Penicillin sensitivity and serum resistance are independent attributes of strains of Neisseria gonorrhoeae causing disseminated gonococcal infection

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Abstract
Isolates of N. gonorrhoeae from patients with disseminated gonococcal infection (DGI) are apparently different from randomly collected isolates from patients with uncomplicated (local) disease. The comparison was based on 6 phenotypic properties: sensitivity to penicillin (PenS), erythromycin and streptomycin; resistance to the bactericidal effects of pooled human sera; requirements for arginine, hypoxanthine and uracil (AHU-); and sensitivity to toxic agar. Although the marked association among these traits made analysis difficult, several factors independently related to virulence were defined. The DGI isolates were significantly more PenS and resistant to serum, even when the other variables were held constant. An apparent correlation between AHU- auxotype and virulence was apparently due to the PenS property of most AHU- isolates. Certain mutations to antibiotic resistance and susceptibility to sera may result in loss of virulence in the gonococcus, perhaps through alteration of cell envelope structure.