Comparison of microscopy and culture for diagnosis of gonorrhea in males

ABSTRACT

The urogenital discharge of 48 male, suffering of pain during intercourse, burning sensation on micturition, morning drop or continuous discharge, was investigated by gramstained smear and culture on Barts modified Thayer Martin medium and Bacto modified chocholate agar medium. Drug sensitivity of the gonococcal isolates were determined. Forty six cases [96%] were positive for N. gonorrhoea by microscopy and 41 [85%] were positive by culture. The Bacto modified Thayer Martin medium gave more positive results than the Barts chocholate agar medium [41 and 37 positive cultures respectively]. The microscopy proved to be more sensitive but less specific than culture. The gonococcal isolates showed the highest sensitivity for seasomycin [95%], cephlex [90%] and erythromycin [83%], least sensitivity for cotrimoxazole [24%], lincomycin [26%] and cloxacillin [29%] and an intermediate sensitivity [73% and 63%] for penicillin G and tetracycline respectively. The examination of gram-stained smear of uretheral discharge of suspected gonorrhoea is a rapid, cheap and highly sensitive method but has a low specificity when compared with culture. It seems to be useful as a screening test which if positive should be coloborated by culture. The other advantage of culture is the possibility of evaluating susceptibility to antibiotics which proved to be essential for effective treatment