Gonococcal serology. A comparison of three different tests.

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Abstract
Three serological tests for the detection of gonococcal antibodies were compared: an enzyme-linked immunosorbent assay (ELISA), an indirect hemagglutination reaction (IHA) and a gonococcal complement-fixation test (GCFT). The ELISA was performed with gonococcal pili of a Rotterdam strain (1443) as antigen, the IHA with pilus antigen of an American strain (2686, Buchanan) and the GCFT with whole gonococci of a single strain (46695, Oliver) as antigen. The tests were performed on sera from the same groups of Dutch patients; samples of sera were taken at the 1st examination and generally 11-22 days later. The ELISA and the IHA were more sensitive than the GCFT. The specificity of the tests was equal in low-risk groups; the GCFT was slightly more specific in high-risk groups. The ELISA and the IHA did not differ in sensitivity and specificity. The agreement between the ELISA and IHA for patients with uncomplicated gonorrhea was low (.vkappa. = 0.44), the agreement between the GCFT and the 2 pilus assays was less (.vkappa. = 0.26 and 0.20). The sensitivities were highest for sera from patients with oropharyngeal gonorrhea or with gonococcal complications; the ELISA and the IHA were more sensitive than the GCFT.