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1.  Isolation of Neisseria lactamica from the female genital tract. A case report. 
Neisseria lactamica was isolated from the genital tract of a young patient with a persistent vaginal discharge. Although infection with N lactamica occurs very rarely, the importance of complete biochemical identification of neisseriae is emphasised in view of the serious social and medicolegal consequences which could result from a misdiagnosis of gonorrhoea.
PMCID: PMC1045817  PMID: 7427704
4.  Serogrouping Neisseria gonorrhoeae: correlation of coagglutination serogroup WII with homosexually acquired infection. 
With coagglutination reagents prepared against W antigens, 205 clinical isolates of Neisseria gonorrhoeae were classified into three serogroups WI, WII, and WIII. Of 195 strains isolated from patients who acquired their infection in the Edinburgh area, 85 (44%) belonged to serogroup WI and 110 (56%) to serogroup WII. Serogroup WII accounted for 90% of all isolates from homosexual men and for 34% and 47% of isolates from heterosexual men and women respectively (p less than 0.001). In homosexual men serogroup WII predominated regardless of the anatomical site from which the strain was isolated, and accounted for 94% of rectal, 90% of urethral, and 81% of pharyngeal isolates.
PMCID: PMC1046343  PMID: 6435813
5.  Differentiation of gonococcal and non-gonococcal neisseriae by the superoxol test. 
We evaluated the superoxol (catalase) test as a means of differentiating gonococci from related species of organisms which were cultured from a variety of anatomical sites. An isolate was almost certainly not a gonococcus if it gave a negative superoxol test result, as all but one of 596 available gonococci gave positive test results. However, a proportion of the non-gonococcal neisseriae and isolates of Branhamella catarrhalis, also gave positive test results. The superoxol test is thus a useful addition to the techniques available for the characterisation of gonococci, but additional procedures are needed to confirm the identities of isolates giving positive results.
PMCID: PMC1046441  PMID: 6423211
6.  Neisserial colonisation of the pharynx. 
The spectrum of neisserial colonisation of the pharynx was determined from 3557 throat exudates cultured on modified New York City (MNYC) medium. Oxidase positive Gram-negative diplococci (GNDC) were isolated from 1204 (33.8%) of the throat cultures. Neisseria gonorrhoeae, N meningitidis, and N lactamica accounted for 20.3%, 74.2%, and 3.7% of the oxidase positive GNDC respectively. The observed coexistence of gonococci and meningococci in the pharynx (0.39%) was significantly different (p less than 0.001) from the theoretical expected value (1.7%). The prevalence of pharyngeal infection in patients with gonorrhoea was 4.3% for all men, 11% for homosexual men, and 7.9% for women. Despite the risks of disseminated infection and spread to sexual partners, the detection of pharyngeal gonorrhoea is less important than that of endocervical infection in women, urethral infection in heterosexual men, and anorectal infection in homosexual men.
PMCID: PMC1046189  PMID: 6409342
7.  Rapidity and reliability of gonococcal identification by coagglutination after culture on modified New York City medium. 
The combination of culture on modified New York City (MNYC) medium and identification of neisserial isolates by the Phadebact gonococcus test was evaluated in routine laboratory practice. The sensitivity of coagglutination was 96.7% (318/329 isolates) and that of immunofluorescence (IF) 97.9% (322/329 isolates); the specificity of both methods was 96.8% (120/124 isolates). Of the 329 gonococcal isolates, 286 (86.9%) could be tested by coagglutination and 309 (93.9%) by IF after only 24 hours' incubation. Identification by coagglutination from primary cultures on MNYC medium is considered to be very rapid, simple, and efficient for the cultural diagnosis of anogenital gonorrhoea in women and urethral gonorrhoea in men. Because of the high prevalence of meningococci in the pharynx and their not infrequent occurrence in the anorectum of homosexual men the identity of isolates from these sites is best confirmed by sugar utilisation tests.
