Longitudinal evaluation of serovar-specific immunity to Neisseria gonorrhoeae

The serovars of Neisseria gonorrhoeae that are predominant in a community c hange over time, a phenomenon that may be due to the development of immunit y to repeat infection with the same serovar. This study evaluated the epide miologic evidence for serovar-specific immunity to N. gonorrhoeae. During a 17-month period in 1992-1994, all clients of a sexually transmitted diseas e clinic in rural North Carolina underwent genital culture for N. gonorrhoe ae. Gonococcal isolates were serotyped according to standard methods. Odds ratios for repeat infection with the same serovar versus any different sero var were calculated on the basis of the distribution of serovars in the com munity at the time of reinfection. Of 2,838 patients, 608 (21.4%; 427 males and 181 females) were found to be infected with N. gonorrhoeae at the init ial visit. Ninety patients (14.8% of the 608) had a total of 112 repeal gon ococcal infections, Repeat infection with the same serovar occurred slightl y more often than would be expected based on the serovars prevalent in the community at the time of reinfection, though the result was marginally nons ignificant (odds ratio = 1.5, 95% confidence interval 1.0-2.4; p = 0.05). C hoosing partners within a sexual network may increase the likelihood of rep eat exposure to the same serovar of N. gonorrhoeae. Gonococcal infection di d not induce evident immunity to reinfection with the same serovar.