Gram negative coci

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82 Terms

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Neisseria, kingella, eikenella, simonsiella, alysiella

Neisseriaceae includes several genera such as

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Moraxella catarrhalis

though once classified with neisseria, now belongs to the family moraxellaceae, along with other moraxella species and acinetobacter. it is clinically significant as a respiratory pathogen

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diplococci

most members of the neisseria genus are?

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Neisseria elongata, Neisseria weaver, Neisseria Bacillifornis

most members of the neisseria genus in rod shaped form are?

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oxidase positive and Catalase positive

Most species are _____ and _____ , aiding in preliminary identification.

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Neisseria Elongata and Neisseria bacilliformis

Exceptions, as they are oxidase and catalase negative

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Biochemical characteristics

Many Neisseria species are capnophilic, requiring elevated CO₂ levels for optimal growth. They thrive in humid environments, are fastidious (needing enriched media like chocolate agar), and are sensitive to environmental changes.

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Neisseria species

fastidious organisms, sensitive to drying, temperature fluctuations, and nutrient deprivation. These characteristics make transport and culture in clinical settings particularly challenging.

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Neisseria gonorrhoeae and Neisseria meningitidis

These pathogenic Neisseria species are iron-dependent. They require iron to survive and obtain it by binding to human transferrin, a blood plasma protein that transports iron.

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Neisseria gonorrhoeae

Acquire through sexual contact

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Neisseria Meningitidis

Acquire through respiratory droplets

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Transferrin binding receptors

Allow the bacteria to scavenge iron from host transferrin

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Capsule

Prevents phagocytosis and aids in immune evasion

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Pili

Enable adhesion to epithelial and mucosal surfaces

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Pili

Also contribute to twitching motility and biofirl formation

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Protein 1, Protein 2, Protein 3

Outer Membrane Proteins

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Protein 1 (Porin, porA, porB)

Forms pores to facilitate nutrient and waste exchange

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Neisseria Meningitidis, Neisseria gonorrhoeae

porA and porB are expressed in ______ while only porB is found in _______

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protein 2 (Opacity proteins, opa)

Promote tight adherence to epithelial and phagocytic cells

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Phase variable

helping evade the immune system

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Protein 3 (Rmp-Reduction modifiable)

Interferes with host antibody activity by binding to igG, which may prevent complement-mediated killing.

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Lipopolygosaccharide

An endotoxin similar to lipopolysaccharid(LPS), but lacking the O-antigen side chain

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Lipid A

component is responsible for inflammatory damage contributing to fever, sepsis, and tissue destruction

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immunoglobulin A protease

Cleaves secretory IgA on mucosal surfaces, facilitating mucosal colonization and immune evasion

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Neisseria gonorrhoeae

the causative agent og gonorrhea, a common sexually transmitted infection

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Gonos

the term gonorrhea comes from the greek word_____ meaning flor of seed

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the clap, brothel

it is also known as ______ possible derived from the french word Clapoir meaning ______

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Neisseria gonorrhoeae

Causes an acute, pyogenic (pus-forming) infection of non-ciliated columnar and transitional epithelium.

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urethra, endocervix, rectum, pharynx, conjunctiva, and fallopian tube.

Neisseria gonorrhoeae – Infection Sites

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Neisseria gonorrhoeae

Transmitted primarily through sexual contact (vaginal, anal, oral) and vaginal birth (neonatal infection).

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humans

Neisseria gonorrhoeae – Host Specificity

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T1 and T2

Piliated, virulent forms

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T3 to T5

Non-piliated, avirulent forms

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2 to 7 days post- exposure

Incubation period(neisseria gonorrhoeae)

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Neisseria gonorrhoeae Infection in Males

Acute urethritis is the most common presentation. Symptoms include purulent urethral discharge and dysuria (painful urination).

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Neisseria gonorrhoeae Infection in Males

Most cases are symptomatic, with only 3–5% asymptomatic.

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Neisseria gonorrhoeae Infection in Females

Symptoms include dysuria, cervical discharge, and lower abdominal pain.

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Neisseria gonorrhoeae Infection in Females

Up to 50% of infections may be asymptomatic, making diagnosis and control challenging.

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Neisseria gonorrhoeae Infection in Females

  • Pelvic Inflammatory Disease (PID)

  • Ectopic pregnancy

  • Infertility

  • Perihepatitis (Fitz-Hugh–Curtis syndrome) – inflammation of the liver capsule with violin string adhesions

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Anorectal and Oropharyngeal

More prevalent in men who have sex with men, but can occur in any sexually active individual

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Anorectal and Oropharyngeal

Often asymptomatic or present with non-specific symptom(rectal pain with discharge)

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Opthalmia Neonatorum

Neonatal conjunctivitis acquired during vaginal delivery through an infected birth canal

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Opthalmia Neonatorum

Can lead to blindness if not treated promptly

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1% silver nitrate(crede’s method)

prevention for neonotarum previously

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Erythromycin, neomycin, or chloramphenicol ointments

prevention for neonotarum Currently

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Urethra

Neisseria gonorrhoeae – Specimen Collection Men

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Endocervix

Neisseria gonorrhoeae – Specimen Collection Women

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Rectum, pharynx, joint fluid

Neisseria gonorrhoeae – Specimen Collection Other sites

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Cotton and calcium alginate swabs

inhibitory to Neisseria gonorrhoeae

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Dacron or Rayon swabs

Cotton and calcium alginate swabs examples?

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JEMBEC, Gono-pak, Transgrow, Amies medium with charcoal

Neisseria gonorrhoeae – Transport Media

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Neisseria gonorrhoeae

Not recommended for pharyngeal specimens due to similar-looking normal flora.

