Gonorrhea In Women Research Articles

Diagnosis of gonorrhoea in women. Role of the rectal sample.

Diagnosis of gonorrhoea in women. Role of the rectal sample.

Inhibition of Neisseria gonorrhoeae by a factor produced by Candida albicans.

When Candida albicans is present on Transgrow specimens, Neisseria gonorrhoeae is detected less frequently or else can be seen in Gram stains but cannot be readily cultured. When C. albicans and N. gonorrhoeae are grown together on Transgrow, the gonococcal cells die off much more readily than N. gonorrhoeae grown on Transgrow alone. By use of a cross-streaking technique on agar plates, it has been demonstrated that C. albicans produces a soluble substance inhibitory to N. gonorrhoeae, although not to other microorganisms tested. Preliminary results indicate that this inhibitory factor can be extracted by the use of tertiary butanol. Since approximately one-third of the Transgrow specimens with growth contains yeasts, of which C. albicans is by far the most frequent, this factor presents an important complication in the diagnosis of gonorrhea in women.

Inhibition of Neisseria gonorrhoeae by a Factor Produced by Candida albicans

When Candida albicans is present on Transgrow specimens, Neisseria gonorrhoeae is detected less frequently or else can be seen in Gram stains but cannot be readily cultured. When C. albicans and N. gonorrhoeae are grown together on Transgrow, the gonococcal cells die off much more readily than N. gonorrhoeae grown on Transgrow alone. By use of a cross-streaking technique on agar plates, it has been demonstrated that C. albicans produces a soluble substance inhibitory to N. gonorrhoeae, although not to other microorganisms tested. Preliminary results indicate that this inhibitory factor can be extracted by the use of tertiary butanol. Since approximately one-third of the Transgrow specimens with growth contains yeasts, of which C. albicans is by far the most frequent, this factor presents an important complication in the diagnosis of gonorrhea in women.

Diagnosis of gonorrhoea in women: comparison of sampling sites.

A total of 250 women, 100 of them named contacts of men with gonorrhoea, were tested for infection. Each had prepared smear and culture specimens from urethra, endocervix, and vagina. The smears were Gram-stained and examined immediately. Cultures were taken using Stuart's transport medium with later inoculation of both selective and non-selective media for each specimen.It was shown that examination of specimens from urethra and endocervix gave results superior to those found on examination of vaginal material alone. The study revealed that nearly one infected woman in three would have been missed if vaginal material only had been examined. Failure to secure a prompt scientific diagnosis has serious epidemiological implications.Our results find support in the work of others. We conclude that the suggestion in some quarters that examination of vaginal material for the detection of gonococci is adequate should be abandoned. Any who feel unwilling to accept this view should at least supplement their testing with examination of urethral and endocervical specimens.

Gonococcicidal action of copper in vitro

Several copper and cupric ion sources have been shown to kill or inhibit the growth of Neisseria gonorrhoeae in vitro. Micromolar amounts of copper sulfate and copper chloride kill gonococci during relatively brief incubation while the organisms are in suspension. Inhibition of gonococcal or meningococcal growth is achieved by concentrations of cupric ion several-fold more dilute than is necessary to inhibit growth of E. coli. The sensitivity of gonococci to killing by copper may have application in relationship to the use of copper-containing intrauterine devices and prophylaxis against genital gonorrhea in women.

Trichomonas vaginalis infection and rectal gonorrhoea in women

No abstract available

Doxycycline HCl (Vibramycin) as a single dose oral treatment of gonorrhoea in women.

Whilepenicillin remainsthedrugofchoice inthe treatmentofgonorrhoea, theincreasing incidence of strains ofgon:cocci less sensitive topenicillin makes thecontfnued search forother effective antibiotics of thegreatestimportance. Ideally, alltreatments should beable tobegiven atone attendance, whether by injection or orally. Doxycycline hydrochloride (Vibramycin) ina single oraldosewas showntobe effective inthetreatmentofuncomplicated gonorrhoeainthemale(Sylvestre and Gallai, 1968; Domescik, McLone,Scotti, andMackey,1969). We reporthereon our experiences withthesame drug using a single oraldoseregime inthetreatmentof acutegonorrhoea inthefemale. Material andmethods Afterdiagnosis bymeans ofGram-stained smears taken fromtheurethra andcervix, 115women suffering from uncomplicated gonococcal urethritis and/or cervicitis were treated witha single oraldoseof300mg. (3capsules) of

Gonorrhea in women: treatment with sulfamethoxazole and trimethoprim.

