Rationalization of microscopy in the detection of Neisseria gonorrhoeae in women

Abstract

This study looks at the sensitivity of microscopy in the diagnosis of Neisseria gonorrhoeae (NG), the effect of microscopy on time to treatment of NG and the added value of microscopy in the management of gonorrhoea. Women diagnosed with NG at an inner city genitourinary (GU) medicine clinic between August 2005 and July 2006 were identified and the notes reviewed. There were 103 women who were culture positive for NG. The sensitivity of microscopy was 38%. Microscopy is a point of care test (POCT) and in this group, it facilitated the treatment of 19% (n=20) of cases of NG infection at the first visit to a GU medicine service. If a POCT is not available, this would result in delayed treatment (32% of patients waited longer than 14 days and 3% did not return for treatment). In total, 29% of women did not return for test of cure, therefore confirming that effective first-line therapy is essential in the treatment of N. gonorrhoeae.