Gram-negative cocci

mucous membranes of the genitalia, anorectal area, oropharynx, or conjunctiva.

Where can Neisseria gonorrhoeae be found during infection?

Neisseria gonorrhoeae

What is the leading cause of sexually transmitted diseases?

person-to-person spread via sexual contact (rectal intercourse, orogenital sex) and from an infected mother to a newborn during birth.

How is Neisseria gonorrhoeae transmitted?

Asymptomatic carriers

What is a significant reservoir for Neisseria gonorrhoeae transmission?

• Pili

• Protein II (Opa)

• RMP

• Porin (PorB)

• Capsule

• Lipooligosaccharide (Endotoxin)

• outer membrane proteins I-III.

What are the virulence factors of Neisseria gonorrhoeae?

• Mediate genetic exchange

• attachment to mucosal cells

• invasion of host cells

• inhibition of phagocytosis.

What is the function of pili in Neisseria gonorrhoeae?

Facilitates adherence to phagocytic and epithelial cells

What does Protein II (Opa) do in Neisseria gonorrhoeae?

Blocks the bactericidal effect of host IgG.

What does RMP do in Neisseria gonorrhoeae?

• Acute purulent urethritis

• prostatitis

• epididymitis

What diseases can Neisseria gonorrhoeae cause in males?

• Acute purulent urethritis

• acute cervicitis

• Pelvic Inflammatory Disease (PID).

What diseases can Neisseria gonorrhoeae cause in females?

Infection of the uterus (endometritis), fallopian tubes (salpingitis), and/or ovaries (oophoritis).

What is Pelvic Inflammatory Disease (PID)?

Fever, lower abdominal pain, abnormal menstrual bleeding, cervical motion tenderness.

What are the symptoms of PID?

• Sterility

• ectopic pregnancy

• abscesses

• peritonitis

• perihepatitis (Fitz-Hugh-Curtis syndrome).

What are the complications of PID?

Ophthalmia neonatorum

Neisseria gonorrhoeae infection of the conjunctiva in newborns, leading to blindness.

• Pharyngitis

• anorectal infections

• conjunctivitis.

What localized infections can Neisseria gonorrhoeae cause?

Using transport medium with charcoal (Ames medium) in an environment with increased CO2.

How should Neisseria gonorrhoeae specimens be transported?

Gram-negative diplococci

What is the Gram stain appearance of Neisseria gonorrhoeae?

• Thayer-Martin medium

• Modified Thayer-Martin (MTM)

• Martin Lewis (ML)

• GC-LECT agar

• New York City (NYC) agar.

What selective media is used for Neisseria gonorrhoeae culture?

Thayer-Martin medium

Chocolate agar with VCN

gram-positive bacteria

Vancomycin in Thayer-Martin medium inhibits?

gram-negative bacilli

Colistin in Thayer-Martin medium inhibits?

yeast

Nystatin in Thayer-Martin medium inhibits?

Modified Thayer-Martin (MTM)

Same with Thayer-Martin + Trimethoprim

swarming Proteus spp.

Modified Thayer-Martin (MTM) inhibits?

Martin Lewis (ML)

Same with MTM except that nystatin is replaced with anisomycin, and the concentration of vancomycin is increased

GC-LECT agar

Contains antimicrobials to inhibit bacteria found in oropharyngeal specimens (vancomycin, lincomycin, colistin, amphotericin B and trimethoprim)

New York City (NYC)

Contain lysed horse blood, horse plasma, yeast dialysate, and the same antibiotics as MTM

• Facultative anaerobe

• oxidase positive

• ferments glucose only

• DNAse negative

What are the biochemical characteristics of Neisseria gonorrhoeae?

Extended-spectrum cephalosporins

What is the treatment for Neisseria gonorrhoeae?

By applying erythromycin ointment to the eyes of newborns.

How can gonococcal ophthalmia neonatorum be prevented?

The oropharyngeal and nasopharyngeal mucous membranes.

Where does Neisseria meningitidis commonly colonize?

contaminated respiratory droplets in close-contact settings.

How is Neisseria meningitidis transmitted?

Neisseria meningitidis

What is the leading cause of fatal bacterial meningitis?

• Pili

• Capsule (9 serogroups: A, B, C, D, X, Y, Z, W135, 29E)

• Endotoxin (LPS)

• Opa

• PorA

• PorB

• IgA protease.

What are the virulence factors of Neisseria meningitidis?

• Meningococcemia

• fulminant meningococcemia (Waterhouse-Friderichsen syndrome)

• meningitis

What diseases can Neisseria meningitidis cause?

• Spiking fevers

• chills

• arthralgia

• muscle pain

• petechial rash

What are the symptoms of meningococcemia?

Waterhouse-Friderichsen syndrome

Fulminant meningococcemia with septic shock, adrenal gland hemorrhage, DIC, and coma.

• Penicillin G

• extended-spectrum cephalosporins

• chloramphenicol

• rifampin

• minocycline

What is the treatment for Neisseria meningitidis?

