Neisseria spp. and Moraxella spp.

These are gram - diplococci that are catalase and oxidase +

Neisseria spp. and Moraxella spp.

What is the first test for Neisseria spp. and Moraxella spp.?

oxidase test

What family is Neisseria from?

Neisseriaceae

Neisseria spp. usually has 3 aerotolerance, what are these?

1. aerobic

2. capnophilic

3. anaerobic

What is the most common aerotolerance of Neisseria spp.?

aerobic

Neisseria spp. can be grown anaerobically with the presence of what?

inorganic substance

What is the usual shape for Neisseriaceae?

diplococci or kidney-bean shaped

Where in the normal flora can we find the Neisseriaceae

1. mucous membranes of respiratory tract

2. urogenital tract

They are also gram - diplococci that are oxidase + BUT catalase -

1. kingella

2. eikenella

3. simonsiella

4. alysiella

They are oxidase and catalase + BUT are gram - bacilli

1. Neisseria elongata

2. Neisseria weaveri

3. Neisseria bacilliformis

What are the two common primary human pathogens?

1. Neisseria gonorrhoeae

2. Neisseria meningitidis

What is another term for Neisseria gonorrhoeae?

gonococci

What is another term for Neisseria meningitidis?

meningococci

• This is a primary human pathogen

• Not usually a part of the normal flora

• Always pathogenic

• Is a fastidious organism that requires iron

Neisseria gonorrhoeae

• This is a primary human pathogen

• Is a commensal inhabitant of URT carriers

• Invasive pathogen

• Part of the normal flora

• Is a fastidious organism that requires iron

Neisseria meningitidis

How many virulence factors of Neisseria spp. are there?

7

• This is a virulence factor of Neisseria spp.

• This is where Neisseria gonorrhoeae and meningitidis are getting their iron from

receptors for human transferrin

• This is a virulence factor of Neisseria spp.

• Only the Neisseria meningitidis has this

capsule

• This is a virulence factor of Neisseria spp.

• Only the Neisseria gonorrhoeae has this

• Has 5 colony types

• They provide initial attachment to the host tissues

• Inhibits phagocytosis

pili or fimbriae

In the virulence factor of N. gonorrhoeae, this has five types. Which out of those 5 types are considered virulent

type 1 and 2

In the virulence factor of N. gonorrhoeae, this has five types. Which out of those 5 types are considered avirulent

type 3, 4, 5

• This is a virulence factor of N. gonorrhoeae and N. meningitidis

• Has three antigenic variations

proteins in the cell membrane

What is the first antigenic variation of proteins in the cell membrane?

protein I (por)

What is the second antigenic variation of proteins in the cell membrane?

protein II (opa)

What is the third antigenic variation of proteins in the cell membrane?

protein III (Rmp)

• This is a virulence factor of N. gonorrhoeae and N. meningitidis

• One of the three antigenic variations

• Located in the outer cell membrane

• Major protein is porin

protein I (por)

• This is a virulence factor of N. gonorrhoeae and N. meningitidis

• Adheres to phagocytic and epithelial cells

protein II (opa)

porA & porB is specific to?

N. meningitidis

porB is specific to?

N. gonorrhoeae

• This is a virulence factor of N. gonorrhoeae and N. meningitidis

• Blocks the hosts serum bactericidal action

protein III (Rmp)

What is the hosts' serum bactericidal action called?

immunoglobulin G

What are the two immunoglobulins that the virulence factors of N. gonorrhoeae and N. meningitidis can block?

1. immunoglobulin A

2. immunoglobulin G

What does "Rmp" stand for?

reduction modified protein

• This is a virulence factor of N. gonorrhoeae and N. meningitidis

• Considered as major in vivo virulence factor

• Mediates damage to body tissues and elicits an inflammatory response

core lipooligosaccharide

What is another term for core lipooligosaccharide?

endotoxin

What does LOS mean?

lipooligosaccharide

Under LOS, this happens when the outer membrane fragments released during rapid growth containing LOS

blebbing

• This is a virulence factor of N. gonorrhoeae and N. meningitidis

• Differentiation from lipopolysaccharide found in most gram - bacilli

lipid moiety

• This is a virulence factor of N. gonorrhoeae and N. meningitidis

• This cleaves the IgA on mucosal surfaces

IgA protease

What is the only host for N. gonorrhoeae

human

N. gonorrhoeae means flow of seed or ma clapoir, what does ma clapoir mean?

brothel

What are the causes when you have N. gonorrhoeae?

acute pyogenic infection of the non-ciliated columnar and transitional epithelium

When you have N. gonorrhoeae, where can you usually get samples? or where is it usually found? (multiple answers)

• urethra

• endocervix

• an*l canal

• pharynx

• conjunctiva

What is the 1st common bacterial infection for STI

Chlamydia trachomatis

What is the 2nd common bacterial infection for STI?

Neisseria gonorrhoeae

What is the primary reservoir of N. gonorrhoeae?

asymptomatic carrier

How long is the incubation period for N. gonorrhoeae?

2-7 days

In men, where do we get a specimen if they have N. gonorrhoeae?

urethra

In men, how many is the percentage of those who are asymptomatic?

10%

Why are 10% of men asymptomatic to N. gonorrhoeae? this is because of what strain?

AHU strain

What does AHU strain mean?

Arginine, Hypoxanthine, Uracil

If a man has N. gonorrhoeae, what could be the two possible complications?

