Evaluation of the Lirnulus Amebocyte Lysate Assay for Presumptive Diagnosis of Gonorrhea in Men at a Clinic for Sexually Transmitted Diseases

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Abstract
Specimens of urethral exudate from 200 men with uncomplicated urethritis were tested for Neisseria gonorrhoeae by the Limulus amoebocyte lysate assay, culture on modified Thayer-Martin medium and gram-stained smear. As compared with cultures, the sensitivity and specificity of the Limulus assay were 94.8% and 89.3%, respectively; the sensitivity and specificity of the gram stain were 98.8% and 100.0%, respectively. The accuracy of prediction of the presence of N. gonorrhoeae was significantly better by gram-stained smear than by the Limulus assay. Unless the Limulus assay is modified, as it was in this study, it does not appear to have a role in the presumptive diagnosis of gonorrhea in men at a clinic for sexually transmitted diseases.

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