Correlation of auxotype and penicillin susceptibility of Neisseria gonorrhoeae with sexual preference and clinical manifestations of gonorrhea.
Strains of Neisseria gonorrhoeae requiring arginine, hypoxanthine, and uracil (Arg-Hyx-Ura-) are highly susceptible to penicillin G, and have been associated with asymptomatic urethral infection and disseminated gonococcal infection (DGI). The authors recovered Arg-Hyx-Ura- strains from 48% of 282 heterosexual men and women, versus only 9% of 69 homosexual or bisexual men (P less than 0.0001). In a separate population of consecutive men with urethral gonococcal infections, urethral discharge was absent in 0 of 96 homosexual men, versus 18 of 261 heterosexual men (P less than 0.025). Homosexual men accounted for none of 41 cases of DGI in men in 1970--1973, compared with 35% of men with uncomplicated gonorrhea in 1978. These findings suggest that asymptomatic urethral gonococcal infection and DGI are uncommon in homosexual men, perhaps because infection with Arg-Hyx-Ura- strains is relatively uncommon. Screening cultures of urethral specimens for N. gonorrhoeae had a low yield among homosexual men in the population studied. Strains of N. gonorrhoeae recovered from homosexual men were significantly more resistant to penicillin than were isolates from heterosexual subjects; this was true even for non-Arg-Hyx-Ura-strains. This difference may help to explain the lesser efficacy of ampicillin in treatment of rectal gonococcal infection in homosexual men.
D000328:Adult; D001120:Arginine / Q000494:pharmacology; D005069:Evaluation Studies as Topic; D005260:Female; D006069:Gonorrhea / Q000382:microbiology / Q000503:physiopathology*; D006716:Homosexuality; D006801:Humans; D007042:Hypoxanthines / Q000494:pharmacology; D008297:Male; D009344:Neisseria gonorrhoeae / Q000187:drug effects* / Q000502:physiology*; D010400:Penicillin G / Q000494:pharmacology*; D010403:Penicillin Resistance; D012723:Sex; D014498:Uracil / Q000494:pharmacology; D014522:Urethral Diseases / Q000382:microbiology; D014861:Washington
D007042:Hypoxanthines; D014498:Uracil; D001120:Arginine; D010400:Penicillin G