An epidemiological evaluation of the use of microbiological tools for identifying gonorrhoea infection networks

We aimed to assess the utility of various techniques for identifying gonorr hoea infection networks. All residents of a non-metropolitan North Carolina county visiting a sexually transmitted disease (STD) clinic during a 17-mo nth period were screened for gonorrhoea. Infection networks were estimated by serovar type combined with antibiotic resistance, arbitrarily primed pol ymerase chain reaction (AP-PCR), or temporal clustering. The residential ad dresses of infected patients were geocoded and mapped. Among 2 serovar type s, the presence of distinguishing characteristics of a network, based on qu estionnaire data, was assessed with prevalence ratios and 95% confidence in tervals (CIs) relative to those not in the network. Twenty-five serovar typ es were identified among 759 gonorrhoea infections. In one serovar, the net works further delineated by temporal clusters correlated with particular AP -PCR types. In most instances, however, different ty-ping techniques painte d different network pictures. No refined serovar network stood out as havin g a particular set of characteristics that could be used to shape intervent ion. Teasing out an individual infection network with unique characteristic s will require the development and use of other microbiological tools.