precipitation patterns of sonicated, acid-extracted and other extracts from Branhamella catarrhalis were examined by double diffusion-in-gel technique, using antiserum to B . catarrhalis . Acid extract gave rise to 4 distinct precipitates . One of these lines was further studied . The bacterial component responsible for this line was trypsin-sensitive, indicating that it was a protein . It was anodally localized by crossed immunoelectrophoresis . By absorption of antiserum with whole bacteria, the precipitating capacity of the serum was diminished, suggesting that the protein antigen (P-antigen) was exposed on the bacterial surface . F(ab')22-fragments of IgG from antiserum, but not from normal rabbit serum, precipitated the P-antigen, indicating that it was a true antigen-antibody reaction . It was possible to make an IgG preparation monospecific for the P-antigen, by absorbing antiserum with trypsinized bacterial extract . 31 strains of B . catarrhalis, 9 strains of N . gonorrhoeae, 10 strains of N . meningitis, 12 other Neisseria spp . and 2 strains of H . influenzae were investigated for presence of cros-reacting surface antigens, using IgG monospecific for the P-antigen and 125I-labelled protein A from Staphylococcus aureus . After antibody exposure, all 31 strains of B . catarrhalis showed abundant uptake of protein A . No significant uptake was detected on any other investigated strain . Hence, the P-antigen appears to be characteristic of B . catarrhalis . The possibility of a serological identification of the species is introduced . Precipitating antibodies against the P-antigen were demonstrated in 69% of normal human sera. Sex Transm Dis, 1980 Oct-Dec, 7(4), 183 - 7 Laboratory diagnosis of gonorrhea by a simple transformation test with a temperature-sensitive mutant of Neisseria gonorrhoeae; Zubrzycki L et al.; A temperature-sensitive mutant of Neisseria gonorrhoeae strain tsA-1 was used in a transformation test for the laboratory diagnosis of gonorrhea . This transformation test (C test) is based on a spotting of a DNA lysate, obtained through simple base-acid extraction of a cervical-swab specimen, onto a lawn of tsA-1, which is then incubated for one to two days at 37 C . Of 1,053 cervical-swab specimens tested, 52 contained the gonococcal DNA necessary for restoring the ability of tsA-1 to grow well at 37 C; 49 of the 52 specimens were identified as N . gonorrhoeae by routine diagnostic laboratory procedures . The time required for the C test is two to three days, which is shorter than that required for routine diagnostic laboratory tests, and the C test involves a minimum of common laboratory supplies and expertise . The discrepancies between results of the C test and routine procedures are explained as follows . In one case an isolate suspected to be N . gonorrhoeae was nonreactive in the sugar fermentation test, and in two cases the agar plates were overgrown with yeasts; neither situation affected the C test. Sex Transm Dis, 1980 Oct-Dec, 7(4), 175 - 7 Pharyngeal carriage of Neisseria meningitidis and anogenital gonorrhea: evidence for their relationship; William DC et al.; The relationship between pharyngeal carriage of Neisseria meningitidis and anogenital infection with Neisseria gonorrhoeae was investigated at two separate clinics for sexually transmitted diseases in New York City . Of the entire study group of 738 patients, 310 (42%) had pharyngeal N . meningitidis . Gonorrhea appeared in 130 (17.9%) of the 738 patients . Of the 130 patients with anogenital gonorrhea, 73 (56.3%) had N . meningitidis-positive pharyngeal cultures . Neisseria meningitidis was found in the pharyngeal cultures of 39% of the gonorrhea-free patients; 23.2% of patients with N . meningitidis-positive pharyngeal cultures had concomitant anogenital gonorrhea . Of the patients free of pharyngeal N . meningitidis, 13.1% had anogenital gonorrhea . In both facilities, the pharyngeal carriers of N . meningitidis had a 1.9 times greater risk of genital gonorrhea as compared with N . meningitidis-negative patients . Patients with anogenital gonorrhea at both study sites were 1.4-1.7 times more likely to be pharyngeal carriers of N . meningitidis as compared with gonorrhea-free patients. Sex Transm Dis, 1980 Oct-Dec, 7(4), 165 - 7 Improved recovery of Neisseria gonorrhoeae from clinical specimens by selective enrichment and detection by immunologic methods; Lue YA et al.; Five thousand eight hundred forty-nine cervical and rectal swabs were cultured for Neisseria gonorrhoeae . Swabs remained in Amies' transport medium for approximately 2 hr before primary plating and enrichment for 6 hr in a selective broth . Neisseria gonorrhoeae was detected in 87 specimens . In 72 (83%) of the 87, N . gonorrhoeae was detected by primary plating, and in 15 (17%), detection was possible only after enrichment . Although enrichment is advantageous in recovering N . gonorrhoeae from swabs that have been in transport medium for several hours, the advantage of the enrichment technique over immediate direct plating remains to be determined . Positive enrichment broth cultures were tested at 6 hr for the presence of N . gonorrhoeae; 52% were positive by counterimmunoelectrophoresis, 71% were positive by coagglutination, and 97% were positive by enzyme-linked immunosorbent assay. Br J Exp Pathol, 1980 Oct, 61(5), 521 - 7 A comparison of the association of Neisseria gonorrhoeae with human and guinea-pig genital mucosa maintained in organ culture; Johnson AP et al.; Organ cultures of human and guinea-pig genital mucosa were inoculated with Neisseria gonorrhoeae, and the association of the bacteria with the epithelial surface of each tissue was studied by light microscopy and by scanning electron microscopy . Gonococci attached to the mucosa of human fallopian tube, adhering specifically to the surface of non-ciliated epithelial cells . In contrast, gonococci rarely attached to the mucosal surface of guinea-pig uterine horn, vagina or bladder, although organisms were occasionally seen associated with the submucosal tissue in areas where the epithelium had sloughed, and in extracellular mucus secretions . There is no evidence from this study that gonococci adhere to guinea-pig tissue in a manner analogous to that seen with human genital tissue. J Infect Dis, 1980 Oct, 142(4), 532 - 7 Role of magnesium in the enzyme-linked immunosorbent assay for lipopolysaccharides of rough Escherichia coli strain J5 and Neisseria gonorrhoeae; Ito JI Jr et al.; An enzyme-linked immunosorbent assay for antibody to the lipopolysaccharides (LPSs) of a rough strain of Escherichia coli (J5) and Neisseria gonorrhoeae was developed . When standard methods of this assay were applied to these LPSs, no antibody was measured . By radiolabeling smooth and rough endotoxins with 51Cr, it was discovered that the rough LPS was not adhering to the polystyrene tubes . When Mg++ was added, however, all endotoxins absorbed to the solid phase . With this assay antiserum to core glycolipid had higher titers against its smooth parent strain than did homologous glycolipid had higher titers against its smooth parent strain that did homologous antiserum, and antisera to gonococci had high homologous but low heterologous titers . Thus, these data demonstrate that bulky O side chains do not hinder the penetration of antibody to core glycolipid and that LPSs from gonococci are heterogeneous but do cross-react. Infect Immun, 1980 Oct, 30(1), 281 - 8 Preparation and crossed immunoelectrophoretic analysis of cytoplasmic and outer membrane fractions from Neisseria gonorrhoeae; Collins ML et al.; Cell envelopes were obtained from lysates of Neisseria gonorrhoeae, colony type T1, prepared with lysozyme, ethylenediaminetetraacetate, and Brij 58 . This preparation was separated into cytoplasmic (inner) and outer membrane fractions by equilibrium sucrose density gradient centrifugation . The former fraction was 10-fold enriched in L-lactate dehydrogenase activity with respect to the latter . On the basis of buoyant density in sucrose, polypeptide patterns in sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and enzymatic activity, these preparations appear similar to cytoplasmic and outer membrane preparations from other gram-negative bacteria . The membrane