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1.  Survival of Chlamydia trachomatis in different transport media and at different temperatures: diagnostic implications. 
We compared the survival of a laboratory strain of Chlamydia trachomatis serovar L-2 in different media and at different temperatures (room temperature, 4 degrees C, and -70 degrees C). At these temperatures the best storage medium was 2SP (0.2 mol/l sucrose in 0.02 mol/l phosphate buffer supplemented with 10% fetal calf serum). We used material obtained from patients to study the sensitivity of the culture method as a function of sample storage time and temperature. Compared with results on direct inoculation, material stored in 2SP for 48 hours gave 11% fewer positive cultures at 4 degrees C and 14% fewer at room temperature. Of samples which gave negative results on direct inoculation, 4% were positive after storage at 4 degrees C for 48 hours and 2% after storage at -70 degrees C for a week. As expected, the number of inclusion forming units in the original material proved to be important for the percentage of positive cultures among the stored samples.
PMCID: PMC1046443  PMID: 6367887
2.  Enzyme-linked immunosorbent assay for detecting gonococcal antibodies using two antigenically different gonococcal pili as antigen. 
Antibodies to pilar antigens of two gonococcal strains isolated in Rotterdam (6650 and 1443) were detected using enzyme-linked immunosorbent assays (ELISA). Paired sera (the first sample taken at the first examination (D1) and the second 11-22 days later (D2)) from women with and without gonorrhoea attending a sexually transmitted disease (STD) clinic were studied. The sensitivity of the ELISA using gonococcal pili 6650 as antigen (ELISA 6650) was significantly higher than that using gonococcal pili 1443 as antigen (ELISA 1443). The specificity of the two tests differed little. On D1 the sensitivity in women with uncomplicated gonorrhoea was 69% in the ELISA 6650 and 45% in the ELISA 1443; the corresponding values in asymptomatic infected women were 75% and 57% respectively. The agreement (both in positive and in negative results) between the two tests was less than might have been expected (kappa = 0.41).
PMCID: PMC1046143  PMID: 6131727
3.  Antibodies to gonococcal pili in women with asymptomatic gonorrhoea. Diagnostic value of the ELISA for testing women attending an STD clinic. 
The diagnostic efficacy of an enzyme-linked immunosorbent assay (ELISA) using gonococcal pili 6650 as antigen was studied in asymptomatic women attending an STD clinic. Of the 182 women studied, gonorrhoea was diagnosed in 29%. The value of the ELISA was calculated on the basis of four arbitrary cut-off points in the test. The best predictive values for a positive result (PV(+)) were obtained at an absorbance value of A greater than or equal to 1.15 and A greater than or equal to 1.30 and that for a negative result at A greater than or equal to 0.85. When patients with a history of gonorrhoea were excluded, the PV(+) rose only at A greater than or equal to 1.15 (not at A greater than or equal to 1.30) and the PV(-) rose slightly. To be of use in the diagnosis of gonorrhoea in asymptomatic patients the ELISA should be used as follows: the result is positive at A greater than or equal to 1.15 and negative at A less than 0.85, the PV(+) then being 0.52 and the PV(-) 0.85. Whenever sera give a result between A = 0.85 and A = 1.15, the test should be repeated.
PMCID: PMC1046142  PMID: 6131726
4.  Gonococcal serology. A comparison of three different tests. 
Three serological tests for the detection of gonococcal antibodies were compared: an enzyme-linked immunosorbent assay (ELISA), an indirect haemagglutination reaction (IHA), and a gonococcal complement-fixation test (GCFT). The ELISA was performed with gonococcal pili of a Rotterdam strain (1443) as antigen, the IHA with pilus antigen of an American strain (2686, Buchanan), and the GCFT with whole gonococci of a single strain (46695, Oliver) as antigen. The tests were performed on sera from the same groups of Dutch patients; samples of sera were taken at the first examination and generally 11-22 days later. The ELISA and the IHA were more sensitive than the GCFT. The specificity of the tests was equal in low-risk groups, but the GCFT was slightly more specific in high-risk groups. The ELISA and the IHA did not differ in sensitivity and specificity. The agreement between the ELISA and IHA for patients with uncomplicated gonorrhoea was low (chi = 0.44), but the agreement between the GCFT and the two pilus assays was less (chi = 0.26 and 0.20). The sensitivities were highest for sera from patients with oropharyngeal gonorrhoea or with gonococcal complications; again the ELISA and the IHA were more sensitive than the GCFT.
PMCID: PMC1046130  PMID: 6130818
5.  Detection of Neisseria gonorrhoeae antigen by a solid-phase enzyme immunoassay. 
The Gonozyme test (Abbott Laboratories) is a new enzyme immunoassay for detecting Neisseria gonorrhoeae antigens in specimens from the urethra in men and the endocervix in women. To evaluate the usefulness of the assay 249 patients were investigated. The results obtained with the immunoassay were compared with those of culture and microscopy of Gram-stained smears. The sensitivity and specificity of the test were high in men with urethritis and acceptable in different groups of women. As the sensitivity of the Gonozyme test was much higher than that of microscopy for endocervical specimens it might be useful as a rapid screening test for the detection of gonorrhoea in women.
