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Detection of Neisseria gonorrhoeae-Reply

Efstratios Demetriou, MD; Ray Sackett, MT(ASCP); David F. Welch, PhD; David W. Kaplan, MD, MPH
JAMA. 1985;253(12):1724. doi:10.1001/jama.1985.03350360049016.
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In Reply.—  We appreciate Dr White's comments regarding our recently published article. We agree that the enzyme immunoassay (EIA) is useful for detecting N gonorrhoeae antigen only in cervical and urethral specimens. (Our own unpublished data with rectal specimens showed that EIA lacked adequate specificity when compared with culture.) Alternately, culture is useful for detecting only those strains of N gonorrhoeae that are culturable under given laboratory conditions. One must analyze the situation relating to specimen handling and transport and the prevalence of vancomycin-sensitive strains before judging the relative merits of culture v EIA for diagnosis of gonorrhea in their particular setting.In our discussion we made the point that EIA offers no clear advantage when compared with a Gram's stain of urethral material from males. We caution that Gram's stain of endocervical secretions from females lacks sufficient sensitivity1 and cannot be used in place of culture or EIA. We


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