After publication of a study describing the successful oral treatment of men suffering from uncomplicated gonorrhea with sulf amethoxazole-trimethoprim, this combination of drugs was used to treat women suffering from gonococcal urethritis and cervicitis. In every case, the diagnosis was confirmed by culture of Neisseria gonorrhoeae. Sulfamethoxazole-trimethoprim was given in the form of Bactrim (Roche) ; two tablets (each one containing 400 mg of sulf amethoxazole and 80 mg of trimethoprim) were taken night and morning for five days. One hundred and sixteen infections in 115 women were treated. Only two therapeutic failures were observed, and another two women were reinfected within a month of treatment, one on two occasions. Skin reactions to treatment were mild and infrequent. Hematologic investigation did not reveal any evidence of blood dyscrasias. This oral preparation can be recommended for the treatment of uncomplicated gonorrhea in women who can be relied upon to take it as directed.

Gonorrhea in women

Gonorrhea in women

Gonorrhea in Women

Two hundred thirty-one female patients of private obstetricians and gynecologists were examined for gonorrhea, using cultural techniques. Specimens were taken from the cervix and rectum of all patients and cultured on Thayer-Martin (TM) selective medium. Six, or 2.6%, were found positive. Of these, all were in the 20- to 29-year age group; only one had knowledge of being exposed to gonorrhea; three were pregnant. The frequently asymptomatic nature of gonorrhea in females, combined with a definable incidence of infection in this patient group, suggests that more frequent use of cultural methods employing TM medium would help control this rapidly increasing disease. Cultures are particularly recommended for women under 30 years who are single, pregnant, or manifest acute vaginitis.

Sensitivity and reproducibility of Thayer-Martin culture medium in diagnosing gonorrhea in women

The Thayer-Martin culture medium was evaluated by culturing specimens from the cervix and rectum of 59 women alleged to have been the source of gonorrhea in men. By testing these women on 3 consecutive days, 50 (85 per cent) were culturally confirmed to have gonorrhea. A single cervical culture detected 89.7 per cent of those infected; repeating a single cervical culture on a subsequent day resulted in a total detection of 96.6 per cent of those infected. The remaining 3.4 per cent in the detection rate was achieved by a single rectal culture. Reproducibility of positive results occurred in 91 per cent of 266 cervical specimens and 89 per cent of 165 rectal specimens. The Thayer-Martin culture medium provides an accurate and reliable means of detecting gonorrhea in women, and its use should be considered for routine screening of high-risk populations.

Direct and delayed methods of immunofluorescent diagnosis of gonorrhoea in women.

Direct and delayed methods of immunofluorescent diagnosis of gonorrhoea in women.

Transgrow, a Medium for Transport and Growth of Neisseria gonorrhoeae and Neisseria meningitidis

FAILURE to diagnose gonorrhea in women who harbor asymptomatic infection is a significant handicap in the control of gonorrhea. This handicap would be partially alleviated if a culture method could be made readily available to all physicians and clinics. Similar considerations apply to detection of nasopharyngeal carriers of meningococci in confined populations. A selective medium for the cultivation of gonococci and meningococci was reported by Thayer and Martin in 1964 (1). An improved medium was described by the same authors in 1966 (2). The Thayer-Martin selective medium is recommended for primary isolation of the gonococcus and meningococcus, especially from sites where these organisms are outnumbered by the more rapid-growing natural bacterial flora. Overgrowth by gram-positive and other gram-negative bacteria and yeast is prevented in most cases because the medium contains 3 units of vancomycin, 7.5 micrograms of colistimethate sodium, and 12.5 units nystatin per milliliter. Although this selective medium has been available since 1964, its use, unfortunately, is limited to large hospitals and health centers closely associated with laboratory facilities. The average practitioner is handicapped in his diagnosis of asymptomatic gonorrhea by the hazards of transportation of suspected specimens to a distant laboratory. At present the most widely used tools for transporting secretions suspected of containing gonococci are the medium of Stuart and coworkers (3), a modified version of which was described by Amies in 1967 (4), and culture plates in candle jars (5). The procedure used by both Stuart and Amies is designed to eliminate oxidation as a cause of death of the gonococcus while the non-nutrient, non-toxic menstruum supresses growth of the gonococcus and other micro-organisms. Although these media seem to be effective in maintaining viability of organisms during transport times of less than 24 hours, their usefulness is somewhat restricted for longer transport periods. The candle jar may be used for transporting specimens, but this method is cumbersome and therefore less practical. An ideal transport medium for secretions suspected of containing gonococci and meningococci should be selective for these pathogens, have a prolonged shelf life, and be of rigid composition for mailing. In addition, it should preserve the viability of the organisms for more than 24 hours at ambient temperatures. Eliminating the required transfer from the non-nutrient transport medium to an isolation plate by combining the transporting vehicle with a culture medium would also be desirable. T'he authors are with the Venereal Disease Research Laboratory, Venereal Disease Branch, State and Community Services Division, Center for Disease Control, Health Services and Mental Health Administration, Public Health Service. Tearsheet requests to John E. Martin, Jr., Venereal Disease Research Laboratory, Center for Disease Control, Atlanta, Ga. 30333.

