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Isolation of Neisseria meningitidis from anogenital specimens from homosexual men
Abstract:
By use of the fluorescent antibody technique, the authors examined 663 consecutive anogenital isolates from men that satisfied the presumptive criteria for Neisseria gonorrhoeae of the Center for Disease Control (Atlanta, Ga.). Most urethral isolates (364 of 368; 98.9%) from men presumed to be heterosexual were confirmed as N. gonorrhoeae. In contrast, urethral (98 of 114; 86%) and anal (136 of 175; 78%) isolates from homosexual men contained N. gonorrhoeae significantly less often (P less than 0.001). Most the isolates with negative results in the fluorescent antibody test for N. gonorrhoeae were shown to be Neisseria meningitidis by use of sugar fermentation reactions. Homosexual men sampled at two bathhouses for gay men were more likely to have oropharyngeal Neisseria isolated from anogenital cultures than were homosexual men screened in a clinic for gay men. Reliance on presumptive criteria for the identification of N. gonorrhoeae in anogenital cultures taken from homosexual men is inappropriate.
Insights
Presumptive identification of Neisseria gonorrhoeae in homosexual men is unreliable. Fluorescent antibody testing confirmed fewer isolates from homosexual men, with many misidentified Neisseria meningitidis.
Area of Science:
- Microbiology
- Infectious Diseases
- Public Health
Background:
- Neisseria gonorrhoeae is a primary cause of sexually transmitted infections.
- Accurate identification of N. gonorrhoeae is crucial for effective treatment and control.
- Previous diagnostic methods may have limitations in specific populations.
Purpose of the Study:
- To evaluate the accuracy of presumptive identification of Neisseria gonorrhoeae in anogenital isolates from men.
- To compare diagnostic yields between heterosexual and homosexual men.
- To assess the utility of presumptive criteria in identifying N. gonorrhoeae in homosexual populations.
Main Methods:
- Utilized the fluorescent antibody technique for N. gonorrhoeae identification.
- Examined 663 anogenital isolates from men meeting presumptive criteria.
- Employed sugar fermentation reactions to identify Neisseria species.
Main Results:
- 98.9% of urethral isolates from presumed heterosexual men were confirmed N. gonorrhoeae.
- Significantly lower confirmation rates for N. gonorrhoeae in homosexual men (86% urethral, 78% anal).
- Neisseria meningitidis was identified in isolates that were presumptively N. gonorrhoeae.
Conclusions:
- Presumptive criteria for N. gonorrhoeae are inappropriate for anogenital isolates from homosexual men.
- Diagnostic inaccuracies can lead to misidentification, particularly with Neisseria meningitidis.
- Further research is needed to refine diagnostic strategies for N. gonorrhoeae in diverse populations.