Non-cultural detection of Neisseria gonorrhoeae in cervical and vaginal washings

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Abstract
Genetic transformation, an indirect sandwich enzyme-linked immunosorbent assay (ELISA) and the Limulus amoebocyte assay were used to indicate the presence of products of Neisseria gonorrhoeae in vaginal and uterine cervical aspirates from 37 women attending a Department of Genito-Urinary Medicine. In parallel with these tests, qualitative and quantitative assessments of the microbial content of aspirates were made. There was wide variation in the numbers of gonococci cultured. The mean viable count for cervical aspirates was 1 x 106 cfu/ml and the range was (5 x 103)—(8 x 106) cfu/ml; the mean count for vaginal aspirates was 8.4 x 104 cfu/ml and the range (1 x 102)—(1 x 106) cfu/ml. Viable counts of organisms other than gonococci in vaginal aspirates were two to tenfold greater than the corresponding counts for cervical aspirates. Of 20 patients with gonorrhoea confirmed by conventional diagnostic cultures, aspirates from 15 (75%) gave a positive transformation result, and 12 (60%) a positive ELISA result; 16 (84.2%) out of 19 of these aspirates tested by the Limulus lysate assay were positive at a dilution of 1 in 100.