Gonococcal infection in symptomatic and asymptomatic persons seeking medical clinics in Sofia--a 3-year study 2008-2010

The aim was to determine the prevalence of gonococcal infection and to compare the results with those received by other researchers, because in Bulgaria a good medical practice for the laboratory confirmation, report and therapy is lacking. A total of 617 specimens from symptomatic and asymptomatic persons attending clinics in Sofia from January 2008 to December 2010 were tested by culture and in-house PCR. Using PCR Neisseria gonorrhoeae was identified in six urethral (6.25%) and eight (1.54%) cervical specimens. By applying culture method, N. gonorrhoeae positive result was found in 12 swabs--one cervical and one urethral swab less. The positive results correspond predominantly to persons with genital complains and suspicions for gonococcal or other sexually transmitted infection. This is the first study in Bulgaria since 1989 and determines the prevalence of N. gonorrhoeae to 2.3% over a 3-year period. Detection by culture was slightly less sensitive than by nucleic acid amplification test (NAAT). Continuous monitoring of gonorrhea by culture and NAAT is important for public health in Bulgaria.