The value of the cervical gram stain in the diagnosis and treatment of gonorrhea in women in a venereal disease clinic.
In a venereal disease clinic population of 8,537 women, 1,179 (70%) of 1,675 cases of gonorrhea were detected at the initial visit by the use of the cervical gram stain. The results of cervical cultures indicated that specificity of the gram stain was 97%. Use of the cervical gram stain, combined with epidemiologic treatment of potentially exposed patients, permitted treatment of 1,531 (91%) of 1,675 infected women at the initial clinic visit; this proportion represented an increase of 42% over treatment based solely upon epidemiologic grounds. Of the 124 patients who were not treated at the initial visit and who required treatment at a second visit, nine (7.3%) developed pelvic inflammatory disease during the interval between visits. Although a test of only moderate sensitivity, the cervical gram stain, used as an adjunct to the culture for Neisseria gonorrhoeae, provided the advantages of diagnosis at the initial visit and informed treatment, facilitated the case-finding process, and minimized treatment defaulter rates and the potential risks of sequelae and transmission of gonorrhea before results of cultures were known.
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002584:Cervix Uteri / Q000382:microbiology*; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis* / Q000188:drug therapy; D006088:Gram-Negative Aerobic Bacteria / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D000292:Pelvic Inflammatory Disease / Q000150:complications
D000900:Anti-Bacterial Agents