preparations were analyzed by high-resolution crossed immunoelectrophoretic procedures . This technique permitted the identification of antigens originating from the structural components of the gonococcal cell . Among those found to be cytoplasmic membrane components was the fast-moving antigen which occurs widely in gram-negative bacteria. Br J Vener Dis, 1980 Oct, 56(5), 327 - 31 Prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infections in Greenland . A seroepidemiological study; Mardh PA et al.; In a sero-epidemiological study of the prevalence of chlamydial and gonococcal infections in Greenland three groups of subjects were studied--262 patients attending an outpatient department in the town of Nuuk (of whom 12% harboured Chlamydia trachomatis and 54% Neisseria gonorrhoeae), 63 controls from the same town, and the entire population of 150 in the settlement of Uvkusigsat . Using a microimmunofluorescence test evidence of exposure to C trachomatis was found in 79% of the female and 26% of the male patients, in 12% and 50% of the female and male controls respectively, and in 51% and 21% of the female and male populations of Uvkusigsat respectively . Using an indirect haemagglutination test antibodies to gonococcal pili were found in sera of 92% of the female and 70% of the male patients, in 30% of the male and 10% of the female controls, and in 41% of the women and 33% of the men in Uvkusigsat . The study indicates that genital chlamydial and gonococcal infections are serious public health problems in Greenland and that such infections are acquired early in both sexes and often occur concomitantly. Br J Vener Dis, 1980 Oct, 56(5), 322 - 4 Oropharyngeal flora and individual susceptibility to neisserial infection; Young H et al.; Beta-haemolytic streptococci were isolated from throat swabs from 49 (10.5%) of 466 patients undergoing cultural examination for gonorrhoea . Although beta-haemolytic streptococci were isolated more frequently from patients with genital or anorectal gonorrhoea (15.9%) than from those without (9.2%), the difference was not statistically significant . When groupable (A, B, C, or G) and other (non-A, -B, -C, or -G) beta-haemolytic streptococci were analysed separately, as statistically significant association between non-A, -B, -C, or -G streptococci and gonococci was observed but not between groupable beta-haemolytic streptococci and gonococci. Br J Vener Dis, 1980 Oct, 56(5), 311 - 3 Comparison of methods for the detection of penicillinase-producing Neisseria gonorrhoeae; Sng EH et al.; In an evaluation of four methods for detecting penicillinase-producing Neisseria gonorrhoeae the chromogenic cephalosporin, rapid iodometric, and penicillin disc diffusion methods gave complete agreement for all the 202 strains of gonococci tested . No false-positive or false-negative results occurred . The filter paper iodometric method detected 99% of the penicillinase-producing strains without any false-positive result. Br J Vener Dis, 1980 Oct, 56(5), 304 - 7 Enzymatic detection of Neisseria gonorrhoeae; Takeguchi MM et al.; In a study using a non-serological enzymatic approach for the detection of Neisseria gonorrhoeae in cervical and urethral swabs, the technique was shown to be technically feasible . The enzyme, 1, 2-propanediol oxidoreductase, was used as a presumptive diagnostic marker for N gonorrhoeae . Enzymatic activity was measured with a fluorometer . Two assay procedures were performed: (a) enzyme detection (two-tube and three-tube assays) requiring 60 minutes; and (b) enzyme inhibition (EI) (90-minute and modified 20-minute assays) . Sensitivities of the two-tube, three-tube, and the 90-minute EI assays with male urethral specimens from a high-prevalence population were 80%, 84%, and 91% respectively . The specificities of these assays in a low-prevalence male population were not determined . Sensitivity of the 90-minute EI assay in a high-prevalence female group was 77% and specificity in a low-prevalence female group was 75% . The modified EI assay was tested only in a low-prevalence female group and had 87% specificity . Although the specificity of the assays needs improvement, several advantages--including early case detection, rapid availability of results, detection of current active infections, and the possibility of automation--are intrinsic in this enzymatic approach. J Lab Clin Med, 1980 Oct, 96(4), 582 - 91 Human seminal plasma inhibition of complement; Petersen BH et al.; Recent studies have shown that human seminal plasma contains chemically and biologically distinct factors which inhibit lymphocyte functions and the serum bactericidal and opsonic activities associated with the killing of gram-negative organisms . Because of the direct association between complement action and serum bactericidal and opsonic activities, inhibition of complement may be one of the possible mechanisms of action of seminal plasma immunoinhibitory factors . Complement hemolytic activity was measured for C3 and C4 in serum Neisseria gonorrhoeae and Escherichia coli bactericidal reaction mixtures with and without addition of seminal plasma . In the presence of seminal plasma, where there was no bactericidal action, C3 and titers were reduced to approximately 50% of the titers in the reactions with complement donor serum . The C3 titers were lower than in the reaction mixtures with immune serum and complement donor serum, where N . gonorrhoeae bactericidal activity occurred . Individual human seminal plasma specimens depressed CH50 activity of pooled normal human sera up to 50% of normal levels . There were no differences in inhibition by seminal plasma specimens from normal or vasectomized men . Treatment with seminal plasma depressed the functional activity of complement components C1 and C3 by more than 50% . Seminal plasma also inhibited alternate pathway activity . Cleavage of factor B was demonstrated . The seminal plasma factor which inhibited complement was of low molecular weight . DPF blocked the seminal plasma complement-inhibitory factor . However, amidolytic activity for serine protease substrates could not be demonstrated . It is likely that the seminal plasma complement inhibitor is a protease inhibitor acting singly or in combination. J Clin Microbiol, 1980 Oct, 12(4), 603 - 5 Isolation of a stable cell wall-defective form of Neisseria gonorrhoeae from a case of untreated gonococcal urethritis; Hickman RK et al.; A cell wall-defective form of Neisseria gonorrhoeae from an exudate of an untreated patient with gonococcal urethritis was isolated on medium containing 7% polyvinylpyrrolidone . Initial attempts to grow the organism by standard microbiological methods had failed . This isolate was incapable of reversion to a normal gonococcus even after numerous subcultures and appeared to be a stable cell wall-defective form. J Clin Microbiol, 1980 Oct, 12(4), 498 - 501 Role of lipopolysaccharide in wheat germ agglutinin-mediated agglutination of Neisseria meningitidis and Neisseria gonorrhoeae; Frasch CE; Wheat germ agglutinin, having specificity for N-acetyl glucosamine, agglutinated known nonencapsulated Neisseria meningtidis strains, but failed to agglutinate encapsulated strains of all serogroups tested Presence of a capsule, therefore, blocked wheat germ agglutinin agglutination of N . meningitidis strains . In contrast, Neisseria gonorrhoeae strains were strongly agglutinated, providing additional evidence for nonencapsulation of N . meningitidis strains . In contrast, Neisseria gonorrhoeae strains were strongly agglutinated, providing additional evidence for nonencapsulation of N . gonorrhoeae . Purified lipopolysaccharide from a single N . meningitidis and N . gonorrhoeae strains tested . Thus, in absence of capsular polysaccharide wheat germ agglutinin agglutinates Niesseria strains through interaction with lipoplysaccharide in the outer membrane . Of 34 nongroupable throat N . meningitidis isolates, 10 failed to agglutinate in wheat germ agglutinin, suggesing that at least some nongroupable . N . meningitidis strains may possess capsule-like materials. Can Med Assoc J, 1980 Sep 6, 123(5), 381 - 4 Auxotypes of Neisseria gonorrhoeae isolated from localized and disseminated infections in Montreal; Turgeon PL et al.; A survey