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Neisseria gonorrhoeae

Gram stain shows:

  • Gram-negative intracellular diplococci within polymorphonuclear leukocytes

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Neisseria gonorrhoeae

Does not grow on Blood sheep agar

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Chocolate or Selective agar

preffered agar for neisseria gonorrhoeae

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Modified thayer martin, martin lewis, and now york city agar

what are the selective agars for Neisseria gonorrhoeae

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35 in 3-5% CO2

Incubation for neisseria spp

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72 hours

how many hours should you monitor the incubation period for neisseria spp?

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Neisseria gonorrhoeae

Colony Morphology: Small, gray to tan, translucent, and raised colonies after 24–48 hours.

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Neisseria gonorrhoeae

Oxidase Test: Positive

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1% dimethyl-p-phenylenediamine dihydrochloride andTetramethyl-p-phenylenediamine dihydrochloride

Reagents for neisseria gonorrhoeae

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Purple color within 10 seconds

Positive result for Neisseria gonorhoeae

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Neisseria gonorrhoeae

Carbohydrate Utilization Test: Fermenter

  • Medium: Cystine Trypticase Agar (CTA)

  • pH Indicator: Phenol red

  • Positive Result: Acid production indicated by yellow color

  • Fermentation Pattern:

    • N. gonorrhoeae ferments glucose only

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Neisseria meningitidis

  • Exclusively found in humans

  • Can exist as a commensal organism in the nasopharynx, but may become invasive

  • Major cause of:

    • Endemic and epidemic meningitis

    • Meningococcemia

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Neisseria meningitidis

  • Rapid-onset, severe infection presenting as:

    • Meningitis

    • Sepsis without meningitis

  • Mortality rate: Up to 25% even with treatment

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Petechial rash

Small pinpoint hemorrhagic spots

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Purpura

Hemorrhaging into skin or mucous membranes forming bruises

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Neisseria meningitidis

Severe cases may lead to:

  • Disseminated Intravascular Coagulation (DIC)

  • Septic shock

  • Adrenal hemorrhage (Waterhouse-Friderichsen Syndrome)

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Neisseria Meningitidis

  • Drug of choice: Third-generation cephalosporins (e.g., ceftriaxone, cefotaxime)

  • Chemoprophylaxis for close contacts:

    • Rifampin or ciprofloxacin

    • Azithromycin (alternative in areas with ciprofloxacin resistance)

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Moraxella catarrhalis

  • Belongs to the family Moraxellaceae (includes Moraxella, Acinetobacter, Psychrobacter)

  • Found only in humans

  • Commensal of the upper respiratory tract

  • Opportunistic pathogen, especially in children and the elderly

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Moraxella catarrhalis

Third most common cause of:

  • Acute otitis media

  • Sinusitis in children
    Also associated with:

  • Bronchitis and pneumonia in elderly and immunocompromised patients

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Moraxella catarrhalis

  • Gram stain: Gram-negative diplococci, often intracellular

  • Colony morphology: Smooth, opaque, gray to white colonies

Hockey puck appearance:colonies remain intact when pushed across agar surface with a loop
Older colonies may develop a wagon wheel appearance

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Neisseria

  • Gram stain: Kidney/coffee bean–shaped diplococci

  • Oxygen requirement: Obligate aerobe

  • Capnophilic: Yes

  • Motility: Non-motile

  • Pyogenic: Yes

  • Catalase: Positive

  • Oxidase: Positive

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Moraxella catarrhalis

  • Gram stain: Kidney/coffee bean–shaped diplococci

  • Oxygen requirement: Obligate aerobe

  • Capnophilic: Yes

  • Motility: Non-motile

  • Pyogenic: No

  • Catalase: Positive

  • Oxidase: Positive

  • Special Tests: DNAse +, Butyrate esterase +, Non-fermenter of carbohydrates

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Acinetobacter

  • Gram stain: Short coccobacilli

  • Oxygen requirement: Obligate aerobe

  • Capnophilic: Not necessarily

  • Motility: Non-motile

  • Pyogenic: Yes

  • Catalase: Positive

  • Oxidase: Negative

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Kingella

  • Gram stain: Bacilli

  • Oxygen requirement: Obligate aerobe

  • Capnophilic: Yes

  • Motility: Non-motile

  • Pyogenic: Yes

  • Catalase: Negative

  • Oxidase: Positive

  • Tests: Nitrate reduction and indole tests used

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N. gonorrhoeae

  • Catalase: +

  • Oxidase: +

  • Superoxol: Positive

  • Carbohydrate Utilization: Glucose only

  • ONPG Test: Negative

  • Neufeld Quellung: Negative

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N. meningitidis

  • Catalase: +

  • Oxidase: +

  • Superoxol: Weakly + / mostly –

  • Carbohydrate Utilization: Glucose & maltose

  • ONPG Test: Negative

  • Neufeld Quellung: Positive

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N. lactamica

  • Catalase: +

  • Oxidase: +

  • Superoxol: Negative

  • Carbohydrate Utilization: Glucose, maltose, lactose

  • ONPG Test: Positive

  • Neufeld Quellung: Negative

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N. sicca

  • Catalase: +

  • Oxidase: +

  • Superoxol: Negative

  • Carbohydrate Utilization: Glucose, maltose, sucrose, fructose

  • ONPG Test: Positive

  • Neufeld Quellung: Negative

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N. flavescens

  • Catalase: +

  • Oxidase: +

  • Superoxol: Negative

  • Carbohydrate Utilization: Non-fermenter

  • ONPG Test: Negative

  • Neufeld Quellung: Negative

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Moraxella catarrhalis

  • Catalase: +

  • Oxidase: +

  • Superoxol: Negative

  • Carbohydrate Utilization: Non-fermenter

  • ONPG Test: Negative

  • Neufeld Quellung: Negative