Asymptomatic gonorrhea: selective screening and guidelines for identification of high risk patients

As recently as 1980, gonorrhea ranked first among communicable diseases in the U.S.A. More alarming was the fact that 75 to 80 percent of infected females were reported to be asymptomatic. As more of these asymptomatic individuals were discovered, the tendency to do routine gonococcal screening in women increased. Of late, however, the trend to abstain from doing routine gonococcal screening has become more evident because of the low yield of positive cultures in the majority of the population screened. The St. Joseph's Medical Center is a single residency (Family Practice) teaching hospital serving the community of Yonkers, N.Y. The St. Joseph's Family Health Center serves as the model unit where our residents work and is also the main outpatient facility of the hospital. The objective of our study was to determine the incidence of asymptomatic gonorrhea prospectively and randomly, in our female patients, to form guidelines to separate high from low risk patients, and to discuss the question of whether gonococcal screening should be performed routinely in females.