recently made in the United States on the regional distribution of auxotypes of Neisseria gonorrhoeae suggested that isolates from different geographic areas often differ in auxotype . A subsequent auxotyping study in Montreal of 901 isolates of N . gonorrhoeae, 15 from patients with disseminated gonococcal infection, proved interesting in many regards . Gonococcal genetic medium, modified by the addition of other amino acids, was used . Most (93%) of the strains isolated from patients with localized infection belonged to one of the following three phenotypes: arginine-, hypoxanthine- and uracil-dependent (44%); prototrophic (33%); and proline-dependent (16%) . Of the 15 strains responsible for disseminated infection 14 required arginine, hypoxanthine and uracil for growth. J Clin Microbiol, 1980 Sep, 12(3), 301 - 3 Evaluation of four methods for isolation of Neisseria gonorrhoeae; Carlson BL et al.; Bio-Bag (Marion Laboratories, Kansas City, Mo.) type C is made up of a ziplock plastic bag which contains a Thayer-Martin plate and a crushable CO2-generating ampoule . This system was compared with the candle extinction jar, Gono-Pak (Nasco, Fort Atkinson, Wis.), and JEMBEC (GIBCO Diagnostics, Lawrence, Mass.) systems to determine their efficiency and reliability for the isolation of Neisseria gonorrhoeae . A total of 191 anal and 130 urethral specimens were tested . There were 104 isolates of N . gonorrhoeae (24 anal and 80 urethral) . The candle jar and Bio-Bag systems each detected 98 (94%) of the isolates . The Gono-Pak and JEMBEC systems detected 102 (98%) and 100 (96%) of the 104 isolates, respectively . These differences are not statistically significant . The Bio-Bag has the advantage of immediate CO2 release as compared with the Gono-Pak and JEMBEC systems, where CO2 production is dependent on the release of moisture from the medium . The Bio-Bag is a useful system, especially in situations where it is not convenient to use a candle jar. Antimicrob Agents Chemother, 1980 Sep, 18(3), 416 - 23 Pyocin inhibition of Neisseria gonorrhoeae: mechanism of action; Morse SA et al.; Purified R-type pyocins (611 131) from Pseudomonas aeruginosa PA103 exhibited bactericidal activity against Neisseria gonorrhoeae . Killing of gonococci was a single-hit process requiring as few as 1 pyocin per colony-forming unit . Deoxyriboinucleic acid, ribonucleic acid, protein, and lipid syntheses were rapidly and completely inhibited . Oxygen uptake was also inhibited, but occurred after the inhibition of macromolecular synthesis . The cell lysis which occurred after pyocin inhibition of gonococcal growth was the result of endogenous gonococcal autolysin activity. Rev Infect Dis, 1980 Sep-Oct, 2(5), 725 - 45 Community-acquired purulent meningitis: a review of 1,316 cases during the antibiotic era, 1954-1976; Geiseler PJ et al.; This review of 1,316 cases of purulent meningitis assessed changes in the etiology, clinical features, and fatality rate during the antibiotic era . Hemophilus influenzae was the most frequent cause of purulent meningitis (458 cases), Neisseria meningitidis the second most frequent (396 cases), and Streptococcus pneumoniae the third most frequent (178 cases) . No bacterial etiology was found for 148 patients with purulent meningitis, the fourth major category of meningitis throughout the 23 years surveyed . Few patients had notable underlying diseases or predisposing conditions; 77.4% were less than 10 years old, but only 13 patients were less than one month old . Patients with meningitis caused by Staphylococcus aureus or various streptococci commonly had associated suppurative foci and the highest fatality rate . There were 103 deaths, of which 70.8% occurred during the first 48 hr of hospitalization . Antibiotics had been given to 54.6% of patients before admission to the hospital . Bacteriologic and cerebrospinal fluid (CSF) findings for patients who received antibiotics prior to admission ("pretreated") were compared with these findings for those who had not had antibiotics in 1,032 cases of meningitis caused by H . influenzae, N . meningitidis, or S . pneumoniae . No significant differences in white blood cell counts or in glucose or protein concentrations in CSF were noted among patients infected with any of the three organisms; positive cultures of blood and CSF were significantly less frequent in "pretreated" patients whose disease was caused by any of the three organisms, and particularly in those with meningitis due to N . meningitidis . Nasopharyngeal, throat, and rectal swabs and CSF specimens from 141 patients were cultured for virus . Enteroviruses were isolated from rectal swabs of two patients with bacterial meningitis and from the CSF of two patients (in mixed culture with Salmonella enteritidis in one case). Infect Immun, 1980 Sep, 29(3), 886 - 91 Iron-controlled infection with Neisseria meningitidis in mice; Holbein BE; An iron-controlled infection was obtained after the intraperitoneal infection of Neisseria meningitidis strain M1011 into normal mice . The infection progressed rapidly but then disappeared in concert with the disappearance of plasma transferrin iron . Parenteral iron dextran enhanced and prolonged the infection in mice at dosages above 15 mg of Fe per kg . Studies on the distribution of iron dextran within the physiological iron pools and the importance of timing with the iron dextran addition indicated that high serum iron, available early during infection, was necessary to promote infection . High levels of iron in the reticuloendothelial system did not stimulate infection . A working hypothesis to explain the roles of iron in infection was developed: N . meningitidis obtains iron for growth from the transferrin pool, and iron dextran maintains transferrin iron levels during infection. J Gen Microbiol, 1980 Aug, 119(Pt 2), 451 - 8 The isolation and characterization of a 1,2-propanediol oxidoreductase from Neisseria gonorrhoeae; McDonald HC et al.; An enzyme which oxidizes 1,2-propanediol in the presence of NAD+ has been purified from lysates of Neisseria gonorrhoeae . The enzyme was activated by monovalent cations, had a pH optimum between 9 and 10, and showed a substrate specificity unlike any known alcohol or glycerol dehydrogenase . The enzyme had an apparent Km of 17 mM for 1,2-propanediol and 0 . 37 mM for NAD+ . When chromatographed on a Sephadex G-150 column, the enzyme eluted as a single peak in the molecular weight region of a bovine serum albumin marker . An antibody to the purified enzyme was prepared in goats . When antiserum was reacted with the enzyme in immunodiffusion experiments, a single precipitin band was detected . When the enzyme was mixed with an excess of antibody and then reacted with substrate, enzyme activity was completely inhibited. J Clin Microbiol, 1980 Aug, 12(2), 286 - 7 Aberrant strain of group G Neisseria meningitidis; Uyeda CT et al.; A glucose-negative group B strain of Neisseria meningitidis isolated from a meningitis case is described . A brief review of Neisseria identification procedures is also presented. J Clin Microbiol, 1980 Aug, 12(2), 284 - 5 Urethritis caused by Neisseria meningitidis; Karolus JJ et al.; A glucose-negative group B strain of Neisseria meningitidis isolated from a meningitis case is described . A brief review of Neisseria identification procedures is also presented. Infect Immun, 1980 Aug, 29(2), 507 - 11 Effect of environment on sensitivity of Neisseria gonorrhoeae to Pseudomonas aeruginosa bacteriocins; Stein DC et al.; The effect of environmental variation on the susceptibility of Neisseria gonorrhoeae to pyocin produced by Pseudomonas aeruginosa was examined . Susceptibility to at least one pyocin was demonstrated in strains of N . gonorrhoeae (99%), N . meningitidis (35%), and N . lactamica (47%) . The degree of sensitivity to pyocin displayed by N . gonorrhoeae was affected by varying the pH of the growth environment . Gonococcal strains were more sensitive to growth inhibition by pyocins at an alkaline pH and less sensitive to growth inhibition at an acid pH . Inhibitory titers fluctuated during nonselective subculture of fresh clinical isolates . There was no apparent correlation between auxotype and sensitivity to pyocin . Also, no relationship between