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To the Editor.—
In their article on pharyngeal gonorrhea, Tice and Rodriguez noted a lower recovery rate of N gonorrhoeae from the pharynx in the prostitute population that they studied, compared with results from prior studies. Dr Harrison, in the accompanying editorial, addressed this question, stating that data on the type of sexual activity in which these women engaged are lacking. Another reason may be the method of culturing used. Tice and Rodriguez state that the cultures of their prostitute population were done using sterile cotton-tipped swabs; they do not state how they swabbed their active-duty population, but their incidence of pharyngeal recovery of N gonorrhoeae in this group was higher (6% v 2.2%). Cotton swabs often contain fatty acids and other inhibitory factors that can decrease the recovery rate of N gonorrhoeae. Perhaps reculturing the study population with noninhibitory swabs, eg, calcium alginate, would result in a still higher
Zajdowicz T. Pharyngeal Gonorrhea. JAMA. 1982;247(19):2663. doi:10.1001/jama.1982.03320440014021