PMCID: PMC1046018  PMID: 6802440
8.  Reactivity of the limulus lysate assay with uterine cervical secretions. A preliminary evaluation. 
A limulus lysate assay was performed on cervical secretions from 66 women. When secretions were tested at a 1/100 dilution the assay gave a positive result in 15 (62.5%) of 24 patients with gonorrhoea confirmed by Gram-stained smear or culture or both. When secretions from seven of the nine remaining patients who had gonorrhoea but negative results to the limulus lysate test were retested at 1/50 dilution, two gave a positive result, increasing the positivity rate of the test to 17 (70.8%) of 24 infected patients. Material from one patient with a history of contact with gonorrhoea and from three (7.3%) of the other 41 patients without any history of gonorrhoea gave positive reactions.
PMCID: PMC1045917  PMID: 6786702
9.  Chlamydia trachomatis and Ureaplasma urealyticum in men attending a sexually transmitted diseases clinic. 
Urethral specimens from 480 heterosexual patients were examined for Chlamydia trachomatis. Chlamydia were isolated from 32.7% of men with non-specific urethritis (NSU), from 16.1% of men with gonorrhoea, and from 4.1% of men without urethritis. Chlamydial isolation was not related to duration of symptoms, presence of discharge, or past history of attendance at the clinic. Urine from 176 heterosexual patients was examined for Ureaplasma urealyticum. Ureaplasmas were present in 53.8% of men with NSU, in 28% of men with gonorrhoea, and in 32.9% of men with no urethritis. Detection rates for ureaplasmas in patients with chlamydia-negative and chlamydia-positive NSU were similar, but ureaplasmas were present in significantly greater numbers in patients with chlamydia-negative NSU than in those with chlamydia-positive NSU.
PMCID: PMC1045888  PMID: 7214120
10.  Oropharyngeal flora and individual susceptibility to neisserial infection. 
Beta-haemolytic streptococci were isolated from throat swabs from 49 (10.5%) of 466 patients undergoing cultural examination for gonorrhoea. Although beta-haemolytic streptococci were isolated more frequently from patients with genital or anorectal gonorrhoea (15.9%) than from those without (9.2%), the difference was not statistically significant. When groupable (A, B, C, or G) and other (non-A, -B, -C, or -G) beta-haemolytic streptococci were analysed separately, as statistically significant association between non-A, -B, -C, or -G streptococci and gonococci was observed but not between groupable beta-haemolytic streptococci and gonococci.
PMCID: PMC1045816  PMID: 6775772
11.  Detection of antigonococcal IgA in cervical secretions by indirect immunofluorescence: an evaluation as a diagnostic test. 
Using an indirect immunofluorescent-antibody method, antigonococcal IgA was detected in the cervical secretions of 56 (72%) of 78 women with untreated gonorrhoea but in only 25 (5%) of 490 non-infected women. The low sensitivity--comparable to that of Gram-stain microscopy--the expense, and the laboriousness of the test militate against its use as a routine diagnostic procedure.
PMCID: PMC1045782  PMID: 6775763
12.  Rapid carbohydrate utilization test for the identification of Neisseria gonorrhoeae. 
A rapid carbohydrate utilization test for the identification of N. gonorrhoeae was investigated, with reference to its use in a routine diagnostic laboratory. The rapid test was shown to give accurate results in agreement with those of a conventional serum-free sugar medium. Because of the shorter time taken for the confirmation of an isolate, and several other advantages, it is proposed that the rapid test is an extremely useful alternative to conventional sugar tests. Immunofluorescence was also used to identify isolates of N. gonorrhoeae and the rapid carbohydrate utilization test was found to assist in differentiating between N. gonorrhoeae and N. meningitidis when equivocal or negative immunofluorescence results were obtained.