colony morphology and pyocin sensitivity was seen. J Bacteriol, 1980 Aug, 143(2), 847 - 51 Genetic locus (nmp-1) affecting the principal outer membrane protein of Neisseria gonorrhoeae; Cannon JG et al.; An increase in the apparent molecular weight of the principal outer membrane protein (POMP) of Neisseria gonorrhoeae is associated with introduction of the penB2 genetic marker, which results in low-level, relatively nonspecific antibiotic resistance . Limited proteolysis of the two forms of POMP showed that they had few if any peptides in common . The nonspecific antibiotic resistance of penB2 was separated from the change in POMP by genetic transformation and by isolation of spontaneous penB mutants that showed no change in POMP . The genetic locus involved in the change from one POMP to another, which we have designated nmp-1, is closely linked to, but not identical with, penB2. Can J Microbiol, 1980 Aug, 26(8), 863 - 73 Glucose-6-phosphate dehydrogenase from Neisseria gonorrhoeae: partical characterization of the enzyme and inhibition by long-chain fatty acid acyl-coenzyme A derivatives; Cacciapuoti AF et al.; The glucose-6-phosphate dehydrogenase from Neisseria gonorrhoeae was inhibited by long-chain fatty acid acyl-coenzyme A derivatives . The inhibition was increased at low concentrations of flucose 6-phosphate and was greater with the NAD-linked activity (ca . 0.05 mM inhibitor required for 50% inhibition) than with the NADP-linked activity (ca . 0.2 mM required for 50% inhibition) . Bovine serum albumin and spermine could prevent the inhibition by the acyl coenzyme A derivatives, but neither of these compounds nor high concentrations of cofactors or substrate could reverse the effect . Dilution of enzyme-inhibitor preincubation mixtures appeared to reverse the inhibition . The inhibition by steroyl-coenzyme A was of the mixed type, and the inhibitor appeared to have a greater affinity for the free enzyme (Ki = 0.016-0.05 mM) than for enzyme bound to cofactor or substrate (Kis = 0.07-0.08 mM) . Glucose-6-phosphate dehydrogenase activity was also inhibited competitively by adenosine 5'-triphosphate and was strongly regulated by adenylate energy charges values between 0.9 and 1.0 . Kinetic and other characteristics of the enzyme are presented, and the possible role of glucose-6-phosphate dehydrogenase as a target for fatty acid toxicity in gonococci, mediated in the form of the acyl-coenzyme A derivatives, is discussed. Antimicrob Agents Chemother, 1980 Aug, 18(2), 360 - 1 Resistance to penicillin and identification of penicillinase-producing Neisseria gonorrhoeae among clinical isolates in Thailand; Crum JW et al.; Penicillin-resistant Neisseria gonorrhoeae from 405 patients were studied by determination of penicillin minimal inhibitory concentrations an penicillinase production . Eighteen percent were identified as penicillin-producing N . gonorrhoeae and the mean minimal inhibitory concentration, for all except penicillin-producing strains, was 0.805 micrograms/ml. Antimicrob Agents Chemother, 1980 Aug, 18(2), 355 - 6 In vitro activity of Ro 13-9904, cefuroxime, cefoxitin, and ampicillin against Neisseria gonorrhoeae; Yoshikawa TT et al.; In vitro susceptibilities of 87 isolates of non-penicillinase-producing Neisseria gonorrhoeae and 8 isolates of penicillinase-producing N . gonorrhoeae to Ro 13-9904, cefuroxime, cefoxitin, and ampicillin were determined . Ro 13-9904 was the most effective of the four drugs, inhibiting growth of both non-penicillinase-producing and penicillinase-producing N . gonorrhoeae. Antimicrob Agents Chemother, 1980 Aug, 18(2), 281 - 8 Effects of steroid hormones on Neisseria gonorrhoeae; Lysko PG et al.; Various steroids were tested for their effects upon gonococcal O2 consumption and glucose catabolism . The ability to inhibit gonococcal O2 uptake appeared to be related to the molecular configuration of the steroid . The presence of lipophilic groups enhanced inhibition, whereas the addition of hydrophilic groups markedly diminished inhibition . Steroid inhibition decreased with an increasing number of polar groups . Glucose catabolism was inhibited by steroid hormones, and the degree of inhibition was influenced by pH and medium composition . Changes in growth medium and pH also resulted in differential steroid inhibition of O2 uptake . Under certain conditions, lactate partially relieved this inhibition . Gonococci that were grown in one environment and shifted to a new environment were inhibited by steroids to the same extent as if they had been originally grown in the new environment . The differential effects of medium and pH upon steroid inhibition may be due to structural rearrangements involving membrane phase transitions or to altered receptor affinity. Br J Vener Dis, 1980 Aug, 56(4), 249 - 51 Antibiotic sensitivities of gonococci isolated in Rotterdam and results of treatment with cefuroxime; Nayyar KC et al.; In a study of the efficacy of cefuroxime in the treatment of 278 cases of acute gonorrhoea (including rectal and pharyngeal infections and infections due to penicillinase-producing Neisseria gonorrhoeae), high cure rates were found for both male (98.8%) and female patients (98.6%) . Disadvantages of this treatment are its high cost and the relatively high proportion of patients who develop postgonococcal urethritis. Br J Vener Dis, 1980 Aug, 56(4), 244 - 8 Gonorrhea in Rotterdam caused by penicillinase-producing gonococci; Nayyar KC et al.; Recently the prevalence of strains of penicillinase-producing Neisseria gonorrhoeae (PPNG) in the Netherlands has increased . A study of demographic and clinical data from patients with gonorrhoea due to PPNG strains, and of the biological characteristics of the strains isolated in Rotterdam, show that Asian strains of PPNG seem at present to be endemic in the Netherlands . Spectinomycin was found to be effective in the treatment of patients with gonorrhoeea due to PPNG strains. Br J Vener Dis, 1980 Aug, 56(4), 235 - 8 Bacterial interference of Neisseria gonorrhoeae by alpha-haemolytic streptococci; McBride ME et al.; Fifty pharyngeal isolates of alpha-haemolytic streptococci were tested against 20 cervical isolates of Neisseria gonorrhoeae for bacterial interference in vitro using the lawn-spotting method . Forty-seven (94%) isolates of streptococci showed inhibitory activity toward N gonorrhoeae, although nine of these were inhibitory to only one isolate of N gonorrhoeae . Isolates of N gonorrhoeae varied widely in their sensitivity to streptococci; the most sensitive were inhibited by 40 isolates of streptococci and the least sensitive by only 14 isolates . Species of Streptococcus found to inhibit growth of N gonorrhoeae were S mitis, S MG intermedius, S sanguis II, S mutans, and S morbillorum. Br J Vener Dis, 1980 Aug, 56(4), 252 - 4 Sensitivity of Neisseria gonorrhoeae to spectinomycin and thiamphenicol; Grunder K et al.; Between 1966 and 1978 the sensitivities of strains of Neisseria gonorrhoeae (70-80 strains in each year) to penicillin, thiamphenicol, and spectinomycin were tested . For penicillin the proportion of less sensitive strains increased from 21% in 1976 to 41% in 1978 and for thiamphenicol from 10% to 18% over the same period . All the strains proved to be sensitive to spectinomycin . A significant correlation in the degree of sensitivity was observed between penicillin and thiamphenicol but not between penicillin and spectinomycin. Br J Vener Dis, 1980 Aug, 56(4), 255 - 8 HR 756--a new cephalosporin in the treatment of gonorrhoea caused by ordinary and penicillinase-producing strains of Neisseria gonorrhoeae; Rajan VS et al.; HR 756, a new cephalosporin, was used in single intramuscular doses of 500 mg to treat 108 men and women with gonorrhoea caused by penicillinase-producing Neisseria gonorrhoeae (PPNG) and non-PPNG . Of 102 patients followed up, 99 (97.05%) were cured . Cure rates for PPNG infections and non-PPNG infections were 98.18% and 95.74% respectively . Few adverse side effects were recorded but possible cross-sensitisation with penicillin was observed . Clinical and laboratory antibiotic susceptibility results correlated well . It is concluded that this drug is safe and effective in treating both PPNG and non-PPNG infectons. Br J Vener Dis, 1980 