Diagnosing gonorrhea. A comparison of standard and rapid techniques.

A timely and accurate technique for diagnosing gonorrhea is necessary if prompt therapy is to be instituted. We screened 567 adolescents who presented for routine gynecologic care or for specific gynecologic or urologic problems. Each patient was tested by standard culture, Gonozyme (Abbott Labs), and Gram's stain. One hundred five patients (18.5%) had an ELISA immunoassay or culture evidence of infection. Overall sensitivity was 90% for Gonozyme and 56% for Gram's stain (females 41%, males 94%). Overall specificity was 97% for Gonozyme and 99% for Gram's stain. No increase in sensitivity of either test was found in women with signs of upper genital tract involvement. The predictive value of a negative Gonozyme was 98% and 85% for a positive result compared to Gram's stain values of 99% and 95%, respectively. Overall clinical efficacy was 96% for Gonozyme and 93% for Gram's stain. Gonozyme, although a sensitive and specific test, has a limited role in the diagnosis of gonorrhea. Gram's stain, although more limited in women, may serve as a useful adjunct in diagnosing gonorrhea.