The modern diagnosis of gonorrhea

Modern identification of Neisseria gonorrhoeae may be either accomplished by direct detection of gonococcal antigen, i.e. without microbiological culturing, or, following culturing, by rapid culture confirmation. The direct detection of gonococcal antigen in an enzyme immuno-assay (Gonozyme) shows reduced specifity especially with mixed microbial flora, and decreased sensitivity with small numbers of organisms. Culture confirmation may be achieved by a rapid sugar degradation test (API----quadFERM+), by specific enzyme detection using chromogenic substrates (Gonochek II), or by demonstration of protein I specific for Neisseria gonorrhoeae by means of monoclonal antibodies (Mikrotrak, Phadebact monoclonal GC, Gonogen II). Detection of protein I is highly sensitive and specific in both the tests of immunofluorescence and coagglutination.