Serologic diagnosis of gonococcal infection

Indirect haemagglutination test using gonococcal pilus antigen: how useful to diagnose gonorrhoea?

In 1979 an indirect haemagglutination test (gonococcal antibody test) using gonococcal pilus antigen replaced the gonococcal complement fixation test as our routine procedure to show gonococcal antibodies. In the diagnosis of current gonorrhoea the sensitivity of the gonococcal antibody test was far superior to that of the gonococcal complement fixation test (about 55% versus 9% for first episode gonorrhoea). To evaluate the usefulness of the test result the following population groups were studied: 1376 patients undergoing medical examination for gonorrhoea (386 had gonorrhoea), 1384 healthy people aged 15-65, 54 patients with meningococcal disease, 30 children with respiratory tract infection, and 254 patients with evidence of various diseases other than neisserial infections that might be associated with symptoms of arthritis. These investigations showed that (1) non-specific positive gonococcal antibody test results occur rarely, (2) at least half the people who have had gonorrhoea remain seropositive (with titres of 1/40 to 1/160), and (3) a positive test result is more significant the younger the patient and the higher the titre. For younger people a positive test result should always be followed up by bacteriological examination; in all age groups titres of 1/320 or more should indicate medical examination for current gonorrhoea.

Radioimmunoassay for detection of antibodies to Neisseria gonorrhoeae

A radioimmunoassay has been developed and evaluated for the serological diagnosis of gonorrhea. Purified gonococcal antigen was obtained from a culture of Neisseria gonorrhoeae (B370) and labeled with 125I for use in a double-antibody test system. The test was evaluated in populations segregated by sex and risk. The specificity of the assay in females was 90.2% (55/61) in low risk, 82.2% (2,245/ 2,732) in medium risk, and 54.1% (335/619) in high risk. The sensitivity was 69% (20/29) in medium risk and 78.3% (288/367) in high risk. In males, test specificity was 92.3% (24/26) in low risk and 50% (48/96) in high risk. The sensitivity was 70.8% (143/202) in the high-risk group. The data in this study indicate that this assay should not be employed for screening of either high- or medium-risk populations.