PMCID: PMC1046101  PMID: 6816385
6.  Antibiotic sensitivities of gonococci isolated in Rotterdam and results of treatment with cefuroxime. 
In a study of the efficacy of cefuroxime in the treatment of 278 cases of acute gonorrhoea (including rectal and pharyngeal infections and infections due to penicillinase-producing Neisseria gonorrhoeae), high cure rates were found for both male (98.8%) and female patients (98.6%). Disadvantages of this treatment are its high cost and the relatively high proportion of patients who develop postgonococcal urethritis.
PMCID: PMC1045789  PMID: 6775767
7.  Gonorrhea in Rotterdam caused by penicillinase-producing gonococci. 
Recently the prevalence of strains of penicillinase-producing Neisseria gonorrhoeae (PPNG) in the Netherlands has increased. A study of demographic and clinical data from patients with gonorrhoea due to PPNG strains, and of the biological characteristics of the strains isolated in Rotterdam, show that Asian strains of PPNG seem at present to be endemic in the Netherlands. Spectinomycin was found to be effective in the treatment of patients with gonorrhoeea due to PPNG strains.
PMCID: PMC1045788  PMID: 6775766
9.  Activity of eight antimicrobial agents in vitro against N. Gonorrhoeae. 
The sensitivity of four groups of gonococcal strains to ampicillin (Am), penicillin (P), tetracycline (T), rifampicin (Ri), spectinomycin (Sp), sulphamethoxazole (Su), trimethoprim (Tr), and a combination of Su and Tr in the ratio 5:1 (Su/Tr 5:1) has been determined. The various groups of strains were isolated from male civilians (MC), female civilians (FC), and sailors (S) in Rotterdam (R) in 1972, and from FC in Amsterdam (A) in 1967. The S-R strains, which may be regarded as mainly imported, were compared with the MC-R and FC-R (which may be considered as mainly of Dutch origin). Also investigated was whether the incidence of relative resistance to the antibiotics investigated among Dutch strains has changed in the period from 1967 to 1972. For this purpose, the FC-A and FC-R strains were compared. The MC-R and FC-R strains were also compared with one another. Finally, Spearman's rank correlation coefficient r were calculated between the sensitivity distributions for each pair of antibiotics investigated, for all strains. The S-R strains were significantly less sensitive to Am, P, T, Ri, and Tr than the MC-R and FC-R strains. Comparison of the FC-A and FC-R strains revealed that the FC-R strains were significantly less sensitive only to Su/Tr 5:1. A possible explanation for this finding is given. With the exception of one FC-A strain, all gonococcal strains were sensitive to Sp. High values of r (larger than or equal to 0.50) were found between Am and P, Am and T, and P and T for all groups of strains. The values of r between any pair of the antibiotics Am, P, T, Ri, and Tr (with the exception of the pair Am-P) were always highest for the S-R strains. High values of r (larger than or equal to 0.50) were found between Su and Su/Tr 5:1 for all groups of strains. The FC-A strains, unlike the R strains, gave low values of r between Su and Tr and between Tr and Su/Tr 5:1. A possible explanation for this is given. Finally, a hypothesis is put forward to explain the fact that no significant changes were found in the sensitivity of Dutch gonococcal strains to Am, P, T, Ri, Sp, Su, and Tr in the period from 1967 to 1972, while the S strains (which may be regarded as imported) showed a significantly higher percentage of strains relatively resistant to Am, P, T, Ri, and Tr.
PMCID: PMC1046560  PMID: 125618
11.  Relationship of the interval between infections and the similarity of gonococcal strains in recurrent gonorrhoea. 
Paired gonococcal isolates from 38 patients with recurrent episodes of gonorrhoea at varying intervals were examined for similarity by means of gonococcal auxotyping and susceptibility to antibiotics. A different gonococcal strain was the cause of the second infection in 53% of the patients. Longer intervals between infections were significantly associated with greater numbers of dissimilar strains as a cause of the second infection. The same strain was usually found in infections occurring within 60 days of each other whereas different strains were more likely to cause infections occurring more than 60 days apart. The isolates causing the second infection were significantly more susceptible to penicillin.
PMCID: PMC1045722  PMID: 6768420
12.  Rising incidence of chancroid in Rotterdam. Epidemiological, clinical, diagnostic, and therapeutic aspects. 
The incidence of chancroid in Rotterdam has increased by more than five-fold during 1977-78. In a retrospective study of 53 patients with chancroid seen at this clinic during this period, the results of smears were positive in 82% and of cultures in 84% (of those for whom cultures had been performed). Symptoms were generally mild. Treatment with co-trimoxazole was highly effective clinically, as confirmed by in-vitro sensitivity studies.
PMCID: PMC1045705  PMID: 526847
13.  Penicillinase-producing strains of Neisseria gonorrhoeae isolated in Rotterdam. 
This appears to be the first report of the isolation of a penicillinase-producing strain of Neisseria gonorrhoeae in the Netherlands. The presence of a penicillinase-producing gonococcal strain (PPGS) was demonstrated in two of a group of three patients with gonorrhoea. In addition, a penicillin- and ampicillin-sensitive gonococcus strain was isolated from all three patients. The PPGS was most probably imported into Holland from the Philippines. The epidemiological and clinical findings and the results of treatment of infection with this PPGS are discussed.
PMCID: PMC1045360  PMID: 139969

Results 1-13 (13)