Abstract
In addition to the urogenital tract, Neisseria gonorrhoeae infects extragenital sites such as the pharynx and anorectal canal. Culture and a ligase chain reaction (LCR)-based assay were compared for their performance for the diagnosis of N. gonorrhoeae infection with specimens from various urogenital and extragenital sites of 200 men and 125 women. The sensitivity and specificity of the LCR assay with male urethral swabs were both 100%, compared to values of 95.9 and 100%, respectively, for culture of urethral swabs or 98.0 and 100%, respectively, for LCR with first-void urine (FVU). For women, LCR with FVU showed the highest sensitivity (94.7%), and culture of urethral samples showed the lowest sensitivity (63.2%) (P < 0.05). In a selected subgroup of 47 men and 22 women at increased risk, the rates of pharyngeal infection were 15 and 18%, respectively, and those of anorectal infection were 13 and 45%, respectively. The sensitivity of LCR was greater than that of culture for both pharyngeal and anorectal specimens. Thus, the overall performance of LCR testing with swabs or FVU was better than that of culture for the diagnosis of genital or extragenital gonorrhea.
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- Birkenmeyer L., Armstrong A. S. Preliminary evaluation of the ligase chain reaction for specific detection of Neisseria gonorrhoeae. J Clin Microbiol. 1992 Dec;30(12):3089–3094. doi: 10.1128/jcm.30.12.3089-3094.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ching S., Lee H., Hook E. W., 3rd, Jacobs M. R., Zenilman J. Ligase chain reaction for detection of Neisseria gonorrhoeae in urogenital swabs. J Clin Microbiol. 1995 Dec;33(12):3111–3114. doi: 10.1128/jcm.33.12.3111-3114.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ho B. S., Feng W. G., Wong B. K., Egglestone S. I. Polymerase chain reaction for the detection of Neisseria gonorrhoeae in clinical samples. J Clin Pathol. 1992 May;45(5):439–442. doi: 10.1136/jcp.45.5.439. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Iwen P. C., Walker R. A., Warren K. L., Kelly D. M., Hinrichs S. H., Linder J. Evaluation of nucleic acid-based test (PACE 2C) for simultaneous detection of Chlamydia trachomatis and Neisseria gonorrhoeae in endocervical specimens. J Clin Microbiol. 1995 Oct;33(10):2587–2591. doi: 10.1128/jcm.33.10.2587-2591.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Judson F. N., Ruder M. A. Effect of hysterectomy on genital infections. Br J Vener Dis. 1979 Dec;55(6):434–438. doi: 10.1136/sti.55.6.434. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kinghorn G. R., Rashid S. Prevalence of rectal and pharyngeal infection in women with gonorrhoea in Sheffield. Br J Vener Dis. 1979 Dec;55(6):408–410. doi: 10.1136/sti.55.6.408. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lee H. H., Chernesky M. A., Schachter J., Burczak J. D., Andrews W. W., Muldoon S., Leckie G., Stamm W. E. Diagnosis of Chlamydia trachomatis genitourinary infection in women by ligase chain reaction assay of urine. Lancet. 1995 Jan 28;345(8944):213–216. doi: 10.1016/s0140-6736(95)90221-x. [DOI] [PubMed] [Google Scholar]
- Lewis J. S., Fakile O., Foss E., Legarza G., Leskys A., Lowe K., Powning D. Direct DNA probe assay for Neisseria gonorrhoeae in pharyngeal and rectal specimens. J Clin Microbiol. 1993 Oct;31(10):2783–2785. doi: 10.1128/jcm.31.10.2783-2785.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mahony J. B., Luinstra K. E., Tyndall M., Sellors J. W., Krepel J., Chernesky M. Multiplex PCR for detection of Chlamydia trachomatis and Neisseria gonorrhoeae in Genitourinary specimens. J Clin Microbiol. 1995 Nov;33(11):3049–3053. doi: 10.1128/jcm.33.11.3049-3053.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Smith K. R., Ching S., Lee H., Ohhashi Y., Hu H. Y., Fisher H. C., 3rd, Hook E. W., 3rd Evaluation of ligase chain reaction for use with urine for identification of Neisseria gonorrhoeae in females attending a sexually transmitted disease clinic. J Clin Microbiol. 1995 Feb;33(2):455–457. doi: 10.1128/jcm.33.2.455-457.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Thayer J. D., Martin J. E., Jr Improved medium selective for cultivation of N. gonorrhoeae and N. meningitidis. Public Health Rep. 1966 Jun;81(6):559–562. [PMC free article] [PubMed] [Google Scholar]
- Thin R. N., Shaw E. J. Diagnosis of gonorrhoea in women. Br J Vener Dis. 1979 Feb;55(1):10–13. doi: 10.1136/sti.55.1.10. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tice A. W., Jr, Rodriguez V. L. Pharyngeal gonorrhea. JAMA. 1981 Dec 11;246(23):2717–2719. [PubMed] [Google Scholar]