Evaluation of an enzyme immunoassay for IgM antibodies to Treponema pallidum in syphilis in man.Müller, F; Moskophidis, M
doi: 10.1136/sti.60.5.288pmid: 6386097
An enzyme immunoassay (EIA) for the detection of immunoglobulin M (IgM) antibodies to Treponema pallidum was investigated for specificity and sensitivity. Using the results in serum from 1192 patients with successfully treated syphilis, the assay was calculated to be about 97% specific. As in any other IgM enzyme linked immunosorbent assay (ELISA), rheumatoid factor played an important part in causing false positive results. Pre-absorption of serum with aggregated IgG was therefore necessary to perform the test. Evaluation of the results in serum from 385 patients with untreated primary, secondary, and latent syphilis as well as patients with untreated reinfections showed that the sensitivity of the assay depended on the stage of infection and varied between 98% and 93%. IgM antibody titres were about ten times higher in the EIA than in the indirect immunofluorescence assay using the IgM fractions of serum. From the results it may be concluded that the EIA is an appropriate technique not only for rapid and sensitive measurement of IgM antibodies in most patients with untreated syphilis but also for selecting treponemal IgM non-reactive patients.
Endemic non-venereal syphilis (bejel) in Saudi Arabia.Pace, J L; Csonka, G W
doi: 10.1136/sti.60.5.293pmid: 6487985
A total of 2515 people attending a large military hospital in Saudi Arabia was studied clinically, serologically, and (when appropriate) radiologically for evidence of treponematosis. The indications are that non-venereal endemic syphilis (bejel) is prevalent among the nomadic communities living in rural areas. In contrast, venereal syphilis is much less common, and is found almost exclusively in urban populations. Some of the high risk regions for bejel have been identified, and many people from these locations complained of persistent pain in the legs, which was often associated with radiological evidence of osteoperiostitis of the long bones. Bejel also seems to have become clinically "attenuated" within the last 30 years, with the majority of seroreactors having latent disease. A hypothesis suggesting a reason for this change is put forward, and ways of controlling the infection are outlined.
Stable serum resistance of Neisseria gonorrhoeae as an epidemiological marker.Lavitola, A; Martin, P M; Pean, Y; Guibourdenche, M; Riou, J Y
doi: 10.1136/sti.60.5.298pmid: 6435812
Using a simple and rapid microassay, we tested 100 strains of Neisseria gonorrhoeae isolated from 81 patients (41 men and 40 women) for their sensitivity to killing by normal human serum (NHS). The reproducibility of the test was good when the bactericidal end points were taken as the dilution of fresh NHS that killed more than 95% of the test organisms. The bactericidal end points of strains isolated either from different anatomical sites or from sexual partners correlated well with the levels of sensitivity to serum of corresponding isolates, as well as with auxotypes. When the strains were not highly resistant to killing by NHS, this marker gave a precise definition of each strain and permitted the differentiation of isolates belonging to common auxotypes.
Serogrouping Neisseria gonorrhoeae: correlation of coagglutination serogroup WII with homosexually acquired infection.Reid, K G; Young, H
doi: 10.1136/sti.60.5.302pmid: 6435813
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.
Antimicrobial susceptibility of Neisseria gonorrhoeae isolated in Durban, South Africa.Coovadia, Y M; Kharsany, A; Ramsaroop, U
doi: 10.1136/sti.60.5.306pmid: 6091842
One hundred and forty clinical isolates of Neisseria gonorrhoeae were screened for production of penicillinase by the intralactam strip method and chromogenic cephalosporin test. Minimum inhibitory concentrations (MICs) of penicillin, ampicillin, tetracycline, cefoxitin, cefuroxime, cefotaxime, sulphamethoxazole-trimethoprim (ratio 19/1), and spectinomycin, were measured for 100 strains by the agar dilution method. Seven (5%) of the 140 isolates were identified as penicillinase producing N gonorrhoeae (PPNG). The MICs of penicillin for the seven PPNG strains ranged from 0 X 25 mg/1 to 2 mg/1. Of the 93 non-PPNG strains, 80 (86%) were fully susceptible to penicillin with MICs ranging from 0 X 0037 mg/1 to 0 X 06 mg/1 and 13 (14%) were of intermediate penicillin resistance with MICs greater than or equal to 0 X 125 mg/1. Of the 100 isolates tested, 86% were fully susceptible to tetracycline with MICs of less than 1 mg/1. No spectinomycin resistant strains were encountered in this study. All gonococcal strains were susceptible to the cephalosporins tested as well as to sulphamethoxazole-trimethoprim.
Effect of epidemiological treatment of contacts in preventing recurrences of non-gonococcal urethritis.Fitzgerald, M R
doi: 10.1136/sti.60.5.312pmid: 6487987
Clinical investigations of the usefulness of routine epidemiological treatment of sexual contacts of men with non-gonococcal urethritis (NGU) have produced conflicting results that could have been due to the selection of patients. In this study, which was undertaken in a provincial city, 100 men with untreated sexual partners and 100 demographically similar men with treated sexual partners were reviewed for recurrences of NGU over 12 months. Prolonged courses of tetracyclines were found to be beneficial particularly when the sexual partner gave positive results to tests for chlamydiae. There was, however, no clinical evidence that the men benefited from routine epidemiological treatment of their sexual partners.
Activity of ciprofloxacin against genital tract pathogens.Hart, C A; How, S J; Hobson, D
doi: 10.1136/sti.60.5.316pmid: 6435814
The in vitro activity of the quinolone carboxylic acid, ciprofloxacin, against a variety of genital tract pathogens was examined. Each of 35 isolates of Neisseria gonorrhoeae, including some beta-lactamase producing strains and strains resistant to tetracycline, was inhibited at a concentration of 0.01 mg/l. Most (13 of 20) strains of Gardnerella vaginalis were inhibited at 1 mg/l but three isolates had minimum inhibitory concentrations (MICs) of 8 mg/l or more. Each of seven strains of Chlamydia trachomatis was completely inhibited at a concentration of 2 mg/l. Prolonged (72 hours) exposure of the chlamydiae to ciprofloxacin was required for inhibition at this concentration.