28 Feb, 17 | by flee
Culture of the gonococcus – some historical details
The 43 year period between two BJVD articles1, 2 incubated improvements in the diagnosis of gonorrhoea by laboratory culture. The following 47 gave birth to alternative tests (NAATs), more simple to administer, but whose automation brought loss of personnel and possibly skills: perhaps in microscopy, perhaps in laboratory culture.
In 1927 Colonel Harrison wrote1: “There are differences of opinion as to the value of cultures in the diagnosis of gonorrhoea. Personally I think them indispensable in the case of women and often valuable in male urethritis” (my emphasis).
Laboratory culture of Neisseria gonorrhoeae has always lacked 100% sensitivity. Sampling from multiple sites, on multiple occasions, was necessary to diagnose, to exclude, and, importantly, to monitor any advances, or fluctuations, in the efficiency of laboratory culture. The use of repeated tests to analyse the sensitivity of culture is now impossible, with the universal adoption of epidemiological treatment (before/without diagnosis).