PMCID: PMC1045249  PMID: 819089
14.  Secretory antibody response of the cervix to infection with Neisseria gonorrhoeae. 
Cervical secretions from 157 women were examined for antibody against Neisseria gonorrhoeae by an indirect immunofluorescent antibody test. Antigonococcal antibody was detected in 73 (97%) of 75 infected women, being of the IgG class in 73 (97%), of the IgA class in 71 (95%), and of the IgM class in 29 (39%). IgM antibody was nearly always associated with infections of less than 15 days' duration. Immunoglobulin G, reactive with N. gonorrhoeae, was found in 23 (33%) of 70 non-infected women; of these, 19 had non-gonococcal cervicitis. Neither IgA nor IgM antibodies were detected in these women. Antigonoccal IgA and IgG was found in each of 12 women who had no evidence of infection but were contacts of infected men. Successful treatment resulted in a rapid decline in IgA antibody activity but a more gradual decrease in IgG reactivity.
PMCID: PMC1045650  PMID: 114196
15.  Individual susceptibility to neisserial infection? 
Specimens from genital, anorectal, and pharyngeal sites from 1671 men and 1419 women were cultured for Neisseria gonorrhoeae. Pharyngeal specimens were also cultured for Neisseria meningitidis, N. gonnorrhoeae was isolated from a genital site 2.7 times more often in men and 1.8 times more in women who also carried meningococci in their pharynx than from those who did not; the meningococcus was isolated 3.4 times more often from men and 2.0 times more often from women with genital gonorrhoea than from those without. In both men and women the association of each organism with the other was statistically significant (p less than 0.001) and may be related to sexual behaviour rather than to individual susceptibility to neisserial infection.
PMCID: PMC1045627  PMID: 111765
16.  Serum immunoglobulin response in uncomplicated gonorrhoea. 
Sera from 225 men and 140 women were examined by an indirect immunofluorescent antibody technique for antibody reactive with Neisseria gonorrhoeae. Antigonococcal IgM was demonstrated at a titre of greater than or equal to 16 in about 45% of infected, but in only 3% of non-infected, patients. Most of this antibody occurred in sera of patients who had been infected for less than 14 days. Antibody of the IgA class was found at a titre of greater than or equal to 16 in over half the infected, but in none of the non-infected, patients. IgG antibody reactive with the gonococcus was found in each infected patient at a titre of greater than or equal to 16 but in only 8% of controls. The mean log titre of this antibody was significantly higher in patients who had been infected for more than seven days than in those whose infection was of shorter duration.
PMCID: PMC1045572  PMID: 427515
17.  Isolation of Neisseria meningitidis and Neisseria catarrhalis from the genitourinary tract and anal canal. 
During a 12-month period 285 isolates of Neisseria species, other than Neisseria gonorrhoeae, were cultured from patients attending the Department of Venereology, Royal Infirmary, Edinburgh. There were eight patients in whom genitourinary or rectal isolates of Neisseria meningitidis or Neisseria catarrhalis were found. Differences between data from our series and from previous reports are discussed with particular regard to sites routinely cultured in female patients. We also report in vitro inhibition of N. gonorrhoeae by an isolate of N. meningitidis cultured from the cerivx of a patient.
PMCID: PMC1045468  PMID: 416876
18.  Cultural diagnosis of gonorrhoea with modified New York City (MNYC) medium. 
A simply prepared modified New York City medium, designated MNYC was compared with Thayer Martin (TM) medium for the cultural diagnosis of gonorrhoea. MNYC medium contained lincomycin, commercial gonococcal base and lysed whole blood, whereas the original New York City medium contained fresh horse plasma and haemoglobin solution, a basal medium prepared from basic ingredients and vanocmycin. Using MNYC medium gonococci were cultured from 96.1% of men and 100% of women with gonorrhoea (positive film and/or culture) compared with only 77.6% and 69% respectively using TM medium. There were no patients positive by culture on TM medium but negative by culture on MNYC medium. The proportion of men with positive films but negative culture was reduced from 17.1% on TM medium to 3.9% on MNYC medium. There were no women with positive films but negative cultures on MNYC medium compared with 19% on TM medium. MNYC medium is recommended as a simply prepared and highly efficient medium for the cultural diagnosis of gonorrhoea.
PMCID: PMC1045467  PMID: 416875

Results 1-18 (18)