Aug, 56(4), 227 - 9 One-step staining of Neisseria gonorrhoeae in urethral discharge by methyl green-pyronin; Hanna NF et al.; Methyl green-pyronin (MGP) was used in a one-step procedure to stain smears of urethral discharge from 169 men . Duplicate smears were stained by Gram's method and discharge was cultured for Neisseria gonorrhoeae . The organisms were isolated from 67 specimens and intracellular diplococci were seen in 74 smears after Gram staining and in 77 after staining by MGP . Furthermore, more extracellular and intracellular diplococci were seen in smears stained by MGP than by Gram's method and the proportion of polymorphonuclear leucocytes found to contain the organisms was greater after staining with MGP . Staining with MGP is simple, rapid, inexpensive, and easily automated. Nouv Presse Med, 1980 Jul 12-26, 9(30), 2057 - 9 {Circumscribed peritonitis of genital origin or gonococcal perihepatitis Fitz-Hugh Curtis syndrome (author's transl)}; Bognel JC et al.; Circumscribed peritonitis with perihepatitis resulting from previous female gonococcal infection is now commmonly known as Fitz-Hugh Curtis (FHC) syndrome . Contamination of the peritoneum through the Fallopian tubes and the fact that the gonococcal inflammation (frequency, though not always confirmed) remains superficial with little production of pus explain why the perihepatic lesions are fibrinous, adhesion-forming and tend to subside spontanesouly . The pathophysiological mechanisms, however, are complicated by recent reports of FHC syndrome in males . Beside Neisseria gonorrhoeae, other organisms growing in the genital tract are probably involved . When necessary, coelio-laparoscopy is the method of choice to confirm the diagnosis . The four cases reported here illustrate the various symptomatic and evolutive aspects of the syndrome. JAMA, 1980 Jul 11, 244(2), 157 - 9 The 'borderline' smear in men with urethritis; Arnold AJ et al.; Four hundred three men with signs and symptoms of urethritis were examined by stained slide and culture of urethral exudate . Of these slides, 14.1% were interpreted as "borderline" for gonorrhea, ie, showing typical Gram-negative diplococci on microscopic examination located extracellularly only . Of these, only 10.5% were culture positive for Neisseria gonorrhoeae . Patients with urethritis whose slides are "borderline" should be treated as for nongonococcal urethritis with tetracycline hydrochloride and not with aqueous penicillin G procaine. Am J Public Health, 1980 Jul, 70(7), 705 - 8 Focused interviewing in gonorrhea control; Phillips L et al.; To develop an operational approach to the identification of high risk gonorrhea transmitters, three groups of women infected with Neisseria gonorrhoeae (recent repeaters, routine discoveries, and women with pelvic inflammatory disease) were offered intensive casefinding services during an 18-month period . Approximately three contacts per case were investigated, and 27.4% of the contacts were infected . Of infected contracts, 61% were asymptomatic . Asymptomatic, remote contacts to these women appear to be important in the continuing transmission of gonorrhea . The interviewing approach used reflected that employed in syphilis (thorough, detailed, and long) rather than the more casual interviews usually employed for gonorrhea patients . During this period, gonorrhea morbidity declined 22% . Further exploration of a targeted approach to gonorrhea epidemiology is indicated. Bull Soc Pathol Exot Filiales, 1980 Jul-Aug, 73(4), 353 - 63 {Present sensitivity of Neisseria gonorrhoeae in the Paris area . Results of a comparative therapeutic trial}; Thabaut A et al.; From September 1978 to September 1979, the Authors determined the M . I . C . of 16 antibiotics against 420 Neisseria gonorrhoeae strains collected in Paris area, with standard gel dilution technic . These strains remain susceptible to the greatest proportion of antibiotics tested, except streptomycin . It has been noted, however, that sensibility of a certain percentage of strains, has decreased for penicillins, cyclins, macrolides . Some strains producing beta-lactamase has been identified . Authors compared results given by the gel dilution method to those given by the diffusion or so-called "disc" method . This shows no correlation between radius of inhibition and M . I . G., with no reliable criteria to estimate the area of inhibition . Also, four protocols for therapy were followed: spectinomycin, ampicillin-probenocid, thiamphenicol, minocyclin . The patients were surveyed by physical examination and bacteriological tests . No statistically significant differences could be noted between these four protocols . However, considering the size of the samples, it is not possible to conclude . The authors reassess the necessity to survey the drug-sensitivity of Neisseria gonorrhoeae strains, in each geographical area, following an internationally agreed method . They also conclude to the necessity to compare in vitro sensitivity tests with therapeutic schemes suggested by usual sensitivity to main antibiotics. Sex Transm Dis, 1980 Jul-Sep, 7(3), 116 - 9 Prevalence of pharyngeal gonorrhea in general medical patients with sore throats; Komaroff AL et al.; The prevalence of pharyngeal gonorrhea was investigated in a previously unstudied population: adult patients seeking care for sore throats and other symptoms of respiratory infection in general medical practices . The complaint of sore throat accounts for at least 15 million patient visits each year in the United States . A prospective study of 239 patients in three different settings revealed prevalences of 1% (95% confidence interval of 0.1-3%) in the 192 patients with sore throats, and of zero (95% confidence interval of zero to 3.4%) in 47 patients with respiratory infection symptoms other than sore throat . The data support the position that routine pharyngeal culturing for Neisseria gonorrhoeae for patients who have sore throats is not cost-efficient. J Clin Microbiol, 1980 Jul, 12(1), 35 - 8 SJ-GC, a modified complete medium for growth of Neisseria gonorrhoeae; Shockley RK et al.; A broth medium that supports growth of Neisseria gonorrhoeae to high densities with minimal lysis is described . With most gonococcal strains, inocula of 2 x 10(6) colony-forming units per ml yielded greater than 109 colony-forming units per ml after 8 h of incubation . Scale-up cultures produced 5 to 12 g (wet weight) of cells per liter. J Clin Microbiol, 1980 Jul, 12(1), 15 - 7 Evaluation of the Phadebact Gonococcus Test for confirmation of Neisseria gonorrhoeae; Anand CM et al.; Strains of Neisseria gonorrhoeae grown on Thayer-Martin medium and media with and without serum were examined by the Phadebact Gonococcus Test . By using the direct method, in which colonies from growth media were mixed directly with the reagents on a microscope slide, Thayer-Martin medium, contrary to the manufacturer's claim, was not found to be the medium giving best results, and presence or absence of serum in the media did not affect the results . A large number of inconclusive results were obtained . A modification of the alternative procedure, which uses a heated suspension of the gonococcal cells as the antigen, is described . Of the 432 strains of N . gonorrhoeae examined by this method, 427 were accurately identified . Five strains, however, gave false-negative results . None of the 80 strains of N . meningitidis gave positive results . Nine of nineteen strains of N . lactamica, however, gave clear-cut positive results . Use of the o-nitrophenyl-beta-D-galactopyranoside test in conjunction with the Phadebact Gonococcus Test, particularly on isolates from the pharynx, is recommended. J Bacteriol, 1980 Jul, 143(1), 182 - 7 Cross-linking analysis of Neisseria gonorrhoeae outer membrane proteins; Leith DK et al.; The arrangement of proteins in the outer membrane of Neisseria gonorrhoeae was investigated through the use of cleavable chemical cross-linking reagents and two-dimensional sodium dodecyl sulfate-polyacrylamide gel electrophoresis . Cross-linking of isolated outer membranes yielded dimers and trimers of the major outer membrane protein . In addition, data were obtained suggesting that a stable interaction exists between the major protein