Polysaccharide vaccine against serogroups A, C, Y, and W135.

How is Neisseria meningitidis prevented?

• Ferments glucose and maltose

• oxidase positive

• DNAse negative

What is a distinguishing biochemical test for Neisseria meningitidis?

Normal flora of the upper respiratory tract, occasionally in the female genital tract.

What is the habitat of Moraxella catarrhalis?

Endogenous spread or person-to-person via contaminated respiratory droplets.

How is Moraxella catarrhalis transmitted?

• Otitis media

• sinusitis

• pneumonia

• lower respiratory tract infections

• rarely bacteremia or meningitis.

What diseases does Moraxella catarrhalis cause?

Large, nonpigmented or gray, opaque, smooth, "hockey puck" consistency.

What is the colonial appearance of Moraxella catarrhalis?

• Oxidase positive

• does not utilize carbohydrates

• reduces nitrate to nitrite

• produces DNAse

What are the biochemical characteristics of Moraxella catarrhalis?

• Cephalosporins

• trimethoprim-sulfamethoxazole

• β-lactamase inhibitor combinations

How is Moraxella catarrhalis treated?

β-lactamase production

What is the main antibiotic resistance mechanism of Moraxella catarrhalis?

2–7 days

What is the incubation period of Neisseria gonorrhoeae?

N. animaloris

Some strains exhibit yellow to tan pigment; odor resembles popcorn

N. cinerea

Small, grayish white; Translucent; Slightly granular

N. flavescens

Medium, yellow, opaque, smooth

N. lactamica

Small, nonpigmented or yellowish, smooth, transparent

N. mucosa

Large, grayish, white to light yellow, translucent; mucoid because of capsule

N. polysaccharea

Small, grayish white to light yellow, translucent, raised

N. sicca

Large, nonpigmented, wrinkled, coarse and dry, adherent

N. subflava

Medium, greenish yellow to yellow, smooth, entire edge

35° to 37°C for 72 hours in a CO2-enriched (3 to 7%), humid atmosphere

Incubation conditions and duration for N. gonorrheae

candle jar, CO2 generating pouch and CO2 incubator

Incubation of N. gonorrheae is achieved using a?

agar dilution method or a disk diffusion

for antimicrobial susceptibility testing, according to CLSI what method do they recommend for N. gonorrheae?

fatal bacterial meningitis

Neisseria meningitidis is the leading cause of?

Endotoxin (LPS)

Causes blood vessel destruction (hemorrhage) and sepsis; seen on the skin as tiny, round, red dots of hemorrhage called petechiae; can damage the adrenal glands

IgA protease

Degrades membrane-associated IgA, increasing the host’s susceptibility to invasion

• stiff neck;

• positive Kernig’s and Brudzinski’s signs

Meningitis caused by Neisseria meningitidis in slightly older infants

bulging open anterior fontanelle

Meningitis caused by Neisseria meningitidis in neonates

• 5% Sheep blood

• Chocolate agar

• selective media similar to that of N. gonorrhea

Culture media used for Neisseria meningitidis

• Medium, Smooth, Round, Moist, gray to white

• Encapsulated strains and mucoid

• May be greenish cast in agar underneath colonies

Colonial appearance of N. meningitidis

Penicillin G

Drug of choice for N. meningitidis

microdilution or agar dilution

for AST, what method is recommended for N. meningitidis?

chromogenic cephalosporin test, the cefinase nitrocefin disk test

If AST not available for N. meningitidis, β-lactamase testing can be performed by using the?

saprophytic Neisseria

Other Neisseria spp. are often referred to as the?

• Neisseria gonorrhoeae

• Neisseria meningitidis

• Neisseria lactamica

• Neisseria flavescens

What grows in Thayer Martin medium?

• Neisseria sicca

• Neisseria subflava

• Neisseria mucosa

• Moraxella catarrhalis

What grows in Nutrient agar at 25C?

• Neisseria gonorrhoeae

• Neisseria meningitidis

• Neisseria cinerea

• Neisseria lactamica

• Neisseria sicca

• Neisseria subflava

• Neisseria flavescens

• Neisseria mucosa

• Moraxella catarrhalis

What is oxidase positive?

Neisseria lactamica

What is B Galactosidase positive?

• Neisseria mucosa

• Moraxella catarrhalis

What is positive in reduction of Nitrate?

Moraxella catarrhalis

What is DNAse positive?

• Neisseria gonorrhoeae

• Neisseria meningitidis

• Neisseria lactamica

• Neisseria sicca

• Neisseria subflava

• Neisseria mucosa

What produces acid from glucose?

• Neisseria meningitidis

• Neisseria lactamica

• Neisseria sicca

• Neisseria subflava

• Neisseria mucosa

What produces acid from Maltose?

Neisseria lactamica

What produces acid from Lactose?

• Neisseria sicca

• Neisseria mucosa

What produces acid from Sucrose?

Neisseria sicca

What produces acid from Fructose?