The diagnosis of gonorrhea in a low-prevalence female population: enzyme immunoassay versus culture

In a low-prevalence population for sexually transmitted disease, accurate methods of identifying Neisseria gonorrhoeae infections are of paramount importance. Tests with low sensitivity are of concern to each practitioner. Of no less concern, however, are the possible social and emotional consequenc...

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Bibliographic Details
Published inObstetrics and gynecology (New York. 1953) Vol. 69; no. 5; p. 743
Main Authors Lieberman, R W, Wheelock, J B
Format Journal Article
LanguageEnglish
Published United States 01.05.1987
Subjects
Antigens, Bacterial - analysis
Evaluation Studies as Topic
False Positive Reactions
Female
Gonorrhea - diagnosis
Gonorrhea - epidemiology
Humans
Immunoenzyme Techniques
Military Personnel
Mississippi
Neisseria gonorrhoeae - immunology
Neisseria gonorrhoeae - isolation & purification
Risk
Mississippi
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Summary:In a low-prevalence population for sexually transmitted disease, accurate methods of identifying Neisseria gonorrhoeae infections are of paramount importance. Tests with low sensitivity are of concern to each practitioner. Of no less concern, however, are the possible social and emotional consequences of a false-positive test in a family-based, rural, or military community. Several centers serving high-prevalence populations have shown that the Gonozyme Enzyme Immunoassay may provide many advantages in the rapid detection of gonococcal infection in these groups. Few studies, however, have evaluated its efficacy in low-prevalence populations. We compared the Gonozyme with Martin-Lewis culture medium in 1490 women considered at risk for infection with N gonorrhoeae at Keesler USAF Medical Center, Mississippi. Fifty-three women had culture-proved infections (3.6% disease prevalence). The sensitivity and specificity of the Gonozyme in this population were 92.4 and 97.2%, respectively. However, the predictive value of a positive test was only 55.1%, mandating culture confirmation. It appears that in a low-prevalence female population, standard culture techniques provide a more efficient and reliable means of detecting N gonorrhoeae than does the Gonozyme Enzyme Immunoassay.
ISSN:0029-7844