I and protein II, the second most prevalent protein in the gonococcal outer membrane. Am J Obstet Gynecol, 1980 Jul 1, 137(5), 595 - 9 Rapid presumptive diagnosis of gonococcal cervicitis by the limulus lysate assay; Spagna VA et al.; In an evaluation of the limulus lysate assay (LLA) as a method for detecting gonococcal endotoxin in cervical exudates diluted 1:800, positive LLA results were obtained from 17 of 18 patients (94%) with culture-proved gonococcal cervicitis, and negative results were obtained from 22 of 22 patients (100%) with culture-negative specimens . In vitro tests comparing the sensitivity of the LLA for Neisseria gonorrhoeae and other gram-negative organisms showed the LLA to be more sensitive in detecting N . gonorrhoeae (minimum sensitivity, 10(4) organisms per milliliter) than other commonly encountered urogenital gram-negative bacteria (minimum sensitivity, greater than 10(5) organisms per milliliter) . Thus, in preliminary studies involving otherwise healthy women, the LLA appeared to correlate with bacteriologic methods for diagnosing gonococcal cervicitis and may aid in identifying nongonococcal cervicitis . In addition, the LLA was easy to perform, with test results available within an hour after the patient's initial examination. J Bacteriol, 1980 Jul, 143(1), 198 - 204 Cytoplasmic membrane proteins of spectinomycin-susceptible and -resistant strains of Neisseria gonorrhoeae; Miller MA et al.; Cytoplasmic membranes were isolated and examined from two spectinomycin-susceptible and three spectinomycin-resistant clinical strains of Neisseria gonorrhoeae . A laboratory-derived spectinomycin-resistant mutant, obtained by serial passage on gradually increasing concentrations of the antibiotic, and a susceptible revertant, spontaneously arising from one of the resistant clinical strains, were also studied . Sodium dodecyl sulfate-polyacrylamide slab gel electrophoresis revealed that a major protein, comprising about 7% of total cytoplasmic membrane protein (molecular weight 24,000), was absent in the three clinically isolated spectinomycin-resistant strains . In a revertant, this protein reappeared . During treatment of one of the susceptible strains with spectinomycin, the protein disappeared . However, this correlation was not maintained in the laboratory-derived spectinomycin-resistant mutant . This mutant was of comparable resistant to the clinical isolates, but the 24,000-molecular-weight protein was present in normal quantities . In addition, spectinomycin resistant in clinical isolates was variable compared with stable resistance exhibited by the laboratory-derived mutant . These findings suggested that differences in laboratory-derived versus clinical spectinomycin resistance may be due to different types of resistance mutations. Infect Immun, 1980 Jul, 29(1), 287 - 9 Cotransformation of a serum resistance phenotype with genes for arginine biosynthesis in Neisseria gonorrhoeae; Spratt SK et al.; Two genes (arg-3 and arp-6) marked by arginine auxotrophy and a gene (sac-2) marked by resistance to serum killing were found to be linked by cotransformation . Evidence derived from the linkage of these markers to spc (spectinomycin resistance) suggests that sac-2 may be genetically distinct from a sac gene previously described. Infect Immun, 1980 Jul, 29(1), 181 - 5 Physical map of the conjugal plasmid of Neisseria gonorrhoeae; Tenover FC et al.; The 24.5-megadalton plasmid of Neisseria gonorrhoeae is required for transfer of R-factors and possibly chromosomal markers during conjugal matings between gonococcal strains . We constructed a physical map of one such plasmid, pLE2451, using EcoRI, BglII, and HincII site-specific restriction endonucleases . The patterns of deoxyribonucleic acid digestion obtained with this plasmid were identical to those obtained with three other plasmids of similar size. J Infect Dis, 1980 Jul, 142(1), 23 - 31 Antigenic specificity of antibodies in vaginal secretions during infection with Neisseria gonorrhoeae; Tramont EC et al.; Antibodies in genital secretions of patients with gonorrhea have been shown to inhibit the attachment of gonococci to epithelial cells . The gonococcal antigens for which these antibodies are specific were studied by adsorption of the genital secretions from a patient infected with gonorrhea with purified lipopolysaccharide, outer membrane complex, or purified pili of homologous Neisseria gonorrhoeae and measurement of the reduction of inhibition of attachment of the gonococci to epithelial cells . The removal of antibodies was documented with the use of a solid-phase radioimmunoassay in which the amount of antibody in the adsorbed secretions that bound to a specific gonococcal antigen was shown to be reduced as compared with the amount of antibody in unadsorbed secretions . The antibody in the secretions that inhibited attachment was removed primarily by adsorption with the homologous pili, not with homologous lipopolysaccharide . A preparation of the homologous outer membrane complex that contained pili, cell-wall proteins, and lipopolysaccharide also blocked the inhibitory antibody. J Gen Microbiol, 1980 Jul, 119(1), 179 - 87 The cohesive properties of variants of Neisseria gonorrhoeae strain P9: specific pilus-mediated and non-specific interactions; Trust TJ et al.; The cohesive properties of virulent pilated Neisseria gonorrhoeae strain P9 (P++) have been compared with those of a non-pilated isogenic variant (P-) possessing the same outer membrane components . The binding of P++ gonococci to buccal epithelial cells was dependent on pH, with an optimum at pH 6.5 to 7.0 . This adhesion was markedly inhibited by treatment of the buccal epithelial cells with a neuraminidase/exoglycosidase mixture . In contrast, the binding of P++ gonococci to erythrocytes was unaffected by pH . A possible explanation is that pili bind to a carbohydrate receptor present on buccal epithelial cells but lacking on erythrocytes . The adhesion of P- gonococci to erythrocytes and to buccal epithelial cells was unaffected by pH but enhanced by treatment of the cells with neuaminidase or periodate . Presumably, neuraminic acid residues on host cell surface carbohydrates inhibit adhesion . The finding that P- gonococci bind to amphipathic gels suggests hydrophobic interactions as a possible non-specific mechanism attaching P- gonococci to host cell surfaces. Z Hautkr, 1980 Jun 15, 55(12), 790 - 8 {Therapy of sexually transmissible diseases}; Luger A; Penicillin is still the drug of first choice for the treatment of Syphilis and Gonorrhoea . The therapy of infections with Treponema pallidum requires long lasting stabile blood and tissue levels, Neisseria gonorrhoeae can be eradicated by high serum concentrations of short duration . Chancroid and Donovanosis respond well to tetracylines, macrolide antibiotics and aminoglycosides while the application of sulfonamides or tetracyclines is suitable for the control of Lymphogranuloma venereum . Metronidazole or nimorazole derivatives may cure Trichomoniasis . Infections with Mycoplasmas (Urea-plasma) or Chlamydiae can be treated by tetracyclines only . Genital candidosis usually disappears after topical use of miconazole- or econazole- or clotrimazole-ointments . Herpes genitalis cannot be influenced by pharmacotherapeutical means, relapsing forms may be suppressed by vaccination . Mollusca contagiosa should be removed by the surgical spoon and genital warts can be destroyed by electrocautherization or by topical application of podophyllin solution. Br J Vener Dis, 1980 Jun, 56(3), 148 - 50 Prevalence of cervical gonorrhoea in women with unwanted pregnancies; van der Lugt B et al.; PIP: Abortion performed in women with cervical gonorrhea may result in increasing infection . For this reason cervical specimens were collected from 1688 women attending a gynecological clinic for induced abortion in an urban center in the Netherlands between February and December 1978 . 