Serologic Testing for Gonorrhea

A simple, adequately evaluated serologic test is not now available for use in gonorrhea screening programs. Some of the factors responsible for the relatively low sensitivity and specificity of serologic tests for gonorrhea as compared to cultural techniques are discussed. These include the time required for development of an immunologic response after infection, cross-reactivity with other antigens, and the persistence of antibody after therapy. At present, gonococcal serologic tests may be useful to the clinician in establishing the diagnosis of disseminated gonococcal infection, especially if paired sera demonstrate a change in antibody titer. Current research on the antigenic structure of the gonococcus may lead to the development of improved serologic tests for use in screening programs. However, the performance of any test may vary according to sex of the patient, presence of symptoms, history of prior gonococcal infection, and duration of the current infection. The physician must understand these factors when considering the use of any serologic test for gonorrhea.