Therapy of female gonorrhea with cephaloridine

The treatment of gonorrhea with penicillin has had serious challenges due to the diminished sensitivity of the organism as well as outright resistance. An alternate antibiotic in the treatment of gonorrhea in women has been evaluated in the social health clinics of the Philadelphia Health Department. A single intramuscular injection of 2 Gm. of cephaloridine gave a therapeutic success rate of 94.3 per cent (of 208 patients) without local or systemic reactions. Thayer-Martin selective culture media and delayed fluorescent antibody technique are equally effective for pretreatment diagnosis of gonorrhea in female patients. Delayed fluorescent antibody technique is too sensitive for the posttreatment evaluation of patients. Rectal cultures made no substantial increase in the yield of positive cultures obtained from the cervix or endocervix.

Observations on the culture diagnosis of gonorrhea in women

Specimens were cultured from women suspected of having venereal disease to determine at which anatomical site or sites<i>Neisseria gonorrhoeae</i>can be most commonly found. Of the four sites examined (cervix, urethra, vagina, and rectum), the cervical site was the single site most often infected. When the results of two sites were combined, the cervical and rectal cultures gave the greatest frequency of detection. Nevertheless, it is felt that 6% to 8% of females with gonorrhea will have negative cultures from all four sites at any one visit.

Observations on the Culture Diagnosis of Gonorrhea in Women

Specimens were cultured from women suspected of having venereal disease to determine at which anatomical site or sites Neisseria gonorrhoeae can be most commonly found. Of the four sites examined (cervix, urethra, vagina, and rectum), the cervical site was the single site most often infected. When the results of two sites were combined, the cervical and rectal cultures gave the greatest frequency of detection. Nevertheless, it is felt that 6% to 8% of females with gonorrhea will have negative cultures from all four sites at any one visit.

Latent Gonorrhea in Women

To the Editor:— The letter of Dr. LeMon Clark ( 209 :563, 1969) expanded on the latent gonorrhea in women and the Desdemona distress of female patients with this problem. The most famous example of this dilemma is described from the man's point of view by James Boswell in Boswell's London Journal , 1762-1763, New York: McGraw-Hill Book Co., Inc., 1950, pp 150-160. Boswell had spent considerable time and effort in the seduction of an actress in order to provide himself with a winter of safe copulation and, when signs of gonorrhea appeared, he angrily confronted the young woman, broke off their relationship, and spent the next five weeks in his rooms recovering. Boswell: Pray, Madam, in what state of health have you been in for some time? Louisa: Sir, you amaze me. Boswell: I have but too strong, too plain reason to doubt of your regard. I have for some days

Latent gonorrhea in women.

To the Editor:— In QUESTIONS AND ANSWERS ( 208 :1029, 1969), Evalyn S. Gendel answers a query about conjugal gonorrhea. Her answer may be amplified. Some time ago, a young man with gonorrhea was very upset saying, Well, my wife has been cheating on me because I have been married to her six months and have had intercourse with no one but her. I asked to have his wife come to see me. Examination of the cervix revealed it to be quite clean with no evidence of infection. Massage of the urethra produced a minute drop of pus which when stained revealed gonococci. She had been married previously, had divorced her previous husband a year earlier because of infidelity. She had had some burning and a little discomfort in the vagina at the time of urination for several weeks. She undoubtedly had gonorrhea. Vaginal and cervical infection resolved, but that of

Preliminary Report of Utilization of Intramuscular Oxytetracycline for Treatment of Gonorrhea in Women

Preliminary Report of Utilization of Intramuscular Oxytetracycline for Treatment of Gonorrhea in Women

Endocervical curettement: a newer technique in the diagnosis of gonorrhea in women

1. An endocervical curettement is an additional help in making the diagnosis of gonorrhea by conventional culture.2. A 3 year evaluation has proved it to be both effective and safe.3. Contraindication to this technique is pregnancy.4. The endocervical curettement increases the number of positive gonococcal cultures on conventional methods by 13 per cent.