13 of the women, 0.77%, had positive culture results for Neisseria gonorrhea . Among those women who had a completed family or who came from outside Rotterdam or from outside the neighboring Rijnmond area, the isolation rate was very low . None of the women with positive culture results developed salpingitis following abortion . All of the women were treated prophylactically with tetracycline . There appear to be no reasons for considering women who seek abortions to be in a high-risk group for cervical gonorrhea . J Clin Microbiol, 1980 Jun, 11(6), 631 - 4 Bactericidal screening test for late complement component deficiencies or defects; Eng RH; Congenital complement deficiency has been described in disseminated Neisseria infections . Its occurrences in humans with other kinds of infections have not been described . In the past, CH50 determinations have been used to detect these deficiencies, but this procedure is time consuming and cumbersome . A method of determining the presence of late component deficiencies or defects is described which is easy and inexpensive to perform . An agar pour plate with a serum-sensitive Escherichia coli strain is made, and 2.5-mm wells are put in the agar . Unknown fresh sera are used to fill the wells . An absence of a zone of bacterial growth inhibition around the well after incubation at 37 degrees C overnight indicates a late component defect or deficiency in the test serum . By applying this assay to 35 selected patients, four deficient patients were identified . One had a congenital C5 deficiency and three had C6 deficidencies . It is suggested that the assay be used as a screening test to study the relationship between congenital complement deficiencies and various kinds of infections, especially those caused by organisms which are partially serum sensitive. Ann Intern Med, 1980 Jun, 92(6), 805 - 8 Sexually transmitted diseases and traumatic problems in homosexual men; Owen WF Jr; In addition to gonorrhea and syphilis, both of which may develop primarily at anorectal or pharyngeal sites, a number of conditions, including Neisseria meningitidis urethritis, nonspecific urethritis, anorectal herpes, condyloma acuminatum, amebiasis, giardiasis, shigellosis, typhoid fever, enterobiasis, and hepatitis A and B, have been identified as being transmitted by male homosexual contact . Proctologic complications of anal intercourse include allergic reactions to anal lubricants, prolapsed hemorrhoids, and fistulas, and fissures . Rectosigmoid tears may result from fist, forearm, and foreign body penetration of the bowel . Physicians can best help their homosexual patients by accepting them and their relationships nonjudgmentally and by understanding their special health needs. Am J Clin Pathol, 1980 Jun, 73(6), 774 - 81 Recovery of Chlamydia trachomatis from patients of southeastern venereal disease clinic; Bradley BS et al.; The authors determined the incidences of Chlamydia trachomatis colonization obtained by use of two methods of isolation in 169 specimens from individuals attending a venereal disease clinic . Speciments were collected in phosphate sucrose buffer and planted simultaneously onto McCoy cells previously treated with 5-iodo-2-deoxyuridine (IUDR) and with cycloheximide . As controls, specimens were obtained from 76 hospital employees or medical students without clinical signs of infection and cultured in a similar manner . Qualitatively, recoveries of Chlamydia trachomatis inclusions from the differently treated cells were the same, but the number of inclusions per ml was greater for the cycloheximide-treated cells . Recoveries of Chlamydia trachomatis from the venereal disease clinic population were 33% for those patients who also had simultaneous culture positive for Neisseria gonorrhoeae and 42% for those with nongonococcal urethritis . The recovery of Chlamydia trachomatis from the control group was 5%. J Gen Microbiol, 1980 Jun, 118(2), 523 - 7 The complexity of immunogenicity of Neisseria gonorrhoeae in the guinea pig subcutaneous chamber model; Parsons NJ et al.; The immunogenicity of Neisseria gonorrhoeae in the guinea pig subcutaneous chamber model, assessed by serum bactericidal tests and challenge experiments, is complicated by diversity of immunotypes which may or may not show partial cross-reactions, by the need for antibodies to more than one type-specific antigen for full homologous protection, and possibly by the limited accessibility of the relevant antigens on the cell surface. Br J Vener Dis, 1980 Jun, 56(3), 144 - 7 Identification of Neisseria gonorrhoeae in the routine venerelogical laboratory: Comparative study of coagglutination, direct immunofluorescence, and sugar fermentation reaction; Rufli T; The coagglutination (CoA) method for the identification of Neisseria gonorrhoeae colonies grown on selective culture media was used on 116 strains in a routine venereological laboratory together with the direct immunofluorescence (IF) test and the sugar fermentation reaction . Correlation of results between the CoA method and the direct IF test and between the CoA test and the sugar fermentation reaction was 95.7% and 97% respectively . The sugar fermentation reaction requires subcultures and is more time-consuming than the IF test; the latter needs elaborate technical equipment and experience . The CoA method however can be carried out with the primary culture, is technically easy to perform and to reproduce, and the result is available within minutes. Infect Immun, 1980 Jun, 28(3), 991 - 1000 Gonococci-human polymorphonuclear leukocyte interactions: metabolic studies associated with attachment and ingestion; Krieger AG et al.; Utilizing monolayers of human polymorphonuclear leukocytes, optimal conditions for attachment and ingestion of Neisseria gonorrhoeae were determined . Both attachment and ingestion were optimal at 36 degrees C when a bacteria-leukocyte ratio of 100:1 was employed . After 30 min of incubation, log-phase viable type 2 gonococci were attached to 90% of leukocytes, whereas log-phase viable type 4 gonococci were ingested by 80 to 90% of cells . Respiratory inhibitors had no effect on attachment or ingestion, whereas glycolytic inhibitors blocked ingestion but did not affect attachment of gonocci to the leukocyte surface . Inhibition was dose dependent and partially reversible . The oxidative metabolism of leukocytes with gonococci attached or ingested was also examined . Attachment of log-phase type 2 gonococci stimulated a minimal increase in glucose oxidation and oxygen consumption by leukocytes in contrast to marked increases by leukocytes that had ingested viable type 4 or heat-killed typed 2 organisms . These results demonstrate that attachment of log-phase type 2 gonococci to the surface membrane does not stimulate significant leukocyte oxidative metabolism nor initiate the phagocytic process. Infect Immun, 1980 Jun, 28(3), 785 - 91 Cross-linking analysis of the outer membrane proteins of Neisseria gonorrhoeae; Newhall WJ et al.; The organization of outer membrane proteins of Neisseria gonorrhoeae was investigated by using two-dimensional dodecyl sulfate-polyacrylamide gel electrophoresis and cross-linking agents . A naturally occurring protein aggregate, which may be composed of two proteins of 50,000 molecular weight, was detected in all strains . Treatment of whole cells with cross-linking agents yielded several additional complexes, suggesting that other proteins are arranged in the outer membrane as near neighbors . The principal outer membrane protein (molecular weight, 34,000) cross-linked (i) to itself to form a complex whch appeared to be trimeric, (ii) to the 28,000-molecular-weight outer membrane protein to form a bimolecular comlex, and (iii) to the 28,000-molecular-weight outer membrane protein in a 3:1 ratio . The formation of these complexes was independent of (i) colony type, (ii) colony opacity, (iii) pH during growth, and (iv) presence of markers for drug resistance or hypersensitivity. Inflammation, 1980 Jun, 4(2), 137 - 44 IgA paraprotein inhibition of human neutrophil chemotaxis . Reduced activity following treatment with IgA-specific protease from Neisseria gonorrhoeae; Van Epps DE et al.; Removal of the Fc region of human IgA m components by treatment with IgA-specific protease from Neisseria gonorrhoeae reduces the neutrophil chemotactic inhibitory activity associated with IgA M components . This observation, along with the failure of an IgA halfmer paraprotein to inhibit neutrophil chemotaxis, emphasizes the importance of the IgA Fc region in the inhibition of