Utility of monoclonal antibody coagglutination to identify Neisseria gonorrhoeae

The Phadebact monoclonal gonococcus coagglutination test was evaluated with 1367 (996 anogenital and 371 pharyngeal) neisserial isolates from patients who gave positive diagnostic test results for Neisseria gonorrhoeae. The overall correlation with carbohydrate utilisation was 99.7%. The Phadebact test had a specificity of 100% (286/286) and a sensitivity of 99.7% (1077/1080). The three non-reactive strains were epidemiologically linked and were of a very unusual serovar. Unlike polyclonal antibody based tests, the monoclonal antibody test provides reliable identification of gonococci from anogenital and pharyngeal sites. Because non-reactive strains are rare, however, negative anogenital isolates from heterosexual patients should be tested biochemically. The use of two reagents comprising separate pools of monoclonal antibodies against gonococcal protein IA and IB permitted the identification of an appreciable number of double infections, which would otherwise have been missed. Genital, rectal, and pharyngeal isolates from the same patient should be identified individually.