Isolation of N. meningitidis from patients in a gonorrhea screen program: a four-year survey in New York City.

In the course of the screening program for gonorrhea in New York City, a total of 964 N. meningitidis strains were recovered from the genitourinary tract and/or anal canal over a four-year period (April 1975-April 1979), the rate of such recoveries having tripled during that time. The majority of strains were isolated from anal canal cultures of male patients most of whom were seen in a clinic treating homosexuals. N. meningitidis and N. gonorrhoeae were cultured together from 41 patients: in 24 cases from different sites and in 17 instances from the same specimen. Evidence of clinically significant N. meningitidis involvement of genitourinary sites was obtained in a number of cases of urethritis and proctitis as well as in three instances of epidemiologically linked cases. The rising frequency of N. meningitidis isolations from these sites, with its potential clinical implications, should alert microbiologists, clinicians, and epidemiologists to the need for careful distinction of meningococcal from gonorrheal infection, particularly among homosexual men.