Quantitation of Neisseria gonorrhoeae from women with gonorrhea

The number of infecting organisms has been shown to be an important variable in animal models of infection with Neisseria gonorrhoeae. This variable may also be important in the natural transmission of gonorrhea in humans. The number of gonococci in the cervicovaginal area of women with gonorrhea is unknown, as are the effects of certain physiologic or therapeutic variables on the number of gonococci. In this study a semiquantitative technique for the enumeration of N. gonorrhoeae was used; 10 ml of phosphate-buffered saline was directed against the cervix and vaginal wall, and the number of colony-forming units (cfu) of N. gonorrhoeae in the aspirate was determined. The number of N. gonorrhoeae recovered ranged from 4.0 X 10(2) to 1.8 X 10(7) cfu. The geometric mean number was 1.45 X 10(5) cfu, with a standard deviation of 1.04 X 10(1) cfu. Statistical analyses showed that the number of gonococci was not influenced by the use of oral contraceptives, concurrent infection with Trichomonas vaginalis and/or Corynebacterium (Haemophilus)vaginalis, time of douche prior to examination, or phase of the menstrual cycle at which the women were examined. The results indicated a wide range in the number of N. gonorrhoeae recoverable by vaginal irrigation but failed to define the reason for this variability.