Isolation of Neisseria meningitidis from anogenital specimens from homosexual men.

By use of the fluorescent antibody technique, the authors examined 663 consecutive anogenital isolates from men that satisfied the presumptive criteria for Neisseria gonorrhoeae of the Center for Disease Control (Atlanta, Ga.). Most urethral isolates (364 of 368; 98.9%) from men presumed to be heterosexual were confirmed as N. gonorrhoeae. In contrast, urethral (98 of 114; 86%) and anal (136 of 175; 78%) isolates from homosexual men contained N. gonorrhoeae significantly less often (P less than 0.001). Most the isolates with negative results in the fluorescent antibody test for N. gonorrhoeae were shown to be Neisseria meningitidis by use of sugar fermentation reactions. Homosexual men sampled at two bathhouses for gay men were more likely to have oropharyngeal Neisseria isolated from anogenital cultures than were homosexual men screened in a clinic for gay men. Reliance on presumptive criteria for the identification of N. gonorrhoeae in anogenital cultures taken from homosexual men is inappropriate.