Sexually Transmitted Infections

Birry, A; Kasatiya, S

doi: 10.1136/sti.55.4.239pmid: 385012

The microhaemagglutination assay for Treponema pallidum antibodies (MHA:TP-CSF), the Veneral Disease Research Laboratory (VDRL-CSF), and the fluorescent treponemal antibody (FTA-CSF) tests were used to detect treponemal antibodies in 3157 samples of cerebrospinal fluid from patients with syphilis, with neurological, metabolic, or immunological disorders, and with undetermined diagnoses. An agreement of 99.5% between the results of the MHA:TP-CSF and FTA-CSF tests was obtained for all the CSF samples whereas that of only 95.5% was obtained for samples from the known case of syphilis. The MHA:TP-CSF test is simple, economical, rapid, and specific but not as sensitive as the FTA-CSF test.

Gomez, C I; Stenback, W A; James, A N; Criswell, B S; Williams, R P

doi: 10.1136/sti.55.4.245pmid: 39583

Pilated Neisseria gonorrhoeae of colony type 1 (T1) and non-pilated bacteria of colony type 4 (T4) were observed by transmission (TEM) and scanning electron microscopy (SEM). No pili were observed on T4 gonogocci, but two types of pili--straight, type a, and bent, type b--were seen on T1 by TEM. When incubated with human sperum and examined by either TEM or SEM, T1 gonococci were seen to attach by individual pili, by several pili wound together as a rope, or by direct contact. Gonococci from T4 colonies attached only by direct contact. Treatment with typsin (1 mg/ml) damaged or removed pili from gonococci. After incubation with trypsin, attachment of pilated gonococci to sperm was decreased significantly, but such treatment did not affect attachment of non-pilated gonococci. Incubation of gonococci from either colony type in 0.1 mmol/l ferric nitrate, followed by incubation with sperm, significantly increased attachment of only T4 bacteria. No pili were seen on T4 gonococci treated with ferric nitrate; thus, it appears that factors other than pili alone are concerned in attachment of these gonococci to sperm.

Mårdh, P A; Baldetorp, B; Håkansson, C H; Fritz, H; Weström, L

doi: 10.1136/sti.55.4.256pmid: 114195

Quantative determinations of the mucociliary activity of human Fallopian tube epithelium maintained as organ cultures were performed using a light beam reflex method. In non-infected organ cultures the mucociliary wave (MCW) frequency slowly decreased during the first 54 hours of culture maintenance. In organ cultures experimentally infected with fresh isolates of Neisseria gonorrhoeae producing T1/T2 colonies the MCW frequency either decreased to subnormal values or completely ceased whereas in organ cultured infected with a laboratory-adapted gonococcal strain the MCW frequencies remained within normal range. In organ cultures exposed to gonococcal endotoxin prepared from the laboratory-adapted strain, as well as in cultures in which cell-free filtrates of medium from organ cultures infected with N. gonorrhoeae (producing T1/T2 colonies) were added to the culture medium, the ciliary activity decreased and subsequently ceased. The same phenomenon occurred when organ cultures were challenged with Escherichia coli endotoxin. The ciliostatic effect appeared before any morphological changes in the surface epithelium, including the cilia, were demonstrable by scanning electron microscopy.

McMillan, A; McNeillage, G; Young, H; Bain, S S

doi: 10.1136/sti.55.4.265pmid: 114196

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.

McMillan, A; Pattman, R S

doi: 10.1136/sti.55.4.271pmid: 114197

Urethral gonorrhoea was diagnosed by culture in 957 (18.8%) of 5076 new male patients attending a sexually transmitted diseases clinic; the infection was asymptomatic in 38 (4%) of these patients. The diagnosis in only six (0.3%) out of 2159 men with urethral gonorrhoea but with no symptoms or signs of urethritis would have been missed if urethral cultures had not been performed.

Schofield, C B

doi: 10.1136/sti.55.4.274pmid: 486246

Incidences of genital gonorrhoea in women higher or lower than expected occurred in patients aged 15--19 years four years after similar findings in those aged 10--14 years. This pattern was followed five years later in those aged 20--24, 11 years later in those aged 25--34, and 20 years later in those aged 35--44 years. Thus, cohorts of women at greater or lesser risk of acquiring gonorrhoea appear to exist. Most cohorts with a high incidence could be identified when in the 10--14 age group. Especially high rates of infection are predicted in the 25--34 age group in the mid-1980s and in the 35--44 age group in the late 1980s. These findings will affect the timing of health education on sexually transmitted diseases in schools and will demand a high degree of awareness among general practitioners, gynaecologists, and those working in family planning and well-women clinics of the possibility of gonorrhoea occurring in women in these age groups.

Thin, R N; Rendell, P; Wadsworth, J

doi: 10.1136/sti.55.4.278pmid: 486247

Although gonorrhoea is often regarded as the sexually transmitted disease against which others are measured, its infectivity is not clearly understood. Estimates of the infection rate have varied from 5--90%. In this study, 50 couples with gonorrhoea were matched with 50 couples with genital yeast infection. Gonorrhoea was diagnosed in both partners of 32 couples and genital yeast infection in both partners of 21 couples. These figures provide an indication of the sexual transmission of these conditions. The higher figure for gonorrhoea may be related to a greater urgency in tracing contacts.

Willcox, J R; Fisk, P G; Barrow, J; Barlow, D

doi: 10.1136/sti.55.4.281pmid: 486248

In a prospective study of unselected, female patients attending a sexually transmitted disease clinic one in eight patients would have been errouneously declared free of infection in the absence of a chlamydial culture service. Chlamydia trachomatis is now accepted as a causative organism of non-specific urethritis and post-gonococcal urethritis in men and non-specific genital infection in women. Thus, facilities for isolation of C. trachomatis should be an essential aid in the management of women attending STD clinics. Male patients would also benefit if such facilities were readily available.

Thambar, I V; Simmons, P D; Thin, R N; Darougar, S; Yearsley, P

doi: 10.1136/sti.55.4.284pmid: 114198

In a double-blind comparison of two regimens of triple tetracycline (Deteclo, Lederle) in the treatment of nongonococcal urethritis, 68 (88.6%) of 70 patients treated with one tablet twice for 21 days and seen four weeks after starting therapy had satisfactory results. This was significantly better than the findings among the 73 patients treated with one tablet twice daily for seven days and followed for four weeks, among whom only 47 (64.4%) had satisfactory results. Results were also better for the group treated with the 21-day regimen at three months afer the start of treatment. When analysed individually at four and 12 weeks, urethral discharge, urethral Gram-stained smears, and first-glass urine test all gave similar results, which were markedly better than those before treatment. It appears that the longer course of treatment it indicated where any regular partner may not be treated. Slightly fewer patients had satisfactory results among those who admitted consuming alcohol than among those who did not. Chlamydiae-negative patients, treated for seven days, had fewer clinically satisfactory results than other sub-groups.

Balsdon, M J; Green, N; Andrew, C W; Jackson, D H

doi: 10.1136/sti.55.4.289pmid: 90513

A simple, rapid, staining method for the identification of Trichomonas vaginalis has been tested on cultured trichomonads and specimens of vaginal discharge. Fifty-eight stained slides of vaginal discharge were examined and trichomonads were correctly identified in the 31 specimens from patients with confirmed vaginal trichomoniasis. No false-positive results were obtained. This staining procedure could prove a useful addition to wet-film and cultural methods.