Auxotypes, penicillin susceptibility, and serogroups of Neisseria gonorrhoeae from disseminated and uncomplicated infections.

We examined auxotypes, penicillin susceptibility, and outer membrane serogroups of 137 strains of Neisseria gonorrhoeae isolated from patients with disseminated gonococcal infection (DGI) and 137 control strains from patients with uncomplicated gonorrhea. We analyzed separately the data for strains isolated from systemic sites in patients with DGI and for strains from local sites in patients with the clinical syndrome of DGI (SDGI) who had negative systemic cultures. We found the nutritional requirement for arginine, hypoxanthine, and uracil (AHU auxotype) significantly more often among DGI strains than among SDGI strains. By using commercially available serogrouping reagents to detect outer membrane protein antigens, we found that regardless of strain auxotype, dissemination correlated best with the presence of protein IA antigens. We did not find that gonococci isolated from DGI are highly susceptible to penicillin. Susceptibility to low concentrations of penicillin correlated only with the AHU requirement, not with serogroup or isolation from a patient with DGI or SDGI.