Comparative evaluation of enzyme immunoassay and culture for the laboratory diagnosis of gonorrhea.

A commercially available, solid-phase enzyme immunoassay (EIA), called Gonozyme, was compared to Martin-Lewis medium in Jembec plates for the laboratory diagnosis of gonorrhea. A total of 577 clinical specimens (419 urethral and 158 endocervical) were collected from a high-risk, walk-in patient population attending a sexually transmitted disease clinic. The results showed that EIA was comparable to a conventional cultural procedure for identifying infected and noninfected males. In addition, the system may be used reliably for performing test of cure on urethral samples obtained from this male population. Gonozyme was also comparable to culture in identifying females who had gonococcal infection. However, because of the high incidence of false positive test results, most likely attributable to antigen persistence in endocervical secretions, EIA is not recommended for performing test of cure in the female. Overall, the Gonozyme system is an easily performed, rapid, and reliable system that provides for a noncultural alternative for the laboratory diagnosis of gonorrhea.