neutrophil chemotaxis by IgA M components. Ann Emerg Med, 1980 Jun, 9(6), 314 - 5 Penile edema in childhood gonorrhea; Fleisher G et al.; A two-year-old boy with painless penile edema was seen in our emergency department . No discharge was present initially, but palpation of the urethra expressed a drop of material from the meatus . Neisseria gonorrhoeae was isolated, and the edema resolved rapidly following penicillin treatment . This report provides, to out knowledge, the first description of penile venereal edema in a child and discusses the diagnostic considerations in penile swelling. J Bacteriol, 1980 Jun, 142(3), 879 - 87 Terminal branching of the respiratory electron transport chain in Neisseria meningitidis; Yu EK et al.; The respiratory components of the envelope membrane preparation of Neisseria meningitidis were investigated . Oxidase activities were demonstrated in this fraction in the presence of succinic acid, reduced nicotinamide adenine dinucleotide, and ascorbate-N,N,N',N'-tetramethyl-p-phenylene-diamine (TMPD) . Differences in the kinetics of inhibition by terminal oxidase inhibitors on the three oxidase activities indicated that ascorbate-TMPD oxidation involved only an azide-sensitive oxidase, whereas oxidation of the physiological substrates involved two oxidases, one of which was relatively azide resistant . Spectrophotometric studies revealed that ascorbate-TMPD donated its electrons exclusively to cytochrome o, whereas the physiological substrates were oxidized via both cytochromes o and a . The effects of class II inhibitors on the oxidases suggest terminal branching of the electron transport chain at the cytochrome b level . A model of the respiratory system in N . meningitidis is proposed. Acta Pathol Microbiol Scand {C}, 1980 Jun, 88(3), 155 - 62 An indirect haemagglutination test for demonstration of gonococcal antibodies using gonococcal pili as antigen . II . Serological investigation of patients attending a dermato-venereological outpatients clinic in Copenhagen; Reimann K et al.; A total of 1223 serum specimens were obtained from 649 consecutive patients attending a dermatovenereological out-patient clinic in Copenhagen with a request for venereal disease control . The sera were examined for gonococcal antibodies by both a gonococcal complement fixation test (GCF) and an indirect haemagglutination test using gonococcal pili as antigens (IHA) . The diagnosis of current gonococcal infection in 28 per cent of the patients was based on positive culture for Neisseria gonorrhoeae from one or more of the following sites: urethra, rectum and fauces in all patients, and/or cervix in female patients . The specificity, sensitivity and predictive values of positive and negative test results were calculated for the various groups of patients on the assumption that all positive results, both in patients without gonorrhoea but with a previous gonococcal infection and in patients without known current or previous infection, were false positives . The following values were found: Sensitivity: IHA 45-100%, GCF 6-29% . Specificity: IHA 65-89%, GCF 97-100% . Predictive value of positive test result: IHA 43-74%, GCF 69-100% . Predictive value of negative test result: IHA 78-100%, GCF 61-85%. An Esp Pediatr, 1980 May, 13(5), 381 - 90 {Infections of the central nervous system . A review of 295 cases (author's transl)}; Perez-Yarza EG et al.; Authors report results of treatment of 295 cases of CNS infection, of which 220 were bacterial meningitis and 75 viral meningitis . Positive cultures wre obtained in 62% of bacterial meningitis (122 "Neisseria meningitidis", eight "Pneumococci", three "Haemophylus influenzae" type B and three "M . tuberculosis") . Mortality in bacterial meningitis was 9%, and only 2% in viral meningitis . The main epidemiological, clinical and laboratory data are discussed. Jugosl Ginekol Opstet, 1980 May-Aug, 20(3-4), 203 - 7 {Bacteriological findings in the cervical mucus of sterile women}; Dolenec N; In 61 sterile women the cervical secretion was examined bacteriologically . Neisseria gonorrhoeae was found in one women (1.6%), in two women the nutrient media remained sterile, in three women no pathogenic bacteria were observed, while in the remaining 55 women (90.16%) there were microorganisms without any pathogenic effect on the cervix . The kind and percentage of the isolated bacteria are shown in tabular form. Obstet Gynecol, 1980 May, 55(5 Suppl), 154S - 161S Significance of polymicrobial bacterial superinfection in the therapy of gonococcal endometritis-salpingitis-peritonitis; Monif GR; The application of sophisticated anaerobic technology coupled with culdocentesis has radically altered out concepts of endometritis-salpingitis-peritonitis (ESP) . The demonstration of a polymicrobial predominantly anaerobic peritonitis in selected cases of ESP polarized conceptual thought into gonococcal and nongonococcal etiology . The data that substantiated the concept of anaerobic infection following initial infection by Neisseria gonorrhoeae are reviewed . Therapy studies utilizing doxycycline have indicated that there is an anticipated therapeutic response when dealing with monoetiologic disease (gonococcal ES or gonococcal ESP) . When polymicrobial infection ensues with or without the concomitant presence of N gonorrhoeae, an alternate therapeutic response may evolve . It is currently postulated that the significance of an altered therapeutic response is due to augmented structural damage to the fallopian tubes by superinfecting anaerobes . The current goal of therapy is to reproduce as closely as possible the anticipated therapeutic response observed with monoetiologic disease. Hautarzt, 1980 May, 31(5), 245 - 50 {Growth patterns of Neisseria gonorrhoeae: occurrence and significance}; Kellogg DS; The introduction of transparent mediums for the growth of the gonococcus in the laboratory led to a definitive examination of colonial morphology . Characteristics, such as size, elevation, colour, highlights, opacity, . consistency and evaluation of edges make possible to distinguish five colonial types: T1-T5 . The most significant characteristic associated with colony morphology has been virulence; T1/T2-colonies are virulent for humans and T3/T4-colonies are avirulent . Interactions with host cells, metabolic, antigenic and genetic characteristics of N . gonorrhoease of different colonial morphology are discussed. Obstet Gynecol, 1980 May, 55(5 Suppl), 142S - 153S Epidemiology and diagnosis of acute pelvic inflammatory disease; Eschenbach DA; Epidemiologic factors important in acute pelvic inflammatory disease (PID) are the pathogenic organisms Neisseria gonorrhoeae and Chlamydia trachomatis, less pathogenic mycoplasma, and endogenous aerobic and anaerobic bacteria . Other risk factors for PID include the number of sexual partners, previous PID, previous gonorrhea, and male gonorrhea . The patient's age, IUD use, and social factors may be dependent variables for the development of PID . The diagnosis is often difficult to establish; practical diagnostic methods include a careful history and physical examination, laboratory tests (particularly a cervical Gram stain), culdocentesis, and examination of the male . Laparoscopy should be used when the diagnosis is unclear. Sex Transm Dis, 1980 Apr-Jun, 7(2), 85 - 6 Treatment of women with uncomplicated gonococcal infection; Fiumara NJ; The records of 121 women treated for endocervical infection with Neisseria gonorrhoeae during 1978 were examined . Ninety-six women had gonococcal cervictis alone, 16 had concomitant pharyngeal infection, three had concomitant anal infection, and six were infected at all three sites . Ninety-three women returned for examination after treatment; 71 were treated with 4.8 X 10(6) units of aqueous procaine penicillin G without probenecid . There was no therapeutic failure with this treatment at the endocervical (71 patients) or pharyngeal (16 patients) sites . One of six women who had anal infection was still infected one week after treatment . All of 17 women who received tetracycline orally for five days had negative cervical cultures after treatment . Six women with concomitant pharyngeal infection and two with concomitant anal infection also had negative cultures af