1. prostatitis

2. epididymitis

If a woman has N. gonorrhoeae, where do we usually get samples?

endocervix

For women with N. gonorrhoeae, how many % are asymptomatic?

50%

If a woman has N. gonorrhoeae, what are the possible complications?

• PID

• sterility

• ectopic pregnancy

• perihepatitis

What does PID mean?

pelvic inflammatory disease

What is another term for perihepatitis?

Fitz-Hugh-Curtis Syndrome

In newborns, they can get N. gonorrhoeae via vertical transmission through the conjunctiva, what do we call this disease on them?

ophthalmia neonatorum

• This is also known as gonococcal eye infection or connatal infection

• Results in blindness

• Prevented by giving eye drops

• This is also known as gonococcal eye infection or connatal infection

• Results in blindness

• Prevented by giving eye drops

ophthalmia neonatorum

When a baby is born, to avoid getting N. gonorrhoeae in their conjunctiva, what kind of eye drops do we use?

erythromycin eyedrops

What is the specimen of choice for MSM with N. gonorrhoeae and how deep should you go?

anal canal; 4-5cm deep

What is the specimen of choice for men with N. gonorrhoeae and how deep should you go?

urethra; 2cm deep

What is the specimen of choice for women with N. gonorrhoeae?

endocervix

In the specimen collection of N. gonorrhoeae, disinfectants should be?

avoided

In the specimen collection of N. gonorrhoeae, what are the two kinds of swab that should be inhibited?

1. calcium alginate

2. cotton

In specimen collection of N. gonorrhoeae, what are the two preferred swab kinds?

1. dacron

2. rayon

After collecting specimen using swabs from a person that has N. gonorrhoeae, it should be what?

directly plated

If a specimen after specimen collection could not be plated immediately, you need a transport system that has what characteristics?

1. selective media

2. CO2 atmosphere

When a specimen could not be plated immediately and you're using a transport medium, what pattern of streaking is the most suitable?

Z pattern

This is a transport medium for N. gonorrhoeae named JEMBEC, what does it mean?

James E. Martin Biological Environmental Chamber

What are the 4 common transport mediums for N. gonorrhoeae?

1. Gono-Pak

2. Transgrow

3. JEMBEC

4. Amies medium with charcoal

This is a specimen transport system/medium for N. gonorrhoeae, it is used when direct plating is not available but after using this, it must be plated within 6 hours in CAP

amies medium with charcoal

What are the two specimens under direct gonococcal examination of N. gonorrhoeae?

1. urogenital specimen

2. pharyngeal specimen

What will you see when you perform direct microscopic examination to N. gonorrhoeae?

gram - intracellular diplococci commensal to Neiserria spp.

In the direct microscopic examination of N. gonorrhoeae, what will you conclude if it has >5 PMN/field and no bacteria present?

nongonococcal urethritis

When performing direct microscopic examination of N. gonorrhoeae and you see only pus, what can you conclude?

chlamydia trachomatis

What is another name for chlamydia trachomatis?

ureaplasma urealyticum

When performing direct microscopic examination of N. gonorrhoeae and you see bacteria with PMN, what can you infer?

gonorrhea

What is the medium of choice for N. gonorrhoeae?

CAP

N. gonorrhoeae is susceptible to what kind temperature

cold

When plating N. gonorrhoeae, the medium should be at what kind of temperature before inoculation?

room temperature

In N. gonorrhoeae, these three can grow on gonococcal media, are oxidase + BUT catalase -

1. Acitenobacter spp.

2. Capnocytophaga spp.

3. Kingella denitrificans

This is an inhibitor of N. gonorrhoeae that inhibits gram +

vancomycin and lincomycin

This is an inhibitor of N. gonorrhoeae that inhibits gram -

colistin

This is an inhibitor of N. gonorrhoeae that inhibits yeast

nystatin, anisomycin, amphotericin B

This is an inhibitor of N. gonorrhoeae that inhibits swarming proteus spp.

trimethoprim

What are the 5 common selective media used for culturing N. gonorrhoeae

1. Thayer-Martin

2. Modified Thayer-Martin

3. Martin Lewis

4. New York City

5. GC-LECT

Thayer-Martin is one of the selective media for culturing N. gonorrhoeae, what are its components?

vancomycin, colistin, nystatin

Modified Thayer-Martin is one of the selective media for culturing N. gonorrhoeae, what are its components?

vancomycin, colistin, nystatin, trimethoprim

Martin Lewis is one of the selective media for culturing N. gonorrhoeae, what are its components?

vancomycin, colistin, anisomycin, trimethoprim

New York City is one of the selective media for culturing N. gonorrhoeae, what are its components?

vancomycin, colistin, amphotericin B, trimethoprim

GC-LECT is one of the selective media for culturing N. gonorrhoeae, what are its components?

vancomycin, lincomycin, colistin, amphotericin B, trimethoprim

For the macroscopic examination of N. gonorrhoeae, what do you usually see?

small, gray to tan, translucent, raised

How many transfers do you need for N. gonorrhoeae?

5

In T1 and T2 of N. gonorrhoeae, what do you usually see?

smaller and raised colonies

In T3, 4, 5 of N. gonorrhoeae, what do you usually see?

larger and flatter colonies

In N. gonorrhoeae, this makes the isolate nonviable on prolonged incubation, being the reason why we need to transfer 5 times

autolytic enzyme

What helps differentiate true gonorrhea, still showing and maintaining being a diplococci is

10 U penicillin disk

What is the color of a modified oxidase test?

blue

What is the color of an oxidase test?

purple