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doi: 10.1136/sti.56.1.3pmid: 6768419
Infection with two strains of Neisseria gonorrhoeae was found in paired cultures from 8.7% (6/69) of women who had infections of the cervix, rectum, or urethra. Paired gonococcal cultures from each patient were characterised by auxotyping, susceptibility to four antibiotics, and acrylamide gel electrophoresis patterns of the gonococcal cell proteins.
doi: 10.1136/sti.56.1.6pmid: 7370722
The proportion of homosexually acquired cases of primary and secondary syphilis in patients attending venereal disease clinics in the United Kingdom has risen from 42.4% to 54% over a six-year period. Similarly, over the same period, the proportion of homosexually acquired cases of gonorrhoea has risen from 9.8% to 10.9%. The increase in incidence of homosexually acquired infections in both diseases occurred in all areas but particularly in London. Thus the very considerable epidemiological importance of male homosexuals as a high-risk group should receive more, not less, emphasis.
Luger, A; Schmidt, B; Spendlingwimmer, I; Horn, F
doi: 10.1136/sti.56.1.12pmid: 6989443
Routine screening of 404 742 sera by the automated micro-haemagglutination assay (AMHA-TP) and the Venereal Disease Research Laboratory (VDRL) test showed that 9848 specimens gave a reactive result to one of the three assays. Reactive results were confirmed by the fluorescent treponemal antibody absorption (FTA-ABS) test. The possibility of false-positive results varied from 0.04-0.38% of all specimens or from 1.7-15.7% of reactive sera. The VDRL test failed to detect reactivity in 56.54% of sera from patients who had previously been infected with Treponema pallidum. The importance of routine testing by the AMHA-TP is illustrated by the detection of four patients with mesaortitis and two with active neurosyphilis among a selected group of 54 patients who had non-reactive results to the VDRL test. Testing of cerebrospinal fluid specimens by the AMHA-TP test produced more specific results than by the other two tests.
doi: 10.1136/sti.56.1.17pmid: 6989444
Sera from 3028 patients attending a dermatological clinic were examined by the fluorescent treponemal antibody (FTA) test, the fluorescent antibody-absorbed (FTA-ABS) test, the Venereal Disease Research Laboratory (VDRL) test, and Kolmer's test. Eleven cases of late syphilis were found. Sera from 63 (2.08%) of the remaining 3017 patients showed non-specific results; these were found more frequently in patients with pyodermas, neoplasms, acne, mycoses, crural ulceration, and psoriasis than in those with other diseases. No non-specific results were observed in patients with bullous skin diseases and only a few in patients with viral skin diseases and chronic lupus erythematosus. The test producing the most non-specific results was the FTA test, followed by the FTA-ABS test, the VDRL test, and Kolmer's test.
Bos, J D; Hamerlinck, F; Cormane, R H
doi: 10.1136/sti.56.1.20pmid: 6989445
Using a solid-phase radioimmunoassay technique, mean serum IgE concentrations were found to be raised in patients with early syphilis. Antitreponemal specificity of the IgE response was investigated by the fluorescent treponemal antibody absorption test using a fluorescein-isothiocyanate-labelled antiserum against the Fc-fragment of human IgE. Validity of this test procedure was assessed by blocking experiments. The results provide evidence of the antitreponemal specificity of the IgE response in syphilis and indicate a possible role for antitreponemal IgE in the pathogenesis of the Jarisch-Herxheimer reaction and in the immune-complex origin of some of the lesions of secondary syphilis.
doi: 10.1136/sti.56.1.26pmid: 6768418
Isolates of Neisseria gonorrhoeae from 100 white and 113 black patients attending a venereal disease clinic were examined for their susceptibility to ampicillin, penicillin, tetracycline, and spectinomycin. The isolates were also characterised by gonococcal auxotyping. Gonococcal isolates from black patients were more resistant to the antibiotics than those from white patients, since the former were infected with the more antibiotic-resistant auxotypes (Pro, Zero, and Arg) whereas the latter were infected with the more antibiotic-susceptible auxotypes (AHU and others). These data indicate a preferential infection by sub-populations of Neisseria gonorrhoeae in two racial groups.
Noble, R C; Oranje, A P; Michel, M F; Stolz, E
doi: 10.1136/sti.56.1.31pmid: 6768420
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.
doi: 10.1136/sti.56.1.35pmid: 7370719
In cases of gonococcal arthritis the knees, wrists, ankles, hands and feet are the joints most commonly affected. This case is unusual because of the occurrence of gonococcal arthritis in the sacroiliac joint.
Tait, I A; Rees, E; Hobson, D; Byng, R E; Tweedie, M C
doi: 10.1136/sti.56.1.37pmid: 7370720
An investigation of chlamydial infection in sexual contacts of patients with nongonococcal urethritis (NGU) was carried out to determine the clinical signs of infection in the cervix, and their response to chemotherapy, and the incidence of cervical infection in the presence of ectopy and oral contraception. In 202 consecutive female contacts of NGU the isolation rate of Chlamydia trachomatis was 35%. Hypertrophic ectopy and endocervical mucopus were present in 19% and 37% of chlamydia-positive patients respectively and, in all but one, resolved after treatment. Only 14% of those followed up after treatment developed yeast infections. The chlamydial isolation rate was significantly higher in patients with hypertrophic ectopy and endocervical mucopus. Cervical ectopy and oral contraceptives acted additively, each producing a significant effect on the chlamydial isolation rate in the presence of the other but not when present alone.
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